Perceptions of illness and health-seeking behaviour among caregivers of under-five children in Morogoro municipality, Tanzania: a qualitative study

Abstract

This study investigated caregivers’ perceptions of illness and their health-seeking behaviour for children under five in Morogoro Municipality, Tanzania. A qualitative research approach was employed, whereby data were collected through 12 in-depth interviews, 2 focus group discussions, and non-participant observation to explore caregivers’ experiences and healthcare decision-making processes. Guided by the Theory of Planned Behaviour, the qualitative analysis revealed that caregivers hold pluralistic understandings of illness causation, combining biomedical explanations such as poor hygiene and environmental exposure with cultural beliefs in witchcraft and ancestral displeasure. Perceptions of symptom severity influenced caregivers’ responses, often resulting in sequential treatment pathways—starting with home remedies or traditional healers before resorting to biomedical services. Gender norms further constrained decision-making, as male authority over financial resources delayed timely healthcare access. The findings underscore the coexistence of biomedical knowledge and cultural traditions, highlighting the need for culturally sensitive health policies that integrate local belief systems into child health interventions.