Identifying Treatment and Healthcare Seeking Behavior as a Means of Early HIV/AIDS Intervention in Africa

Henry Fomundam, Abraham Tesfay, Andrew Maranga, Lucia Chanetsa, Vieira Muzoola, Frederick Oyaro

Howard University HIV and AIDS Pharmaceutical Care Program, Dar es Salaam, Tanzania.
Howard University HIV and AIDS Pharmaceutical Care Program, Kigali, Rwanda.
Howard University HIV and AIDS Pharmaceutical Care Program, Regional Office, Pretoria, South Africa.
oward University HIV and AIDS Pharmaceutical Care Program, East Africa-Nairobi, Kenya Office, Nairobi, Kenya.

DOI: 10.4236/wja.2012.23022                

Abstract

Background: Late diagnosis of Human Immunodeficiency Virus (HIV) infection and delayed commencement of antiretroviral therapy (ART) in sub-Saharan Africa is known to contribute to high morbidity and mortality. It is therefore, prudent to develop innovative approaches to ensure early HIV diagnosis because patients with low immunity will usually develop opportunistic infections and seek some remedial action. A treatment and health care seeking behavior survey was carried out in semi-urban communities in Malaba and Busia in Kenya and Uganda to evaluate the treatment and healthcare seeking behavior among patients visiting randomly selected drugstores. Methodology: Random sampling was applied and questionnaires were used to collect information from 165 interviewees who visited drugstores seeking health information, treatment and other health related services. Results: The results indicated that among this group of people, 67% visited drugstores before any other health facility. 72.2% sought treatment for various illnesses and services ranging from headaches, body fever, gastro-intestinal disturbances, family planning pills, sexually transmitted infections and chronic medications. Among the patients interviewed, there were a number of factors that affected treatment choice. These included the distance to the facility as well as the absence of a consultation fee or fee for service. Conclusion: With proper support, drugstores can play a major role in the implementation of health interventions that seek to promote early diagnosis and treatment as well as play a pivotal role in educating the population on disease prevention and management. In Sub-Saharan Africa, drugstores can play a major role in HIV and AIDS interventions where most patients seek medical intervention for opportunistic infection.

Keywords

Treatment and Health Seeking Behavior; Drug Stores

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	P. A. Bourne, “Impact of Poverty, Not Seeking Medical Care, Unemployment, Inflation, Self-Reported Illness, and Health Insurance on Mortality in Jamaica,” North American Journal of Medical Sciences, Vol. 1. No. 3, 2009, p. 99.
[2]	S. M. Ahmed, “Exploring Health-Seeking Behaviour of Disadvantaged Populations in Rural Bangladesh,” Karolinska University Press, Stockholm, 2005. http://www.bracresearch.org/publications/thesis_masudbhai.pdf
[3]	A. Grover, R. Kumar and S. K. Jindal, “Socio-Demographic Determinants of Treatment-Seeking Behavior among Chest Symptomatics,” Indian Journal of Community Medicine, Vol. 31, No. 3, 2006, pp. 145-149.
[4]	E. M. Malik, K. Hanafi, S. H. Ali, E. S. Ahmed and K. A. Mohamed, “Treatment-Seeking Behaviour for Malaria in Children under Five Years of Age: Implication for Home Management in Rural Areas with High Seasonal Transmission in Sudan,” Malaria Journal, Vol. 5, No. 1, 2006, p. 60. http://www.malariajournal.com/content/5/1/60
[5]	T. M. Ola, F. O. Aladekomo and B. A. Oludare, “Determinants of the Choice of Treatment Outlets for Infertility in Southwest Nigeria,” Rawal Medical Journal, Vol. 33, No. 2, 2008, pp. 193-196. http://www.scopemed.org/?jft=27&ft=27-1304694550
[6]	Z. Abdu, Z. Mohammed, I. Bashier and B. Eriksson, “The Impact of User Fee Exemption on Service Utilization and Treatment Seeking Behaviour: The Case of Malaria in Sudan,” The International Journal of Health Planning and Management, Vol. 19, No. S1, 2004, pp. S95-S106.
[7]	World Health Organization, “Countries,” 2012. http://www.who.int/countries/en/
[8]	J. Chuma and C. Molyneux, “Treatment-Seeking Behaviour, Cost Burdens and Coping Strategies among Rural and Urban Households in Coastal Kenya: An Equity Analysis,” Tropical Medicine & International Health, Vol. 12, No. 5, 2007, pp. 673-686.
[9]	S. Hausmann-Muela, J. M. Ribera and I. Nyamongo, “Health-Seeking Behaviour and the Health System Response,” DCPP Working Paper No. 14, 2012. http://www.dcp2.org/file/29/wp14.pdf
[10]	M. P. O’Donnell, “Definition of Health Promotion,” American Journal of Health Promotion, Vol. 1, No. 1, 2009, pp. 4-5.
[11]	I. P. Chudi, “Healthcare Problems in Developing Coun- tries,” Medical Practice and Reviews, Vol. 1, No. 1, 2010, pp. 9-11.
[12]	World Health Organization, “Disease Incidence, Prevalence and Disability,” 2012. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html
[13]	AVERT, “Sub-Saharan Africa HIV & AIDS Statistics,” 2012. http://www.avert.org/africa-hiv-aids-statistics.html
[14]	A. R. Maddison and W. F. Schlech, “Will Universal Access to Antiretroviral Therapy Ever Be Possible? The Health Care Worker Challenge,” Canadian Journal of Infectious Diseases & Medical Microbiology, Vol. 21, No. 1, 2010, pp. 64-69. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852293/pdf/idmm21e064.pdf
[15]	HPTN Press, “Initiation of Antiretroviral Treatment Protects Uninfected Sexual Partners from HIV Infection (HPTN Study 052),” 2012. http://www.hptn.org/web%20documents/PressReleases/HPTN052PressReleaseFINAL5_12_118am.pdf
[16]	Y. Abaynew, A. Deribew and K. Deribe, “Factors Associated with Late Presentation to HIV/AIDS Care in South Wollo Zone Ethiopia: A Case-Control Study,” AIDS Research and Therapy, Vol. 8, No. 1, 2011, p. 8. http://www.biomedcentral.com/content/pdf/1742-6405-8-8.pdf
[17]	R. King and H. Fomundam, “Remodeling Pharmaceutical Care in Sub-Saharan Africa (SSA) Amidst Human Resources Challenges and the HIV/AIDS Pandemic,” The International Journal of Health Planning and Management, Vol. 25, No. 1, 2010, pp. 30-48. doi:10.1002/hpm.982
[18]	Kenya National Bureau of Statistics (KNBS) and ICF Macro, “Kenya Demographic and Health Survey 2008- 09,” KNBS Nairobi, and ICF Macro, Maryland, 2009.
[19]	World Health Organization, “The Top 10 Causes of Death,” 2012. http://www.who.int/mediacentre/factsheets/fs310/en/index.html
[20]	J. E. Macfarlane and M. P. Alpers, “Treatment-Seeking Behaviour among the Nasioi People of Bougainville: Choosing between Traditional and Western Medicine,” Ethnicity & Health, Vol. 14, No. 2, 2009, pp. 147-168. http://www.informaworld.com/smpp/516690265-78615192/title~db=all~content=t713421971~tab=issueslist~branches=14 - v1414
[21]	L. Matowe, M. Duwiejua and P. Norris, “Is There a Solution to the Pharmacist Brain Drain from Poor to Rich Countries?” Pharmaceutical Journal, Vol. 272, No. 7283, 2004, pp. 98-99.
[22]	D. R. Katerere and L. Matowe, “Effect of Pharmacist Emigration on Pharmaceutical Services in Southern Africa,” American Journal of Health-System Pharmacy, Vol. 60, No. 11, 2003, pp. 1169-1170.
[23]	Ministry of Health, “Reversing the Trends: The Second National Health Sector Strategic Plan of Kenya,” 2012. http://www.nacc.or.ke/attachments/article/102/NHSSP%20II-2010.pdf
[24]	World Health Organization, “World Health Report 2006: Working Together for Health,” 2012. http://www.who.int/whr/2006/whr06_en.pdf
[25]	Africa Health Worker Observatory (AHWO), “Human Resources for Health Country Profile (Kenya),” 2012. http://www.hrh-observatory.afro.who.int/images/Document_Centre/kenya_country_profile.pdf
[26]	National AIDS and STI Control Programme, “AIDS in Kenya: Trends Interventions and Impact,” 7th Edition, NASCOP, Nairobi, 2005.
[27]	L. Tawfik and S. Kinoti, “The Impact of HIV/AIDS on Health Systems and the Health Workforce in Sub-Saharan Africa: SARA Project,” United States Agency for International Development, Bureau for Africa, Washington DC, 2003.
[28]	E. A. McCarthy, M. E. O’Brien and W. R. Rodriguez, “Training and HIV-Treatment Scale-Up: Establishing an Implementation Research Agenda,” PLoS Medicine, Vol. 3, No. 7, 2006, p. e304. doi:10.1371/journal.pmed.0030304
[29]	H. A. C. M. Voeten, J. M. Otido and H. B. O’Hara. “Quality of Sexually Transmitted Disease Case Management in Nairobi, Kenya: A Comparison among Different Types of Healthcare Facilities,” Sexually Transmitted Disease, Vol. 28, No. 11, 2001, pp. 633-642. doi:10.1097/00007435-200111000-00005
[30]	C. N. Morris and A. G. Ferguson, “Sexual and Treatment-Seeking Behaviour for Sexually Transmitted Infection in Long-Distance Transport Workers of East Africa,” Sexually Transmitted Infections, Vol. 83, No. 3, 2007, pp. 242-245. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2659098/?tool=pmcentrez
[31]	S. Karlsen, L. Say, J. Souza, C. J. Hogue, D. L.Calles, A. M. Gülmezoglu and R. Raine, “The Relationship between Maternal Education and Mortality among Women Giving Birth in Health Care Institutions: Analysis of the Cross Sectional WHO Global Survey on Maternal and Perinatal Health,” BMC Public Health, Vol. 11, No. 1, 2011, p. 606 doi:10.1186/1471-2458-11-606
[32]	C. McAlister and T. F. Baskett, “Female Education and Maternal Mortality: A Worldwide Survey,” Journal of Obstetrics and Gynaecology Canada, Vol. 28, No. 11, 2006, pp. 983-990. http://www.sogc.org/jogc/abstracts/full/200611_womenshealth_3.pdf
[33]	A. K. Mbonye, R. Ndyomugyenyi, P. Magnussen, S. Clark and C. Chandler, “The Feasibility of Introducing Rapid Diagnostic Tests for Malaria in Drug Shops in Uganda,” Malaria Journal, Vol. 9, No.1, 2010, p. 367. doi:10.1186/1475-2875-9-367
[34]	J. Stanback, C. Otterness, M. Bekiita, O. Nakayiza and A. K. Mbonye, “Injected with Controversy: Sales Administration Of Injectable Contraceptives in Drug Shops in Uganda,” International Perspectives on Sexual and Reproductive Health, Vol. 37, No. 1, 2011, pp. 24-29. http://www.guttmacher.org/pubs/journals/3702411.pdf
[35]	E. Patouillard, K. G. Hanson and C. A. Goodman, “Retail Sector Distribution Chains for Malaria Treatment in the Developing World: A Review of the Literature,” Malaria Journal, Vol. 9, No. 1, 2010, p. 50. doi:10.1186/1475-2875-9-50
[36]	Y. Tawfik, J. Nsungwa-Sabitii, G. Greer, J. Owor, R. Kesande and S. Prysor-Jones, “Negotiating Improved Case Management of Childhood Illness with Formal and Informal Private Practitioners in Uganda,” Tropical Medicine & International Health, Vol. 11, No. 6, 2006, pp. 967-973. doi:10.1111/j.1365-3156.2006.01622.x