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Factors Influencing Guardians' Health-Seeking Decisions for Children With Burkitt Lymphoma in Northern and Central
Hellen Rahma Mbutuka1, Gugulethu Mapurisa2,3, Rizine Mzikamanda1
1Baylor College of Medicine Children's Foundation, Lilongwe, Malawi.
Insights
Guardians
Area of Science:
- Pediatric Oncology
- Global Health
- Qualitative Research
Background:
- Burkitt lymphoma (BL) survival rates for children in sub-Saharan Africa are significantly lower than in high-income countries.
- Many children in Malawi are diagnosed with BL at advanced stages, highlighting the need for early detection.
- Understanding guardian decision-making is crucial for improving pediatric cancer outcomes in resource-limited settings.
Purpose of the Study:
- To evaluate the factors influencing health-seeking decisions made by guardians of children diagnosed with Burkitt lymphoma in Malawi.
- To identify barriers and facilitators in the healthcare-seeking process for pediatric BL in Northern and Central Malawi.
Main Methods:
- Conducted in-depth interviews with 20 guardians of children (<18 years) diagnosed with BL.
- Participants were recruited via purposive sampling at the Pediatric Oncology Unit, Kamuzu Central Hospital, Malawi.
- Employed thematic content analysis to interpret qualitative data.
Main Results:
- Four key themes emerged: personal, economic, healthcare access, and social factors influenced guardian decisions.
- Financial status was a primary determinant, alongside knowledge, geographical accessibility, and symptom interpretation.
- Limited disease knowledge and general awareness of childhood cancer impacted symptom interpretation.
Conclusions:
- Financial and non-monetary barriers significantly affect health-seeking behaviors for pediatric BL in Malawi.
- Targeted initiatives to reduce the economic burden on families and community awareness campaigns are essential.
- Improving BL outcomes in Malawi requires addressing these identified barriers to timely and effective care.
Background:
The survival of children with Burkitt lymphoma (BL) in sub-Saharan Africa is disproportionately low compared to high-income countries. In Malawi, many of these children are diagnosed in advanced stages. Early and accurate diagnosis is critical to survival of children with BL. This qualitative study evaluates factors influencing health-seeking decisions of guardians of children with BL in Northern and Central Malawi.
Methods:
We conducted in-depth interviews of guardians of children (<18 years) diagnosed with BL and admitted to the Pediatric Oncology Unit at Kamuzu Central Hospital, in Lilongwe, Malawi, from February to April 2023. Participants were identified using purposive sampling. Data were analyzed using thematic content analysis.
Results:
Twenty guardians participated in the interviews. The median age of the respondents was 41 years, and 65% were females. Four main themes emerged as factors influencing health-seeking behaviors as guardians of children with BL navigated the Malawi health system. These included personal, economic, access to healthcare, and social factors. Financial status consistently emerged as a crucial determinant in the health-seeking behaviors of guardians, but thematic analysis also revealed knowledge and awareness, geographical accessibility, and symptom interpretation as key factors shaping health-seeking behaviors for guardians of children with BL. Symptom interpretation was influenced by the limited knowledge of the disease, and the lack of general awareness about childhood cancer.
Conclusion:
We identified financial and non-monetary barriers affecting health-seeking behavior among guardians of children with BL in Malawi. Targeted initiatives to alleviate the economic burden of cancer on affected families and increased awareness campaigns in the community are critical to improving BL outcomes in Malawi and other low-resourced settings.
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