This study was conducted in order to understand how women in rural Uganda recognise malaria, their treatment-seeking behaviour when malaria is suspected and how the perception of cause may influence this behaviour. Focus group discussions and semi-structured interviews were held with women selected from the general population and from women attending health clinics for both preventive and curative services. The main finding of this study was that the word used for malaria in the local language, omusujja, covered a broad symptom complex which did not consistently correspond to the clinical case definition of malaria. Since there was no specific word for 'malaria', the study was broadened to encompass omusujja. The women reported that omusujja was an important health problem which had various causes, including poor diet, environmental conditions, and the bites of mosquitoes. The symptoms associated with omusujja were quite varied and ranged from generally 'feeling unwell' to a specific fever diagnosis (usually in children) of 'a rise in body temperature'. Women recognised that omusujja posed a particular threat to pregnant women. Preventive actions recommended by the women were in line with their perceptions of cause. The respondents usually mentioned the use of herbs as the first treatment action, followed by the purchase of tablets from shops, with the final recourse being the formal health sector if the previous actions had not effected a cure. The findings suggest that without prior research, malaria control programmes which aim at Vector control and early diagnosis and treatment of cases may prove ineffective and that Information, Communication and Education (IEC) Programmes should be designed, implemented and evaluated with the full participation of the target population at every stage.
