This paper examined care-seeking behaviour and its associated risk factors when a family
member had diarrhoea. Data was obtained from a survey conducted in Chikwawa, a district in
Southern Malawi. Chikwawa is faced with a number of environmental and socioeconomic problems
and currently diarrhoea morbidity in the district is estimated at 24.4%, statistically higher than
the national average of 17%. Using hierarchically built data from a survey of 1403 households
nested within 33 communities, a series of two level binary logistic regression models with Bayesian
estimation were used to determine predictors of care-seeking behaviour. The results show that 68%
of mothers used oral rehydration solutions (ORS) the last time a child in their family had diarrhoea.
However, when asked on the action they take when a member of their household has diarrhoea
two thirds of the mothers said they visit a health facility. Most respondents (73%) mentioned distance
and transport costs as the main obstacles to accessing their nearest health facility and the same
proportion of respondents mentioned prolonged waiting time and absence of health workers as the
main obstacles encountered at the health facilities. The main predictor variables when a member
of the family had diarrhoea were maternal age, distance to the nearest health facility, school level,
and relative wealth, household diarrhoea endemicity, and household size while the main predictor
variables when a child had diarrhoea were existence of a village health committee (VHC), distance to
the nearest health facility, and maternal age. Most households use ORS for the treatment of diarrhoea
and village health committees and health surveillance assistants (HSAs) are important factors in this
choice of treatment. Health education messages on the use and efficacy of ORS to ensure proper and
prescribed handling are important. There is need for a comprehensive concept addressing several
dimensions of management and proper coordination of delivery of resources and services; availability
of adequate healthcare workers at all levels; affordability to accessibility of healthcare resources and
services to all communities; acceptability and quality of care; intensification of health education
messages on the use and management of ORS, and prompt and timely treatment of diarrhoeal illness.