Community self-care, prevention practices, and treatment-seeking behaviors related to malaria: a qualitative study grounded in Orem’s self-care deficit theory in Malanje, Angola

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Background Malaria remains a major public health problem in Angola, where sustained transmission persists despite expanded access to preventive and therapeutic interventions. Understanding community self-care practices is essential to improving malaria control in endemic settings. Objective To explore community perceptions, prevention practices, and treatment-seeking behaviors related to malaria among residents of the Canâmbua neighborhood, Malanje Province, Angola, using Dorothea Orem’s Self-Care Deficit Theory as an analytical framework. Methods A descriptive qualitative study was conducted with 28 adult household members selected through convenience sampling. Data were collected through in-depth semi-structured interviews and direct household observation between May and June 2024. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Results Participants demonstrated substantial biomedical knowledge regarding malaria transmission and symptoms. Preventive practices included mosquito net use, environmental sanitation, and elimination of stagnant water. However, consistent implementation of these measures was hindered by discomfort associated with net use, economic constraints, and limited access to antimalarial medicines in public health facilities. Severe malaria manifestations were occasionally interpreted through sociocultural explanatory models, contributing to delayed care-seeking. Conclusions Despite relatively high levels of malaria-related knowledge, significant self-care deficits persist due to structural and health system barriers. Theory-informed, culturally sensitive interventions that strengthen self-care agency and ensure uninterrupted access to diagnosis and treatment are critical for effective malaria control in peri-urban Angolan settings.

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