Table 1 Example of Household Charts comparing themes

Hh3

Male, with SWK, 21 months old & unknown birth weight.

Approx. 3 months pre, 2 weeks admission, 4 months post.

About 8 months:

Child occasionally gets convulsions, but the cause not clearly understood.

PRE

Health centre-Health centre-Private clinic-Private clinic-(both retirees living in the village) -Public dispensary-duka

POST

Supp Public Dispensary-Private clinic-illness continues (child still not well), duka, Public dispensary, Private clinic.

Believed uvula was causing vomiting, diarrhoea and loss of appetite. Symptoms persisted after it was traditionally cut. Afterwards, diviner diagnosed possession by some evil spirits. Later, suspecting kwashiorkor, neighbours advised mother to seek care from local health facility.

Used to walk long distances to seek care, so as to reduce costs.

Missed meals or reduced intake to help cover expenses for the child during treatment seeking.

Siblings stopped schooling during the child’s admission.

Post

Could not sustain providing nourishing food as prescribed at discharge.

Received support from relatives, neighbours and friends in different forms: advice, loans or foodstuff.

Neighbours convinced the child’s father to accept biomedical care and send funds for the same.

Took long to diagnose the problem despite several visits to local health practitioners and health facilities.

Some levels of mistrust (local hws) regarding post treatment therapy.

Couldn’t access care when needed during a health worker strike.

Sometimes had to self-medicate due to regular drug stock-outs at local facility.

Had initially been referred to a different subcounty hospital. But chose to go to KCH as was unfamiliar with that facility and town in which it is located.

Ensure child fed on nutritious food: fruits, high protein content foods-eggs, milk though couldn’t sustain.

Also, asked to observe and maintain hygiene around the child- limited water sources around her area.