Search

A cross-sectional household survey was carried out in Kibaha district, Tanzania to obtain caretakers' knowledge on symptoms of childhood malaria in children under five years of age in relation to its management. A total of 1530 caretakers were interviewed, 620 (40.5%) reporting malaria attacks among their children in the last three months of which, 432 (70%) reported that the attacks were severe. Only 15.7% (68/432) of those reporting severe attacks could mention convulsions as symptoms of severe malaria, while fever and vomiting were mentioned as symptoms of severe malaria by 93.3% (403/432) and 52.3% (226/432) of the care-takers respectively. Higher level of education was significantly associated with knowledge of symptoms of severe malaria, also with promptness in taking management action. The fact that most of the caretakers reported fever and vomiting as symptoms of severe malaria, and hence the observed high proportion of reported severe malaria, implies that the communities under study do not perceive febrile convulsion as being a symptom of severe malaria. The implication of these findings on the control of malaria through treatment on demand are discussed.

Eighty percent of rural dispensaries are run by the government and 19% by voluntary organisations that charge for some services. After the re-legalisation of the private health sector in 1991, private dispensaries are also emerging in villages. Privatisation is among the health reform policies of the country. Moreover, cost-sharing will be introduced at public dispensaries soon. Perception of 320 patients in the Coast Region of Tanzania on services delivered by the three health sectors has been investigated. Results show that patients are generally satisfied with the services and they would go back to the same dispensaries for treatment. Polydrug prescription was common in all sectors, while lack of prescribed drugs was a main complaint among public dispensaries patients. Voluntary dispensaries patients were less satisfied with long waiting time and with staff that did not give them enough information about the treatment. Currently, health service in public dispensaries is free but cost-sharing will be introduced soon. Most of voluntary and private dispensaries patients stated that the fees for service were moderate. The paper discusses the need for monitoring the implementation of cost sharing in public dispensaries to ensure equity in access to services by rural patients.