{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:24:04Z","timestamp":1773818644476,"version":"3.50.1"},"reference-count":90,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T00:00:00Z","timestamp":1714176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Malaria contributes to excess child mortality in The Gambia. Children under five are at risk of severe malaria and death if not treated promptly and appropriately. It is crucial that a child with fever receive appropriate care from a trained provider. The aim was to identify influences on child fever care-seeking in The Gambia to inform malaria control strategies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This cross-sectional analysis of The Gambia 2019\u201320 Demographic and Health Survey used logistic regression analysis to identify associations between source of care for a child with fever (public or private healthcare provider, other, or no treatment) and mother, child, and household characteristics.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Only 52.0%\u00a0of mothers sought care from a trained healthcare provider for a child with fever\u201445.1% from a public facility and 7.0% from the private sector. 35.2% of mothers did not seek treatment. Mothers in urban households were 2.67 times as likely (aOR, 95%\u00a0CI 1.504\u20134.736) as mothers in rural households to seek care from an informal source (e.g., pharmacy) versus not seeking treatment, and 0.29 times as likely (aOR, 95%\u00a0CI 0.165\u20130.515) as mothers in rural households to seek care from a public provider versus informal source. Mothers in wealthier households were 2.30 times as likely (aOR, 95%\u00a0CI 1.274\u20134.164) as mothers in poorer households to seek care from an informal source versus no treatment and half as likely as mothers in poorer households to seek care from a public provider versus informal source (aOR 0.53, 95%\u00a0CI 0.291\u20130.959).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Maintaining The Gambia\u2019s malaria control achievements will require the active engagement and oversight of private pharmacies along with continued integrated community case management to reach mothers who do not seek care for a child with fever, and remove challenges to seeking appropriate care from trained providers. Whether influenced by convenience, costs, perceived urgency, or other factors, given the likelihood of urban mothers and mothers in wealthier households to seek care from private pharmacies, it will be necessary to incorporate private pharmacies into malaria control strategies while building public sector capacity and workforce, and initiating more effective attitude and behavioural change among mothers and households.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-024-04951-w","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T12:01:48Z","timestamp":1714219308000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Factors influencing fever care-seeking for children under five years of age in The Gambia: a secondary analysis of 2019\u201320 DHS data"],"prefix":"10.1186","volume":"23","author":[{"given":"Laura","family":"Arntson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine R.","family":"McLaughlin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Smit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,27]]},"reference":[{"key":"4951_CR1","volume-title":"2021","author":"WHO. World malaria report","year":"2021","unstructured":"WHO. World malaria report. 2021. Geneva: World Health Organization; 2021."},{"key":"4951_CR2","unstructured":"Gambia Bureau of Statistics (GBoS), ICF. The Gambia Demographic and Health Survey 2019\u201320. Banjul, The Gambia and Rockville, Maryland, USA: GBoS and ICF; 2021. https:\/\/dhsprogram.com\/pubs\/pdf\/FR369\/FR369.pdf."},{"key":"4951_CR3","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1186\/cc2183","volume":"7","author":"A Trampuz","year":"2003","unstructured":"Trampuz A, Jereb M, Muzlovic I, Prabhu RM. Clinical review: severe malaria. Crit Care. 2003;7:315\u201323.","journal-title":"Crit Care"},{"key":"4951_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0163-7258(98)00008-4","volume":"79","author":"CR Newton","year":"1998","unstructured":"Newton CR, Krishna S. Severe falciparum malaria in children: current understanding of pathophysiology and supportive treatment. Pharmacol Ther. 1998;79:1\u201353.","journal-title":"Pharmacol Ther"},{"key":"4951_CR5","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2012.073","volume":"4","author":"R-F Schumacher","year":"2012","unstructured":"Schumacher R-F, Spinelli E. Malaria in children. Mediterr J Hematol Infect Dis. 2012;4: e2012073.","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"4951_CR6","volume-title":"Guidelines for malaria","author":"WHO","year":"2021","unstructured":"WHO. Guidelines for malaria. Geneva: World Health Organization; 2021."},{"key":"4951_CR7","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12936-015-1048-x","volume":"15","author":"K Battle","year":"2016","unstructured":"Battle K, Bisanzio D, Gibson HS, Bhatt S, Cameron E, Weiss DJ, et al. Treatment-seeking rates in malaria endemic countries. Malar J. 2016;15:20.","journal-title":"Malar J"},{"key":"4951_CR8","doi-asserted-by":"publisher","first-page":"e00072","DOI":"10.1016\/j.parepi.2018.e00072","volume":"3","author":"B Dinko","year":"2018","unstructured":"Dinko B, Amakpa E, Kweku M, Amoah P, Tampuori J, Adjuik M, et al. Plasmodium falciparum malaria cases detected for prompt treatment by rapid diagnostic tests in the Ho Teaching Hospital of the Volta Region of Ghana. Parasite Epidemiol Control. 2018;3:e00072.","journal-title":"Parasite Epidemiol Control"},{"key":"4951_CR9","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1016\/j.pt.2008.07.002","volume":"24","author":"B Greenwood","year":"2008","unstructured":"Greenwood B. Control to elimination: implications for malaria research. Trends Parasitol. 2008;24:449\u201354.","journal-title":"Trends Parasitol"},{"key":"4951_CR10","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1136\/bmj.39126.485370.BE","volume":"334","author":"AO Talisuna","year":"2007","unstructured":"Talisuna AO, Meya DN. Diagnosis and treatment of malaria. BMJ. 2007;334:375\u20136.","journal-title":"BMJ"},{"key":"4951_CR11","volume-title":"WHO guidelines for malaria, 16 October 2023","author":"WHO","year":"2023","unstructured":"WHO. WHO guidelines for malaria, 16 October 2023. Geneva: World Health Organization; 2023."},{"key":"4951_CR12","volume-title":"Progress towards Malaria Elimination in The Gambia","author":"WHO Africa","year":"2017","unstructured":"WHO Africa. Progress towards Malaria Elimination in The Gambia. Brazzaville: World Health Organization African Region; 2017."},{"key":"4951_CR13","volume-title":"Global health observatory data repository\/world health statistics","author":"WHO","year":"2024","unstructured":"WHO. Global health observatory data repository\/world health statistics. Geneva: World Health Organization; 2024."},{"key":"4951_CR14","unstructured":"Global Fund. 2022. The Global Fund. Gambia"},{"key":"4951_CR15","doi-asserted-by":"publisher","first-page":"501","DOI":"10.4269\/ajtmh.19-0897","volume":"103","author":"A Hooft","year":"2020","unstructured":"Hooft A, Nabukalu D, Mwanga-Amumpaire J, Gardiner MA, Sundararajan R. Factors motivating traditional healer versus biomedical facility use for treatment of pediatric febrile Illness: results from a qualitative study in Southwestern Uganda. Am J Trop Med Hyg. 2020;103:501\u20137.","journal-title":"Am J Trop Med Hyg"},{"key":"4951_CR16","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.socscimed.2003.11.010","volume":"59","author":"HA Williams","year":"2004","unstructured":"Williams HA, Jones COH. A critical review of behavioral issues related to malaria control in sub-Saharan Africa: what contributions have social scientists made? Soc Sci Med. 2004;59:501\u201323.","journal-title":"Soc Sci Med"},{"key":"4951_CR17","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1111\/j.1365-3156.2005.01476.x","volume":"10","author":"A Worrall","year":"2005","unstructured":"Worrall A, Basu S, Hanson K. Is malaria a disease of poverty? A review of the literature. Trop Med Int Health. 2005;10:1047\u201359.","journal-title":"Trop Med Int Health"},{"key":"4951_CR18","first-page":"87","volume":"18","author":"T Assefa","year":"2008","unstructured":"Assefa T, Belachew T, Tegegn A, Deribew A. Mothers\u2019 health care seeking behavior for childhood illnesses in Derra District, Northshoa Zone, Oromia Regional State, Ethiopia. Eth J Health Sci. 2008;18:87\u201394.","journal-title":"Eth J Health Sci"},{"key":"4951_CR19","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.socscimed.2017.05.040","volume":"185","author":"T Druetz","year":"2017","unstructured":"Druetz T, Bicaba A, Some T, Kouanda S, Ly A, Haddad S. Effect of interrupting free healthcare for children: drawing lessons at the critical moment of national scale-up in Burkina Faso. Soc Sci Med. 2017;185:46\u201353.","journal-title":"Soc Sci Med"},{"key":"4951_CR20","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1046\/j.1365-3156.2002.00835.x","volume":"7","author":"F Mugisha","year":"2002","unstructured":"Mugisha F, Kouyate B, Gbangou A, Sauerborn R. Examining out-of-pocket expenditure on health care in Nouna, Burkina Faso: implications for health policy. Trop Med Int Health. 2002;7:187\u201396.","journal-title":"Trop Med Int Health"},{"key":"4951_CR21","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/1471-2458-10-7","volume":"10","author":"N Uguru","year":"2010","unstructured":"Uguru N, Onwujekwe O, Tasie N, Uzochukwum B, Ezeoke U. Do consumers\u2019 preferences for improved provision of malaria treatment services differ by their socio-economic status and geographic location? A study in southeast Nigeria. BMC Public Health. 2010;10:7.","journal-title":"BMC Public Health"},{"key":"4951_CR22","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1186\/s12936-018-2504-1","volume":"17","author":"E Apetoh","year":"2018","unstructured":"Apetoh E, Tilly M, Baxerres C, Le Hesran JY. Home treatment and use of informal market of pharmaceutical drugs for the management of paediatric malaria in Cotonou. Benin Malar J. 2018;17:354.","journal-title":"Benin Malar J"},{"key":"4951_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(96)00383-8","author":"WK Asenso-Okyere","year":"1997","unstructured":"Asenso-Okyere WK, Dzator JA. Household cost of seeking malaria care a retrospective study of two districts in Ghana. Soc Sci Med. 1997. https:\/\/doi.org\/10.1016\/S0277-9536(96)00383-8.","journal-title":"Soc Sci Med"},{"key":"4951_CR24","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1007\/s10900-014-9872-4","volume":"39","author":"UM Chukwuocha","year":"2014","unstructured":"Chukwuocha UM, Okpanma AC, Nwakwuo GC, Dozie INS. Determinants of delay in seeking malaria treatment for children under-five years in parts of South Eastern Nigeria. J Commun Health. 2014;39:1171\u20138.","journal-title":"J Commun Health"},{"key":"4951_CR25","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s12889-015-1696-3","volume":"15","author":"AP Fenny","year":"2015","unstructured":"Fenny AP, Asante FA, Enemark U, Hansen KS. Malaria care seeking behavior of individuals in Ghana under the NHIS: are we back to the use of informal care? BMC Public Health. 2015;15:370.","journal-title":"BMC Public Health"},{"key":"4951_CR26","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.socscimed.2008.04.007","volume":"67","author":"V Wiseman","year":"2008","unstructured":"Wiseman V, Scott A, Conteh L, McElroy B, Stevens W. Determinants of provider choice for malaria treatment: experiences from The Gambia. Soc Sci Med. 2008;67:487\u201396.","journal-title":"Soc Sci Med"},{"key":"4951_CR27","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1186\/s12889-019-7150-1","volume":"19","author":"M Tanou","year":"2019","unstructured":"Tanou M, Kamiya Y. Assessing the impact of geographical access to health facilities on maternal healthcare utilization: evidence from the Burkina Faso demographic and health survey 2010. BMC Public Health. 2019;19:838.","journal-title":"BMC Public Health"},{"key":"4951_CR28","doi-asserted-by":"publisher","first-page":"994","DOI":"10.3389\/fpsyg.2018.00994","volume":"9","author":"IO Asaolu","year":"2018","unstructured":"Asaolu IO, Alaof\u00e8 H, Gunn JKL, Adu AK, Monroy AJ, Ehiri JE, et al. Measuring women\u2019s empowerment in sub-Saharan Africa: exploratory and confirmatory factor analyses of the demographic and health surveys. Front Psychol. 2018;9:994.","journal-title":"Front Psychol"},{"key":"4951_CR29","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1186\/s12889-023-15434-z","volume":"23","author":"B Zegeye","year":"2023","unstructured":"Zegeye B, Idriss-Wheeler D, Ahinkorah BO, Ameyaw EK, Seidu A-A, Adjei NK, Yaya S. Association between women\u2019s household decision-making autonomy and health insurance enrollment in sub-Saharan Africa. BMC Public Health. 2023;23:610.","journal-title":"BMC Public Health"},{"key":"4951_CR30","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1186\/1475-2875-7-224","volume":"7","author":"C Ess\u00e9","year":"2008","unstructured":"Ess\u00e9 C, Utzinger J, Tschannen AB, Raso G, Pfeiffer C, Granado S, et al. Social and cultural aspects of \u201cmalaria\u201d and its control in central C\u00f4te d\u2019Ivoire. Malar J. 2008;7:224.","journal-title":"Malar J"},{"key":"4951_CR31","volume-title":"The stanford encyclopedia of philosophy (Winter 2020 Edition)","author":"K Steele","year":"2020","unstructured":"Steele K, Stef\u00e1nsson HO. Decision theory. In: Zalta EN, editor. The stanford encyclopedia of philosophy (Winter 2020 Edition). Stanford: Department of Philosophy, Stanford University; 2020."},{"key":"4951_CR32","volume-title":"Anthropology: Theoretical practice in culture and society","author":"M Herzfeld","year":"2001","unstructured":"Herzfeld M. Anthropology: Theoretical practice in culture and society. Oxford: Blackwell Publishers Inc; 2001."},{"key":"4951_CR33","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s40980-021-00099-2","volume":"10","author":"J Banks","year":"2022","unstructured":"Banks J, Sweeney S, Meiring W. The geography of women\u2019s empowerment in West Africa. Spat Demogr. 2022;10:387\u2013412.","journal-title":"Spat Demogr"},{"key":"4951_CR34","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.socscimed.2013.02.031","volume":"86","author":"CJ Colvin","year":"2013","unstructured":"Colvin CJ, Smith HJ, Swartz A, Ahs JW, de Heer J, Opiyo N, et al. Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Soc Sci Med. 2013;86:66\u201378.","journal-title":"Soc Sci Med"},{"issue":"3","key":"4951_CR35","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1016\/j.arcmed.2005.07.007","volume":"37","author":"BJ Okoko","year":"2006","unstructured":"Okoko BJ, Yamuah LK. Household decision-making process and childhood cerebral malaria in The Gambia. Arc Med Res. 2006;37(3):399\u2013402.","journal-title":"Arc Med Res"},{"key":"4951_CR36","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1111\/j.1365-3156.2009.02237.x","volume":"14","author":"E Rutebemberwa","year":"2009","unstructured":"Rutebemberwa E, Kallander K, Tomson G, Peterson S, Pariyo G. Determinants of delay in care-seeking for febrile children in eastern Uganda. Trop Med Int Health. 2009;14:472\u20139.","journal-title":"Trop Med Int Health"},{"key":"4951_CR37","volume-title":"Gambia demographic and health survey 2019\u201320","author":"GBoS.","year":"2021","unstructured":"GBoS. Gambia demographic and health survey 2019\u201320. Maryland: Rockville; 2021."},{"key":"4951_CR38","volume-title":"Guide to DHS statistics, DHS-7 (version 2)","author":"TN Croft","year":"2018","unstructured":"Croft TN, Marshall MJ, Allen CK, Arnold F, Assaf S, Balian S. Guide to DHS statistics, DHS-7 (version 2). Maryland: Rockville; 2018."},{"key":"4951_CR39","unstructured":"Jaiteh MS, Sarr B. 2011. Climate Change and Development in the Gambia; Challenges to Ecosystem Goods and Services."},{"key":"4951_CR40","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/0035-9203(87)90170-2","volume":"81","author":"BM Greenwood","year":"1987","unstructured":"Greenwood BM, Bradley AK, Greenwood AM, Byass P, Jammeh K, Marsh K, et al. Mortality and morbidity from malaria among children in a rural area of The Gambia, West Africa. Trans R Soc Trop Med Hyg. 1987;81:478\u201386.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"4951_CR41","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1186\/s12936-015-0829-6","volume":"14","author":"J Mwesigwa","year":"2015","unstructured":"Mwesigwa J, Okebe J, Affara M, Di Tanna GL, Nwakanma D, Janha O, et al. On-going malaria transmission in The Gambia despite high coverage of control interventions: a nationwide cross-sectional survey. Malar J. 2015;14:314.","journal-title":"Malar J"},{"key":"4951_CR42","unstructured":"Gambia Ministry of Health, The Republic of The. Annual Service Statistics Report 2021. Health Management Information System Unit, Directorate of Planning and Information. https:\/\/www.afro.who.int\/sites\/default\/files\/2022-07\/Final%20Service%20Statistic%20Report%2C%202021.pdf."},{"key":"4951_CR43","volume-title":"Assessment of the health system in The Gambia: overview, medical products, health financing, and governance components","author":"J Sine","year":"2019","unstructured":"Sine J, Saint-Firmin PP, Williamson T. Assessment of the health system in The Gambia: overview, medical products, health financing, and governance components. Washington, DC: Palladium, Health Policy Plus; 2019."},{"key":"4951_CR44","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/heapol\/czac089","volume":"38","author":"H Njie","year":"2023","unstructured":"Njie H, Wangen KR, Chola L, Gopinathanm U, Mdala I, Sundby JS, Ilboudo PGC. Willingness to pay for a national health insurance scheme in The Gambia: a contingent valuation study. Health Policy Plan. 2023;38:61\u201373.","journal-title":"Health Policy Plan"},{"key":"4951_CR45","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1093\/heapol\/czi043","volume":"20","author":"D Filmer","year":"2005","unstructured":"Filmer D. Fever and its treatment among the more and less poor in sub-Saharan Africa. Health Policy Plan. 2005;20:337\u201346.","journal-title":"Health Policy Plan"},{"key":"4951_CR46","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/1475-2875-6-40","volume":"6","author":"LN Kazembe","year":"2007","unstructured":"Kazembe LN, Appleton CC, Kleinschmidt I. Choice of treatment for fever at household level in Malawi: examining spatial patterns. Malar J. 2007;6:40.","journal-title":"Malar J"},{"key":"4951_CR47","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1186\/1475-2875-10-327","volume":"10","author":"M Littrell","year":"2011","unstructured":"Littrell M, Gatakaa H, Evance I, Poyer S, Njogu J, Solomon T, et al. Monitoring fever treatment behaviour and equitable access to effective medicines in the context of initiatives to improve ACT access: baseline results and implications for programming in six African countries. Malar J. 2011;10:327.","journal-title":"Malar J"},{"key":"4951_CR48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12936-015-0844-7","volume":"14","author":"JA Shah","year":"2015","unstructured":"Shah JA, Emina JBO, Eckert E, Yazoume Y. Prompt access to effective malaria treatment among children under five in sub-Saharan Africa: a multi-country analysis of national household survey data. Malar J. 2015;14:1\u201314.","journal-title":"Malar J"},{"key":"4951_CR49","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s12936-019-2892-x","volume":"18","author":"C Taylor","year":"2019","unstructured":"Taylor C, Linn A, Wang W, Florey L, Moussa H. Examination of malaria service utilization and service provision: an analysis of DHS and SPA data from Malawi, Senegal, and Tanzania. Malar J. 2019;18:258.","journal-title":"Malar J"},{"key":"4951_CR50","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s41256-022-00270-2","volume":"7","author":"H Badolo","year":"2022","unstructured":"Badolo H, Bado AR, Hien H, M\u00e9da NA, Susuman AS. Factors associated with mothers\u2019 health care-seeking behaviours for childhood fever in Burkina Faso: findings from repeated cross-sectional household surveys. Glob Health Res Pol. 2022;7:37.","journal-title":"Glob Health Res Pol"},{"key":"4951_CR51","unstructured":"International Household Survey Network (IHSN). Population and Housing Census 2013. The Gambia, 2013. https:\/\/catalog.ihsn.org\/\/catalog\/6065\/download\/74258"},{"key":"4951_CR52","unstructured":"Rutstein SO, Staveteig S. Making the Demographic and Health Surveys Wealth Index Comparable. 2014. https:\/\/dhsprogram.com\/pubs\/pdf\/MR9\/MR9.pdf."},{"key":"4951_CR53","unstructured":"UNDP. Multidimensional Poverty Index 2022; Unpacking deprivation bundles to reduce multidimensional poverty. Briefing note for countries on the 2022 Multidimensional Poverty Index, Gambia. 2022. https:\/\/hdr.undp.org\/sites\/default\/files\/Country-Profiles\/MPI\/GMB.pdf."},{"key":"4951_CR54","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/1751-0473-3-17","volume":"3","author":"Z Bursac","year":"2008","unstructured":"Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:17.","journal-title":"Source Code Biol Med"},{"key":"4951_CR55","unstructured":"SAS Institute Inc. SAS Version 9.4. Cary, NC: SAS Institute Inc.; 2016."},{"key":"4951_CR56","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2875-9-333","author":"LA Smith","year":"2010","unstructured":"Smith LA, Bruce J, Gueye L, Helou A, Diallo R, Gueye B, et al. From fever to anti-malarial: the treatment-seeking process in rural Senegal. Malar J. 2010. https:\/\/doi.org\/10.1186\/1475-2875-9-333.","journal-title":"Malar J"},{"key":"4951_CR57","doi-asserted-by":"publisher","first-page":"e054397","DOI":"10.1136\/bmjopen-2021-054397","volume":"12","author":"ZT Tessema","year":"2022","unstructured":"Tessema ZT, Worku MG, Tesema GA, Alamneh TS, Teshale AB, Yeshaw Y, et al. Determinants of accessing healthcare in Sub-Saharan Africa: a mixed-effect analysis of recent Demographic and Health Surveys from 36 countries. BMJ Open. 2022;12:e054397.","journal-title":"BMJ Open"},{"key":"4951_CR58","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1186\/s12936-021-03898-6","volume":"20","author":"H Broekhuizen","year":"2021","unstructured":"Broekhuizen H, Fehr A, Nieto-Sanchez C, Muela J, Peeters-Grietens K, Smekens T, et al. Costs and barriers faced by households seeking malaria treatment in the Upper River Region, The Gambia. Malar J. 2021;20:368.","journal-title":"Malar J"},{"issue":"2","key":"4951_CR59","doi-asserted-by":"publisher","first-page":"446","DOI":"10.4269\/ajtmh.21-0362","volume":"106","author":"I Hossain","year":"2022","unstructured":"Hossain I, Hill P, Bottomley C, Jasseh M, Bojang K, Kaira M, et al. Healthcare seeking and access to care for pneumonia, sepsis, meningitis, and malaria in Rural Gambia. Am J Trop Med Hyg. 2022;106(2):446\u201353.","journal-title":"Am J Trop Med Hyg"},{"key":"4951_CR60","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1186\/1471-2458-12-946","volume":"12","author":"A Ellis","year":"2012","unstructured":"Ellis A, Traore S, Doumbia S, Dalglish SL, Winch PJ. Treatment actions and treatment failure: case studies in the response to severe childhood febrile illness in Mali. BMC Public Health. 2012;12:946.","journal-title":"BMC Public Health"},{"key":"4951_CR61","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1080\/13648470301265","volume":"10","author":"S Hausmann-Muela","year":"2003","unstructured":"Hausmann-Muela S, Ribera JM. Recipe knowledge: a tool for understanding some apparently irrational behaviour. Anthr Med. 2003;10:87\u2013103.","journal-title":"Anthr Med"},{"key":"4951_CR62","volume-title":"Anthropology and public health; bridging differences in culture and society","author":"VR Kamat","year":"2009","unstructured":"Kamat VR. The anthropology of childhood malaria in Tanzania. In: Hahn RA, Inhorn MC, editors. Anthropology and public health; bridging differences in culture and society. New York: Oxford University Press; 2009."},{"key":"4951_CR63","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1179\/136485905X51283","volume":"99","author":"O Onwujekwe","year":"2005","unstructured":"Onwujekwe O, Ojukwu J, Uzochukwu B, Dike N, Ikeme A, Shu E. Where do people from different socio-economic groups receive diagnosis and treatment for presumptive malaria, in south-eastern Nigeria? Ann Trop Med Parasitol. 2005;99:473\u201381.","journal-title":"Ann Trop Med Parasitol"},{"key":"4951_CR64","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/1475-2875-8-45","volume":"8","author":"E Rutebemberwa","year":"2009","unstructured":"Rutebemberwa E, Pariyo G, Peterson S, Tomson G, Kallander K. Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malar J. 2009;8:45.","journal-title":"Malar J"},{"key":"4951_CR65","volume-title":"Human resources for health","author":"Africa Health Workforce Observatory (AHWO)","year":"2009","unstructured":"Africa Health Workforce Observatory (AHWO). Human resources for health. The Gambia: Country Profile; 2009."},{"key":"4951_CR66","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s10900-015-0107-0","volume":"41","author":"AI Yansaneh","year":"2016","unstructured":"Yansaneh AI, George AS, Sharkey A, Brieger WR, Moulton LH, Yumkella F, et al. Determinants of utilization and community experiences with community health volunteers for treatment of childhood illnesses in Rural Sierra Leone. J Comm Health. 2016;41:376\u201386.","journal-title":"J Comm Health"},{"key":"4951_CR67","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1186\/1472-6963-12-113","volume":"12","author":"A Dillip","year":"2012","unstructured":"Dillip A, Alba S, Mshana C, Hetzel MW, Lengeler C, Mayumana I, et al. Acceptability \u2013 a neglected dimension of access to health care: findings from a study on childhood convulsions in rural Tanzania. BMC Health Serv Res. 2012;12:113.","journal-title":"BMC Health Serv Res"},{"key":"4951_CR68","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1046\/j.1365-3156.2002.00858.x","volume":"7","author":"N Nshakira","year":"2002","unstructured":"Nshakira N, Kristensen M, Ssali F, Reynolds-Whyte S. Appropriate treatment of fever? Use of antimalarial drugs for children\u2019s fevers in district medical units, drug shops and homes in eastern Uganda. Trop Med Int Health. 2002;7:309\u201316.","journal-title":"Trop Med Int Health"},{"key":"4951_CR69","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1093\/tropej\/47.4.230","volume":"47","author":"LA Salako","year":"2001","unstructured":"Salako LA, Brieger WR, Afolabi BM, Umeh RE, Agomo PU, Asa S, et al. Treatment of childhood fevers and other illnesses in three rural Nigerian communities. J Trop Paediatr. 2001;47:230\u20138.","journal-title":"J Trop Paediatr"},{"key":"4951_CR70","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/0035-9203(92)90290-S","volume":"86","author":"RW Snow","year":"1992","unstructured":"Snow RW, Peshu N, Forster D, Mwenesi H, Marsh K. The role of shops in the treatment and prevention of childhood malaria on the coast of Kenya. Trans R Soc Trop Med Hyg. 1992;86:237\u20139.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"4951_CR71","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/1475-2875-11-63","volume":"11","author":"U Haque","year":"2012","unstructured":"Haque U, Scott LM, Hashizume M, Fisher E, Haque R, Yamamoto T, Glass GE. Modelling malaria treatment practices in Bangladesh using spatial statistics. Malar J. 2012;11:63.","journal-title":"Malar J"},{"key":"4951_CR72","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1186\/s12936-020-03371-w","volume":"19","author":"OJ Babalola","year":"2020","unstructured":"Babalola OJ, Ajumobi O, Ajayi IO. Rural\u2013urban disparities and factors associated with delayed care-seeking and testing for malaria before medication use by mothers of under-five children, Igabi LGA, Kaduna Nigeria. Malar J. 2020;19:294.","journal-title":"Malar J"},{"key":"4951_CR73","first-page":"99","volume":"43","author":"GO Adjei","year":"2008","unstructured":"Adjei GO, Darkwah AK, Goka BQ, Bart-Plange C, Alifrangis ML, Kurtzhals JAL, Rodrigues OP. Parents\u2019 perceptions, attitudes and acceptability of treatment of childhood malaria with artemisinin combination therapies in Ghana. Ghana Med J. 2008;43:99\u2013106.","journal-title":"Ghana Med J"},{"key":"4951_CR74","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1046\/j.1365-3156.2003.01058.x","volume":"8","author":"Z Hill","year":"2003","unstructured":"Hill Z, Kendall C, Arthur P, Kirkwood B, Adjei E. Recognizing childhood illnesses and their traditional explanations: exploring options for care-seeking interventions in the context of the IMCI strategy in rural Ghana. Trop Med Int Health. 2003;8:668\u201376.","journal-title":"Trop Med Int Health"},{"key":"4951_CR75","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1186\/s12936-017-1997-3","volume":"16","author":"J Ladner","year":"2017","unstructured":"Ladner J, Davis B, Audureau E, Saba J. Treatment-seeking patterns for malaria in pharmacies in five sub-Saharan African countries. Malar J. 2017;16:353.","journal-title":"Malar J"},{"key":"4951_CR76","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1017\/S0021932002001098","volume":"34","author":"CS Molyneux","year":"2002","unstructured":"Molyneux CS, Murira G, Masha J, Snow RW. Intra-household relations and treatment decision-making for childhood illness: a Kenyan case study. J Biosoc Sci. 2002;34:109\u201331.","journal-title":"J Biosoc Sci"},{"key":"4951_CR77","doi-asserted-by":"publisher","DOI":"10.4159\/9780674028845","volume-title":"The ecology of human development: experiments by nature and design","author":"U Bronfenbrenner","year":"1979","unstructured":"Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge. MA: Harvard University Press; 1979."},{"key":"4951_CR78","doi-asserted-by":"publisher","first-page":"191","DOI":"10.2147\/IJWH.S105483","volume":"8","author":"PE Osamor","year":"2016","unstructured":"Osamor PE, Grady C. Women\u2019s autonomy in health care decision-making in developing countries: a synthesis of the literature. Int J Womens Health. 2016;8:191\u2013202.","journal-title":"Int J Womens Health"},{"key":"4951_CR79","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1007\/s10995-009-0535-5","volume":"14","author":"G Woldemicael","year":"2010","unstructured":"Woldemicael G, Tenkorang EY. Women\u2019s autonomy and maternal health-seeking behaviour in Ethiopia. Matern Child Health J. 2010;14:988\u201398.","journal-title":"Matern Child Health J"},{"key":"4951_CR80","doi-asserted-by":"publisher","first-page":"e04025","DOI":"10.7189\/jogh.12.04025","volume":"12","author":"TP Lewis","year":"2022","unstructured":"Lewis TP, Ndiaye Y, Manzi F, Kruk ME. Associations between women\u2019s empowerment, care seeking, and quality of malaria care for children: a cross-sectional analysis of demographic and health surveys in 16 sub-Saharan African countries. J Glob Health. 2022;12:e04025.","journal-title":"J Glob Health"},{"key":"4951_CR81","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1186\/s12889-023-15494-1","volume":"23","author":"J Sey-Sawo","year":"2023","unstructured":"Sey-Sawo J, Sarr F, Bah HT, Senghore T. Women\u2019s empowerment and nutritional status of children in the Gambia: further analysis of the 2020 Gambia demographic and health survey. BMC Public Health. 2023;23:583.","journal-title":"BMC Public Health"},{"key":"4951_CR82","doi-asserted-by":"publisher","first-page":"e0241488","DOI":"10.1371\/journal.pone.0241488","volume":"15","author":"E Budu","year":"2020","unstructured":"Budu E, Seidu A-A, Armah-Ansah EK, Sambah F, Baatiema L, Ahinkorah BO. Women\u2019s autonomy in healthcare decision-making and healthcare seeking behaviour for childhood illness in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey. PLoS ONE. 2020;15:e0241488.","journal-title":"PLoS ONE"},{"key":"4951_CR83","unstructured":"United Nations The Gambia. 2024. United Nations Sustainable Development Cooperation Framework. The Gambia"},{"issue":"Suppl 6","key":"4951_CR84","doi-asserted-by":"publisher","first-page":"203","DOI":"10.4269\/ajtmh.2007.77.203","volume":"77","author":"C Goodman","year":"2007","unstructured":"Goodman C, Brieger W, Unwin A, Mills A, Meek S, Greer G. Medicine sellers and malaria treatment in Sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hyg. 2007;77(Suppl 6):203\u201318.","journal-title":"Am J Trop Med Hyg"},{"key":"4951_CR85","unstructured":"Jallow A, Manneh S. 2023. Brain drain and its impact on The Gambia\u2019s health sector. The Standard. 24 Oct 2023"},{"key":"4951_CR86","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czi027","author":"PJ Winch","year":"2005","unstructured":"Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE. Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plan. 2005. https:\/\/doi.org\/10.1093\/heapol\/czi027.","journal-title":"Health Policy Plan"},{"key":"4951_CR87","unstructured":"Andrews T. 2012. What is social constructionism. Grounded Theory Review"},{"key":"4951_CR88","first-page":"e252","volume":"6","author":"V D'Acremont","year":"2009","unstructured":"D\u2019Acremont V, Lengeler C, Mshinda H, Mtasiwa D, Tanner M, Genton B. Time to move from presumptive malaria treatment to laboratory-confirmed diagnosis and treatment in African children with fever. PLoS ONE. 2009;6:e252.","journal-title":"PLoS ONE"},{"key":"4951_CR89","doi-asserted-by":"publisher","first-page":"178","DOI":"10.4269\/ajtmh.14-0646","volume":"93","author":"N Prasad","year":"2015","unstructured":"Prasad N, Sharples KJ, Murdoch DR, Crump JA. Community prevalence of fever and relationship with malaria among infants and children in low-resource areas. Am J Trop Med Hyg. 2015;93:178\u201380.","journal-title":"Am J Trop Med Hyg"},{"key":"4951_CR90","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1186\/s12936-021-03950-5","volume":"20","author":"PS Larson","year":"2021","unstructured":"Larson PS, Eisenberg JNS, Berrocal VJ, Mathanga DP, Wilson ML. An urban-to-rural continuum of malaria risk: new analytic approaches characterize patterns in Malawi. Malar J. 2021;20:418.","journal-title":"Malar J"}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-024-04951-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12936-024-04951-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-024-04951-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T12:03:12Z","timestamp":1714219392000},"score":1,"resource":{"primary":{"URL":"https:\/\/malariajournal.biomedcentral.com\/articles\/10.1186\/s12936-024-04951-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,27]]},"references-count":90,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4951"],"URL":"https:\/\/doi.org\/10.1186\/s12936-024-04951-w","relation":{},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,27]]},"assertion":[{"value":"9 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A request and formal approval to access The Gambia 2019\u201320 DHS secondary data were received from ICF. The Oregon State University Institutional Review Board (submission HE-2023\u2013317) determined that this secondary data analysis of The Gambia 2019\u201320 DHS did not meet the definition of human subjects research under the regulations set forth by the Department of Health and Human Services 45 CFR 46, thus no formal ethical approval was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors have provided their consent for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing affiliations, financial, or non-financial interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"124"}}