BMC Public Health Research article Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia Wakgari Deressa* and Ahmed Ali BioMed Central Open Access Address: School of Public Health, Addis Ababa University, P. O. Box 9086, Addis Ababa, Ethiopia Email: Wakgari Deressa* - deressaw@yahoo.com; Ahmed Ali - ahmedhayat82@yahoo.com * Corresponding author Published: 23 July 2009 BMC Public Health 2009, 9:259 doi:10.1186/1471-2458-9-259 This article is available from: http://www.biomedcentral.com/1471-2458/9/259 Received: 23 September 2008 Accepted: 23 July 2009 © 2009 Deressa and Ali; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Malaria remains to be the major cause of morbidity and mortality among pregnant women and children in Ethiopia. The aim of this study was to investigate the local perceptions, practices and treatment seeking behaviour for malaria among women with children under the age of five years. Methods: This community-based study was conducted in 2003 in an area of seasonal malaria transmission in Adami Tulu District, south-central Ethiopia. Total samples of 2087 rural women with children less than five years of age from 18 rural kebeles (the smallest administrative units) were interviewed about their perceptions and practices regarding malaria. In addition, focus group discussions and in-depth interviews were conducted on similar issues to complement the quantitative data. Results: Malaria, locally known as busaa, is perceived as the main health problem in the study area. Mosquitoes are perceived to be the main cause of the disease, and other misperceptions were also widespread. The use of prevention measures was very low. Most mothers were familiar with the main signs and symptoms of mild malaria, and some of them indicated high grade fever, convulsions and mental confusion as a manifestation of severe malaria. Very few households (5.6%) possessed one or two nets. More than 60% of the mothers with recent episodes of malaria received initial treatment from non-public health facilities such as community health workers (CHWs) (40%) and private care providers (21%). Less than 40% of the reported malaria cases among women were treated by public health facilities. Conclusion: Malaria was perceived as the main health problem among women and children. The use of malaria preventive measures was low. A significant proportion of the respondents received initial malaria treatments from CHWs, private care providers and public health facilities. Concerted effort is needed to scale-up the distribution of insecticide-treated nets and improve the knowledge of the community about the link between malaria and mosquitoes. Effective antimalarial drugs should also be available at the grassroots level where the problem of malaria is rampant. Background Despite the considerable increase in funds over the recent years to control malaria in Ethiopia, the disease has been the most frequently reported cause of morbidity and mor- tality [1]. Malaria transmission in the country is highly seasonal and often takes epidemic shape, with signifi- Page 1 of 12 (page number not for citation purposes)