Dying along the ladder of stratification: A view of rural-urban dichotomy in malaria treatment among pregnant women in Ondo State.

Abstract

Studies on malaria related maternal mortality in Nigeria have focused largely on preventive behaviours and healthcare providers' knowledge of treatment regimen. However, negligible attention has been paid to rural - urban differentials and treatment patterns adopted by care seekers in relevant contexts. This study, therefore, investigated the factors that influenced pregnant women's disposition to malaria treatment in rural and urban areas of Ondo state. The Health Belief Model, Theory of Planned Behaviour and Health Utilization Model were used as the theoretical framework. The study employed descriptive survey research design using both quantitative and qualitative data collection techniques. Quantitative data were collected from 927 respondents selected through a multistage sampling technique in 10 Local Government Areas of the state. Qualitative data were elicited from six Key Informant Interviews (KIIs) conducted with Modern and Traditional health providers selected from the list of care providers in each LGA. The quantitative data were analysed employing descriptive statistics, chi-square, T- test and Ordinal Regression, while content analysis was used for the qualitative data Mild malaria were treated at home while severe cases were referred to formal health care, however moderate difference existed in rural (X=1.52, SD=0.49) and urban (X=1.29, SD=0.45) respondents' choice of treatment options. More urban men than their rural counterparts provided respondents first treatment for malaria. Rural respondents (20.9%) than their urban counterparts (19.7%) reported drug failure in their first treatment regimen. Malaria treatment was influenced by socioeconomic and demographic factors both at rural and urban areas of the state. Policy and national programmes aimed at reduction in maternal mortality should recognise .the cultural milieu given its linkage with the aetiology of disease. Without a deliberate intervention, malaria induced maternal morbidity and mortality will remain high not only in Ondo State but Nigerian general.