Help-seeking behavior of mothers of children with and without measles in Shahpur block of district Kangra, Himachal Pradesh, India, 2008
Background: Measles is rightly called as captain of killer team in India. In Himachal Pradesh, despite high immunization coverage, the outbreaks are occurring. Based upon two outbreaks, we conducted a qualitative comparative study to describe the help seeking behavior of mothers of children with measles and to recommend appropriate remedial measures to prevent further outbreaks.
Method: We reviewed the factors under beneficiaries' related head. We used case-definition of measles adapted by the WHO. We conducted four Focus Group Discussions; two in Shahpur case block and two in Nagrota Bagwan comparative block with 20 mothers each in group. We enrolled all 69 mothers of children with measles and equal number of mothers in comparative similarly situated non measles block-matched for age and sex. We used a pre-designed pre-tested data collection semi structured qualitative questionnaire. We compared the responses from mothers of children exposed and unexposed to selected characteristics by Focus Group Discussions and in-depth interviews.
Result: Eighty percent of respondents from case block call measles as Dharassali; 95% mothers have bodily experience of measles. 68% respondents under Shahpur block attribute measles to the curse of goddess-Mata ka vardaan hei and in other block, 55% hold contagion as the cause for illness. For treatment (help) seeking behavior of mothers, 68% from case block go for faith healers followed by 12% by village elders/neighbors/friends/relatives while 59% from comparative block opt for doctors. Nutritional care is given in the form of restricted diet in case area. As follow up practices in the post recovery phase from illness, 58% respondents from Shahpur block invoke the blessings of the goddess Sheetla while 68% of mothers from Nagrota Bagwan block attend the medical clinic.
Conclusion/Recommendations: Faith healing is the principal help seeking behaviour in measles in poor hills. Aggressive IEC activities should be targeted for economic and social behavioral change rather than informing the community and (iii) Improving access to health care facility through provision of mobile services regularly in the remote areas.