T Harpham

Publications (3)6.47 Total impact

• Source

  Available from: Sassy Molyneux

  Article: Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya.

  C S Molyneux, V Mung'Ala-Odera, T Harpham, R W Snow
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  ABSTRACT: Urbanization is an important demographic phenomenon in sub-Saharan Africa, and rural-urban migration remains a major contributor to urban growth. In a context of sustained economic recession, these demographic processes have been associated with a rise in urban poverty and ill health. Developments in health service provision need to reflect new needs arising from demographic and disease ecology change. In malaria-endemic coastal Kenya, we compared lifelong rural (n = 248) and urban resident (n = 284) Mijikenda mothers' responses to childhood fevers. Despite marked differences between the rural and urban study areas in demographic structure and physical access to biomedical services, rural and urban mothers' treatment-seeking patterns were similar: most mothers sought only biomedical treatment (88%). Shop-bought medicines were used first or only in 69% of the rural and urban fevers that were treated, and government or private clinics were contacted in 49%. A higher proportion of urban informal vendors stocked prescription-only drugs, and urban mothers more likely to contact a private than a government facility. We conclude that improving self-treatment has enormous potential to reduce morbidity and mortality in low-income urban areas, as has frequently been argued for rural areas. However, because of the underlying socio-economic, cultural and structural differences between rural and urban areas, rural approaches to tackle this may have to be modified in urban environments.
  Tropical Medicine & International Health 01/2000; 4(12):836-45. · 2.80 Impact Factor
• Article: Child malaria treatment practices among mothers in Kenya.

  H Mwenesi, T Harpham, R W Snow
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  ABSTRACT: A study of 883 mothers with children aged 0-9 years was undertaken in Kilifi district on the Kenyan coast in order to examine child malaria treatment practices. Quantitative and qualitative methods were used to investigate: whether complications of childhood malaria were recognized; decision-making dynamics in treatment-seeking; and the extent and reasons for the use of proprietary treatment. Childhood malaria was perceived as a mild, everyday illness, not preventable but treatable. The link between malaria and mosquitoes was not recognized. Mothers recognized convulsions, anaemia and splenomegaly but did not link them to malaria. Antimalarial drugs were not given or were withdrawn from children suffering from these conditions. Ill children were treated promptly by purchase of over-the-counter drugs at retail outlets. The health education implications of these findings are discussed.
  Social Science [?] Medicine 06/1995; 40(9):1271-7. · 2.70 Impact Factor
• Article: Perceptions of symptoms of severe childhood malaria among Mijikenda and Luo residents of coastal Kenya.

  H A Mwenesi, T Harpham, K Marsh, R W Snow
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  ABSTRACT: Effective community based malaria control programmes require an understanding of current perceptions of malaria as a disease and its severe manifestations. Quantitative and qualitative surveys of mothers on the Kenyan Coast suggest that fever is conceptualised in biomedical terms whereas the aetiology of severe malaria is perceived to be of more complex cultural origin. This is reflected in the treatments sought for convulsions. The results are discussed in the context of ethnographic factors. To be effective, future health information programmes must take cultural beliefs into account.
  Journal of Biosocial Science 05/1995; 27(2):235-44. · 0.98 Impact Factor