A qualitative study of knowledge, attitudes and perceptions towards malaria prevention among people living in rural upper river valleys of Nepal

BACKGROUND: Nepal has made significant progress in decreasing the number of malaria cases over the last two decades. Prevention and timely management of malaria are critical for the National Malaria Program in its quest for elimination. The study aimed to explore the knowledge, attitudes and behaviour towards malaria prevention and treatment among people living in rural villages of Khatyad Rural Municipality in Nepal. METHODS: This qualitative study collected information through virtual in-depth interviews (N = 25) with female and male participants aged between 15 and 72 years. RESULTS: More than half of the participants knew about the causes of malaria, were aware of the complications of untreated malaria and knew that anti-malarial medicines were provided for free at the public health facilities. Participants indicated that their first choice of health care were public health facilities, however limited supply of medications and diagnostics deviated patients to the private sector. While tertiary care costs were not financially viable, participants opted against traditional care for malaria. Factors such as cost of treatment, distance to the health facility and the decision making authority in households influenced health related decisions in the family. Although long-lasting insecticidal nets were distributed and indoor residual spraying was done periodically, several barriers were identified. CONCLUSION: Increased awareness of malaria prevention and treatment among people living in malaria risk areas is important for the National Malaria Program in its quest for malaria elimination in Nepal.