Household satisfaction with health services and choice of response strategies to malaria occurrence: The case of mountain communities of Elgon in Uganda

Abstract

Abstract Background In rural Africa, access to health services is often limited by factors ranging from economics to culture. Additionally, climate change is noted to severely undermine the fragile health systems of such regions. Consequently, climate sensitive diseases including malaria will severely impact human livelihoods and wellbeing. Measuring satisfaction with health service delivery in such areas provides an opportunity to improve the resilience of health systems to such threats. Additionally, understanding factors associated with the choice of response strategies to malaria especially at household level provides an opportunity to design context specific interventions. . Methods In this study, we used polytomous latent class analyses to group the participants ‘responses and an additive Bayesian modelling networks to explore satisfaction with health service delivery as well as factors associated with response strategies of households to malaria. We did this with focus on the rural parts of Uganda in Mount Elgon region. A cross sectional study design was employed including use of a semi-structured questionnaire with sections including; perceptions on climate change, perceptions on malaria, coping with malaria and perceptions regarding health service delivery. In total, 200 responds were recruited into the study. Results We found that approaches to malaria control and management at household level include; use of traditional (54.5%), private (20.5%) and publicly available services (25%). Regarding satisfaction with health services, 66.6% of the respondents were satisfied with health service components of information flow, drug/vaccine access and accessibility. Type of housing, livelihood sources, previous malaria experience and health services were strongly associated with responses to malaria occurrence at household level. The rest of the factors were weakly associated with malaria responses at household level. Conclusion The indigenous interventions utilized by households to manage and control malaria were largely dependent on their satisfaction with health service delivery components. Interventions thus ought to leverage on the local existing knowledge to optimize outcomes and ensure sustainable health. Future studies should focus on larger areas of Elgon and other mountainous areas so as to allow for comparable results.