Authors : Caleb Abundance; Brian Chacha; Oduka Collins; Alex Otieno; Wasike Samwel; Agrey Obare; Martha Obuya; Mitchelle Odhiambo; Evans Ngala; Martin Hillary; Clifford Mocha; Melody Chepkirui; Alice Ongera

Volume/Issue : Volume 11 - 2026, Issue 10 - October

Google Scholar : https://tinyurl.com/bdfkrp92

DOI : https://doi.org/10.38124/ijisrt/26Oct762

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Introduction: Febrile sickness constitutes a common healthcare seeking cause in malaria endemic regions. Despite the continued relevance of malaria as one of the causative agents, it is not the sole source of febrile symptoms. There are several other infections which can result in febrile symptoms. In Migori County, various community and health systems related factors may play an important role in influencing the time taken by the adults in moving from the development of symptoms to health care utilization.  Objective: To identify and summarize the factors which contribute to delayed healthcare utilization by febrile adults with particular focus on studies that could be useful in Migori County and western Kenya region.  Methods: Systematic literature review was carried out using PRISMA 2020.  Findings: The results show that delay in presentation is dependent on a variety of related factors. These can include lack of perception of illness severity during early stages of the disease, self-medication and home treatment, lack of information, distance and access, financial challenges, long waiting periods, perception of quality of service, availability of medication. Findings from Western Kenya reveal that the level of delay in visits to healthcare facilities after fever onset was high and the use of pharmacies and drug shops, as well as other forms of informal health services, was common. Findings specific to Migori include the use of home remedies, self-medication, transport issues, long waiting times, financial challenges and perceptions of illness severity.  Conclusion: There are various factors that contribute to delayed healthcare visits. These need to be incorporated in interventions in Migori County.

Keywords : Healthcare-Seeking Behavior, Delayed Healthcare Presentation, Febrile Sickness.

References :

1. Amoadu, M., Alhassan, A., & Odoom, E. (2026). Delay in malaria care-seeking for children under five in Africa: A systematic review. Malaria Journal, 25, 175. https://doi.org/10.1186/s12936-026-05868-2
2. Brian, B., Goruntla, N., Bommireddy, B. R., Mopuri, B. M., Easwaran, V., Mantargi, M. J. S., Thammisetty, D. P., Bukke, S. P. N., Yadesa, T. M., & Ayogu, E. E. (2025). Knowledge, Attitude, and Practice Towards Responsible Self-Medication Among Pharmacy Students: A Web-Based Cross-Sectional Survey in Uganda. Drug, Healthcare and Patient Safety, 17, 7–23. https://doi.org/10.2147/DHPS.S496924
3. Ceney, A., Tolond, S., Glowinski, A., Marks, B., Swift, S., & Palser, T. (2021). Accuracy of online symptom checkers and the potential impact on service utilisation. PLoS ONE, 16(7), e0254088. https://doi.org/10.1371/journal.pone.0254088
4. Chen, A. M. (2025). Re‐Evaluating Access in Healthcare: Focus on Quality of Care. Public Health Challenges, 4(4), e70100. https://doi.org/10.1002/puh2.70100
5. Circular mobilities and health care seeking practices for perceived malaria illness among Nairobi residents in Kenya. (n.d.). Social Dynamics. Retrieved October 12, 2026, from https://www.tandfonline.com/doi/abs/10.1080/02533952.2025.2532355
6. Coe, M. M., Shawon, R. A., Masheti, M., Oduol, C., Amam, P., Olieng’o, G. O., Timbwa, M., Kamui, M., Thitiri, J., Gimbel, S., Singa, B., & Means, A. R. (2025). “Though there are some challenges, we try our best to follow the guidelines”: A qualitative study exploring determinants of providing guideline-adherent care to hospitalized children in Kenya. Implementation Science Communications, 6, 110. https://doi.org/10.1186/s43058-025-00790-1
7. Debie, A., Wilson, A., Geremew, A. B., Roberts, C. T., Wassie, M. M., & Stephens, J. H. (2025). Facilitators and barriers of healthcare financing modalities for universal maternal healthcare services in East Africa: A qualitative systematic review. BMC Health Services Research, 25, 897. https://doi.org/10.1186/s12913-025-13010-2
8. Determinants of caregiver’s knowledge and practices regarding childhood fever management in a developing setting: A multi-centre cross-sectional assessment—PMC. (n.d.). Retrieved October 12, 2026, from https://pmc.ncbi.nlm.nih.gov/articles/PMC10477664/
9. El Hanafi, A., & Lmejjati, M. (2024). Barriers to Accessing Health Care for Patients Living in Poverty: A Qualitative Study of Diabetic Patients in Morocco. Middle East Journal of Rehabilitation and Health Studies, 11(4), e145225. https://doi.org/10.5812/mejrh-145225
10. Evans, M. V., Andréambeloson, T., Randriamihaja, M., Ihantamalala, F., Cordier, L., Cowley, G., Finnegan, K., Hanitriniaina, F., Miller, A. C., Ralantomalala, L. M., Randriamahasoa, A., Razafinjato, B., Razanahanitriniaina, E., Rakotonanahary, R. J. L., Andriamiandra, I. J., Bonds, M. H., & Garchitorena, A. (2022). Geographic barriers to care persist at the community healthcare level: Evidence from rural Madagascar. PLOS Global Public Health, 2(12), e0001028. https://doi.org/10.1371/journal.pgph.0001028
11. Exploring self-care choices: A qualitative study of self-medication insights among university students in Lira City, Northern Uganda—PMC. (n.d.). Retrieved October 12, 2026, from https://pmc.ncbi.nlm.nih.gov/articles/PMC11816863/
12. Galletta, M., Piazza, M. F., Meloni, S. L., Chessa, E., Piras, I., Arnetz, J. E., & D’Aloja, E. (2022). Patient Involvement in Shared Decision-Making: Do Patients Rate Physicians and Nurses Differently? International Journal of Environmental Research and Public Health, 19(21), 14229. https://doi.org/10.3390/ijerph192114229
13. Global Malaria Programme. (n.d.-a). Retrieved October 12, 2026, from https://www.who.int/teams/global-malaria-programme/case-management/treatment
14. Global Malaria Programme. (n.d.-b). Retrieved October 12, 2026, from https://www.who.int/teams/global-malaria-programme/case-management/treatment
15. Hoyt, J., Barsosio, H. C., Odero, I. A., Omondi, B., Achieng, F., Kariuki, S., Hill, J., & Webster, J. (2024). “If they take it without knowing, they will default…”: Perceptions of targeted information transfer to promote adherence to intermittent preventive treatment with dihydroartemisinin-piperaquine for the prevention of malaria in pregnancy in western Kenya. Malaria Journal, 23(1), 364. https://doi.org/10.1186/s12936-024-05131-6
16. Im, H., Li, F., Stover, S., Abel, C., Farmer, J., García, C. M., Lee, J.-A., & Wyczalkowski, C. K. (2025). Overcoming Transportation Barriers for Low-Income Individuals with Chronic Conditions: Identifying Barriers and Strategies in Access to Healthcare and Food as Medicine (FAM). Healthcare, 13(22), 2869. https://doi.org/10.3390/healthcare13222869
17. Isaacson, S., Adewumi, K., Smith, J. S., Novak, C., Oketch, S., & Huchko, M. J. (2022). A Qualitative Exploration of Barriers to Treatment Among HPV-Positive Women in a Cervical Cancer Screening Study in Western Kenya. The Oncologist, 28(1), e9–e18. https://doi.org/10.1093/oncolo/oyac208
18. Jumhour, H. (n.d.). Delayed Diagnosis in Outpatient Care: A Systematic Review of Documentation Fragmentation as a Hidden Driver of Diagnostic Error. Cureus, 18(2), e102990. https://doi.org/10.7759/cureus.102990
19. Kamau, A., Mtanje, G., Mataza, C., Mwambingu, G., Mturi, N., Mohammed, S., Ong’ayo, G., Nyutu, G., Nyaguara, A., Bejon, P., & Snow, R. W. (2020). Malaria infection, disease and mortality among children and adults on the coast of Kenya. Malaria Journal, 19(1), 210. https://doi.org/10.1186/s12936-020-03286-6
20. Kodom, R. V., & Netangaheni, R. T. (2024). Challenges in accessing patient-centered care and patient empowerment in selected Ghanaian hospitals. Health SA Gesondheid, 29, 2623. https://doi.org/10.4102/hsag.v29i0.2623
21. Kwena, Z. A., Bukusi, E. A., Mwamba, C., Sang, N. M., Okoth, F. O., Morton, J. F., Winters, A., Pollard, D., Van Heerden, A., Humphries, H., Rech, D., Bemer, M., Cooper, S., Sharma, A., & Drain, P. K. (n.d.). Household healthcare seeking patterns for emergent ill-health in Migori, Western Kenya. Frontiers in Public Health, 13, 1658217. https://doi.org/10.3389/fpubh.2025.1658217
22. Lopez, A. R., & Brown, C. A. (2023). Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020. PLOS ONE, 18(8), e0290822. https://doi.org/10.1371/journal.pone.0290822
23. Madera-Garcia, V., Coalson, J. E., Subelj, M., Bell, M. L., Hayden, M. H., Agawo, M., Munga, S., & Ernst, K. C. (2023). Self-Reported Symptoms at Last Febrile Illness as a Predictor of Treatment-Seeking in Western Kenya: A Cross-Sectional Study. The American Journal of Tropical Medicine and Hygiene, 108(1), 212–220. https://doi.org/10.4269/ajtmh.21-0447
24. Mochida, K., Nonaka, D., Wamulume, J., & Kobayashi, J. (2021). Supply-Side Barriers to the Use of Public Healthcare Facilities for Childhood Illness Care in Rural Zambia: A Cross-Sectional Study Linking Data from a Healthcare Facility Census to a Household Survey. International Journal of Environmental Research and Public Health, 18(10), 5409. https://doi.org/10.3390/ijerph18105409
25. Muwonge, H., Akugizibwe, R., Bbosa, G., Damani, A. M., Nakidde, B., Mugahi, R., & Byakika-Kibwika, P. (2025). Syndromic presentation by patients with malaria and respiratory symptoms in a malaria-endemic urban-and-peri-urban setting. BMC Research Notes, 18, 493. https://doi.org/10.1186/s13104-025-07570-z