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Using Qualitative Methods to Explore Lay Explanatory Models, Health-Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia

Harrison S. Banks1*, Girmay Tsegay2, Moges Wubie2, Abreham Tamiru3, Gail Davey1, Max Cooper1

1 Brighton and Sussex Medical School, Brighton, United Kingdom, 2 Debre Markos University, Debre Markos, Ethiopia, 3 IOCC Podoconiosis Project, Debre Markos, Ethiopia

Author Summary

Podoconiosis is a disease that is caused by long-term exposure to red clay soil found in tropical highland areas. This causes swelling of the legs, episodes of intense pain and severe disability. Sufferers of the condition experience stigma and exclusion from the community. Previous work has demonstrated a low rate of re-attendance to clinics and that many patients fail to adhere to their treatment regime of improving foot hygiene. The present study explored areas of health-seeking behaviour and self-care practices to discover the reason behind these failures. It was found that explanatory models of disease causation had a significant impact on decisions to seek healthcare and that participants only turned to Western medical clinics after failure of traditional treatments and with particularly severe symptoms. We identified several form of traditional treatment for the disease, and these tended to be based on cleansing, fluid extraction or faith/symbolism. The most important barrier to self-care and adhering to treatment regimens was an inability to collect adequate water. We call for greater integration with traditional healers, improved access to water through collaboration with other NGOs and the government and the use of expert patients to disseminate information and signpost patients to clinics.


Banks HS, Tsegay G, Wubie M, Tamiru A, Davey G, Cooper M (2016) Using Qualitative Methods to Explore Lay Explanatory Models, Health- Seeking Behaviours and Self-Care Practices of Podoconiosis Patients in North-West Ethiopia. PLoS Negl Trop Dis 10(8): e0004878. doi:10.1371/journal. pntd.0004878


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