Treatment Seeking for a Chronic Disorder: How Families in Coastal Kenya Make Epilepsy Treatment Decisions

Abstract

A person-centered case-study approach was used to account for treatment choices made by families of children with epilepsy seizure disorders in Kilifi, Kenya. Observations of individual families and treatment providers suggest that the local cultural system of illness classification and the process of assessing treatment results are fundamental influences on family decisions to seek treatment for childhood seizure disorders. The findings also indicate that the dominance of these two factors shifts throughout the illness experience. Family classification of seizures and cultural perceptions of their causation are primary in initial treatment seeking, while the perception of results of the last treatment sought dominates subsequent treatment decisions. External factors, including pressure from individuals outside the family, and financial and time resources, are described as secondary constraining factors in the decision making process. A model is presented to summarize the decision making process. The model accounts for treatment seeking in families of children with seizure disorders in coastal Kenya but may also help explain how families manage other chronic conditions.