Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.
BACKGROUND
In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana.


METHODS
This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria.


RESULTS
Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment.


CONCLUSIONS
The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty.
['Awuah|Raphael Baffour|RB|', 'Asante|Paapa Yaw|PY|', 'Sakyi|Lionel|L|', 'Biney|Adriana A E|AAE|', 'Kushitor|Mawuli Komla|MK|', 'Agyei|Francis|F|', 'de-Graft Aikins|Ama|A|']
D000293:Adolescent D000328:Adult D003430:Cross-Sectional Studies D005260:Female D005869:Ghana D007722:Health Knowledge, Attitudes, Practice D006801:Humans D008288:Malaria D008297:Male D008875:Middle Aged D010342:Patient Acceptance of Health Care D014505:Urban Population D035862:Vulnerable Populations D055815:Young Adult
Malaria Urban poor communities Accra Ghana Treatment seeking