Gendered Dimensions of Health-Seeking Behaviour: Evidence from Caregivers of Children Under Five in Morogoro Municipality, Tanzania

Authors

Irene Matern Msambali

Department of Sociology, St. Augustine University of Tanzania, Mwanza (Tanzania)

Ludovick Myumbo

Department of Sociology, St. Augustine University of Tanzania, Mwanza (Tanzania)

Patrick Masanja

Department of Sociology, St. Augustine University of Tanzania, Mwanza (Tanzania)

Article Information

DOI: 10.47772/IJRISS.2025.910000261

Subject Category: Sociology

Volume/Issue: 9/10 | Page No: 3227-3235

Publication Timeline

Submitted: 2025-10-12

Accepted: 2025-10-18

Published: 2025-11-10

Abstract

Gender norms play a critical role in influencing health-seeking behaviour, yet their influence on caregivers' decision-making for children under five remains underexplored in Tanzania. This study examined how culturally constructed gender roles affect caregivers' ability to recognise illness, make healthcare decisions, and access timely treatment in Morogoro Municipality. A qualitative research design was employed, combining semi-structured interviews, focus group discussions, and non-participant observations with 12 caregivers. Thematic analysis revealed three main findings: (i) women are the primary caregivers responsible for identifying and monitoring childhood illnesses but face limited autonomy due to male authority and financial control, (ii) men's roles as household heads and financial providers grant them ultimate decision-making power over healthcare access, and (iii) women exercise situational agency, particularly during emergencies, though these actions often risk social disapproval. The findings are interpreted through the lens of the Gender and Development (GAD) theory, highlighting how gendered power relations mediate health-seeking behaviours and influence child health outcomes. The study underscores the need for interventions that address structural gender inequalities, including community education, male engagement in child health responsibilities, and women's economic empowerment. By enlightening the intersection of gender norms and child health, this research contributes to advancing SDGs 3 (good health and well-being) and 5 (gender equality) in low-resource contexts.

Keywords

Gender norms, health-seeking behaviour

Downloads

References

1. Asefa, A., Morgan, A., Gebremedhin, S., Tekle, E., Abebe, S., Magge, H., & Kermode, M. (2020). Mitigating the mistreatment of childbearing women: evaluation of respectful maternity care intervention in Ethiopian hospitals. BMJ open, 10(9), e038871. https://doi.org/10.1136/bmjopen-2020-038871 [Google Scholar] [Crossref]

2. Bakare, A.A., Graham, H., Agwai, I.C., Shittu, F., King, C., Colbourn, T., ... & INSPIRING Project Consortium. (2020). Community and caregivers' perceptions of pneumonia and care - Seeking experiences in Nigeria: A qualitative study. Pediatr Pulmonol. 55, S104-S112. https://doi.org/10.1002/ppul.24620 [Google Scholar] [Crossref]

3. Barasa, V., & Virhia, J. (2022). Using intersectionality to identify gendered barriers to health-seeking for febrile illness in agro-pastoralist settings in Tanzania. Frontiers in Global women's health, 2, 746402. https://doi.org/10.3389/fgwh.2021.746402 [Google Scholar] [Crossref]

4. Bedford, K.J.A., & Sharkey, A.B. (2014). Local barriers and solutions to improve care-seeking for childhood pneumonia, diarrhoea and malaria in Kenya, Nigeria and Niger: A qualitative study. PLoS One, 9(6), 1-15. https://doi.org/10.1371/journal. pone.0100038 [Google Scholar] [Crossref]

5. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa [Google Scholar] [Crossref]

6. Bryman, A. (2016). Social Research Methods (5th ed.). Oxford University Press. [Google Scholar] [Crossref]

7. Colvin, C.J., Smith, H.J., Swartz, A., Ahs, J.W., de Heer, J., Opiyo, N., ... & George, A. (2013). Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Social science & medicine, 86, 66-78. https://doi.org/10.1016/j.socscimed.2013.02.031 [Google Scholar] [Crossref]

8. Creswell, J.W. (2014). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches (4th ed.). Thousand Oaks, CA: Sage. [Google Scholar] [Crossref]

9. Denzin, N.K., & Lincoln, Y.S. (2011). The SAGE Handbook of Qualitative Research (4th ed.). Sage. [Google Scholar] [Crossref]

10. Feldhaus, I., Silverman, M., LeFevre, A. E., Mpembeni, R., Mosha, I., Chitama, D., ... & George, A. S. (2015). Equally able, but unequally accepted: Gender differentials and experiences of community health volunteers promoting maternal, newborn, and child health in Morogoro Region, Tanzania. International journal for equity in health, 14(1), 70. https://doi.org/10.1186/s12939-015-0201-z [Google Scholar] [Crossref]

11. Flick, U. (2018). An Introduction to Qualitative Research (6th ed.). SAGE Publications. [Google Scholar] [Crossref]

12. Greenspan, J.A., Chebet, J.J., Mpembeni, R., Mosha, I., Mpunga, M., Winch, P.J., ... & McMahon, S. A. (2019). Men's roles in care seeking for maternal and newborn health: a qualitative study applying the three delays model to male involvement in Morogoro Region, Tanzania. BMC pregnancy and childbirth, 19(1), 293. https://doi.org/10.1186/s12884-019-2439-8 [Google Scholar] [Crossref]

13. Kanté, A.M., Gutierrez, H.R., Larsen, A.M., Jackson, E.F., Helleringer, S., Exavery, A., ... & Phillips, J.F. (2015). Childhood illness prevalence and health seeking behavior patterns in rural Tanzania. BMC public health, 15(1), 951. https://doi.org/10.1186/s12889-015-2264-6 [Google Scholar] [Crossref]

14. Kothari, C.R. (2009). Research methodology: Methods and techniques (2nd ed.). New Age International Publishers. [Google Scholar] [Crossref]

15. Lim, W.M. (2025). What is qualitative research? An overview and guidelines. Australasian Marketing Journal, 33(2), 199-229. https://doi.org/10.1177/14413582241264619 [Google Scholar] [Crossref]

16. Lyimo, E.J., Msangi, M., Zangira, A.J., Msaki, R.V., Lekey, A., Rwenyagira, M., ... & Masumo, R.M. (2024). Healthcare-seeking behaviours among mother's having under-five children with severe wasting in Dodoma and Mbeya regions of Tanzania-A qualitative study. PLOS global public health, 4(1), e0001943. https://doi.org/10.1371/journal.pgph.0001943 [Google Scholar] [Crossref]

17. March, C., Smyth, I.A., & Mukhopadhyay, M. (1999). A guide to gender-analysis frameworks. Oxfam. [Google Scholar] [Crossref]

18. Mburu, C.M., Bukachi, S.A., Shilabukha, K., Tokpa, K.H., Ezekiel, M., Fokou, G., ... & Kazwala, R. (2021). Determinants of treatment-seeking behavior during self-reported febrile illness episodes using the socio-ecological model in Kilombero District, Tanzania. BMC Public Health, 21(1), 1075. https://doi.org/10.1186/s12889-021-11027-w [Google Scholar] [Crossref]

19. Ministry of Health (MoH) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF. (2022). Tanzania Demographic and Health Survey and Malaria Indicator Survey 2022 Final Report. Dodoma, Tanzania, and Rockville, Maryland, USA: MoH, NBS, OCGS, and ICF. [Google Scholar] [Crossref]

20. Moser, C.O.N. (1993). Gender planning and development: Theory, practice and training. Routledge. https://doi.org/10.4324/9780203411940 [Google Scholar] [Crossref]

21. Msambali, I.M., & Mwonge, L.A. (2025). Corporate social responsibility initiatives: strategies and mechanisms for promoting public health in Jordan University College in Morogoro Municipality, Tanzania. Discover Health Systems, 4(1), 1-16. https://doi.org/10.1007/s44250-025-00217-7 [Google Scholar] [Crossref]

22. Muraya, K., Ogutu, M., Mwadhi, M., Mikusa, J., Okinyi, M., Magawi, C., ... & Molyneux, S. (2021). Applying a gender lens to understand pathways through care for acutely ill young children in Kenyan urban informal settlements. International Journal for Equity in Health, 20(1), 17. https://doi.org/10.1186/s12939-020-01349-3 [Google Scholar] [Crossref]

23. Naderifar, M., Goli, H., & Ghaljaie, F. (2017). Snowball sampling: A purposeful method of sampling in qualitative research. Strides in development of medical education, 14(3). http://doi.org/10.5812/sdme.67670 [Google Scholar] [Crossref]

24. National Bureau of Statistics (NBS) (2022). Tanzania 2021-22 Demographic and Health Survey and Malaria Indicator Survey. Available at https://microdata.nbs.go.tz/index.php/catalog/38/related-materials Accessed 10 March 2025 [Google Scholar] [Crossref]

25. Ngere, S.H., Olang'o, C., Ochola, K., Oduor, P., Sagam, C.K., Ochieng, B., ... & Nyambedha, E. (2025a). Caregivers' lived experiences of childhood probable pneumonia through a gendered lens in Western Kenya. African Journal of Primary Health Care & Family Medicine, 17(1), 4758. https://doi.org/10.4102/phcfm.v17i1.4758 [Google Scholar] [Crossref]

26. Ngere, S.H., Olang'o, C., Ondeng'e, K., Ochola, K., Sagam, C.K., Maixenchs, M., ... & Nyambedha, E. (2025b). Perceptions of childhood illness and pneumonia recognition: Implications for health-seeking behaviour in Western Kenya. Social Sciences & Humanities Open, 12, 101979. https://doi.org/10.1016/j.ssaho.2025.101979 [Google Scholar] [Crossref]

27. Parpart, J.L. (1993). Who is the 'Other'?: A postmodern feminist critique of women and development theory and practice. Development and change, 24(3), 439-464. https://doi.org/10.1111/j.1467-7660.1993.tb00492.x [Google Scholar] [Crossref]

28. Patton, M.Q. (2015). Qualitative Research & Evaluation Methods (4th ed.). Sage [Google Scholar] [Crossref]

29. Rahimi, S., & Khatooni, M. (2024). Saturation in qualitative research: An evolutionary concept analysis. International Journal of Nursing Studies Advances, 6, 100174. https://doi.org/10.1016/j.ijnsa.2024.100174 [Google Scholar] [Crossref]

30. Rathgeber, E.M. (1990). WID, WAD, GAD: Trends in research and practice. The journal of developing areas, 24(4), 489-502. https://www.jstor.org/stable/4191904 [Google Scholar] [Crossref]

31. Rutebemberwa, E., Pariyo, G., Peterson, S., Tomson, G., & Kallander, K. (2009). Utilization of public or private health care providers by febrile children after user fee removal in Uganda. Malaria journal, 8(1), 45. https://doi.org/10.1186/1475-2875-8-45 [Google Scholar] [Crossref]

32. Sedgwick, P.M. (2015). Multistage sampling. The BMJ 351, h4155. http://doi.org/10.1136/bmj.h4155 [Google Scholar] [Crossref]

33. Story, W.T., & Burgard, S.A. (2012). Couples' reports of household decision-making and the utilization of maternal health services in Bangladesh. Social science & medicine, 75(12), 2403-2411. https://doi.org/10.1016/j.socscimed.2012.09.017 [Google Scholar] [Crossref]

34. United Republic of Tanzania (URT) (2022). Tanzania Reproductive Maternal Neonatal Child and Adolescent Health and Nutrition (Rmcah-N) Investment Project (P170435): Environmental and Social Systems Assessment (ESSA). World Bank. [Google Scholar] [Crossref]

35. Wambui, W.M., Kimani, S., & Odhiambo, E. (2018). Determinants of health seeking behavior among caregivers of infants admitted with acute childhood illnesses at Kenyatta National Hospital, Nairobi, Kenya. Int. J Pediatr. 2018, 1-11. https://doi.org/10.1155/2018/5190287 [Google Scholar] [Crossref]

36. World Health Organisation (WHO) (2011). Guidelines for Drinking-Water Quality, 4th edition. World Health Organisation, Geneva. [Google Scholar] [Crossref]

37. World Health Organisation (WHO) (2024). Gender and health. 2024 [retrieved on 2025 September 15]. Available from: https://www.who.int/health-topics/gender#tab=tab_1 [Google Scholar] [Crossref]

Metrics

Views & Downloads

Similar Articles