Table 3.

Summary of the determinants of agro-pastoralists’ treatment-seeking behavior during a suspected febrile illness episode using the socio-ecological model

Level of influence	Determinant	Illustration
Individual	Age	Children below 3 years of age were promptly taken to a health facility for fear of severe illness progression.
	Expendable income	Families with a low level of income were less likely to visit a health facility out of fear that they would not be able to afford the high costs associated with formal treatment.
	Personal history	Individuals took note of previously used drugs and purchased them from local shops and pharmacies anytime they had similar symptoms.
Socio-cultural	Community perceptions on febrile illness	Most febrile illness were perceived as malaria so antimalarials were purchased for treatment.
		Distinction was made between common and severe febrile illness based on perceived severity of the symptoms.
		Only malaria, typhoid and urinary tract infections were mentioned as causes of febrile symptoms.
		Malaria was associated with fever, chills and joint pains.
		UTIs were perceived to manifest through severe headaches and backache.
		The main typhoid symptoms were considered to be stomachache and constipation.
	Attitudes on formal and informal treatment	Recurrent severe febrile symptoms were associated with witchcraft. As a result, traditional healers were consulted.
		Informal drug sellers were considered to be knowledgeable on the cause of diseases and thus able to prescribe the right treatment.
		Clinicians were perceived as being able to conduct accurate diagnosis. For this reason, their help was normally sought once self-treatment failed.
Ecological	Seasonal livelihood activities	People were unwilling to leave their farming or livestock keeping duties to attend a health facility. Therefore, they preferred purchasing drugs over the counter.
		Herders were less likely to visit a health facility as they looked after livestock in remote areas with no one to be left in charge of the animals.
	Weather	Flooding for part of the year impeded transportation to a health facility.
Policy/structural	Accessibility to health services	Local shops selling medicine were more accessible than health facilities.
		Most of the tests were available in major hospitals located in towns far from the villages.
		Private facilities were closer to the villages and tested patients for malaria, typhoid and urinary tract infections.