Analysis of Knowledge, Practices and Determinants of Formal Healthcare-seeking for Malaria Among Mothers of Children Under Five in Benin in 2023

Introduction: Malaria remains a major public health problem in Benin, especially among children under five, despite the implementation of proven prevention and management strategies. Given the persistent malaria burden, this study was conducted to analyse the knowledge and practices of mothers of under-five children regarding malaria, as well as the determinants of formal healthcare-seeking. Methods: This was a cross-sectional analytical study conducted among mothers of under-five children, selected from three villages in the commune of Zogbodomey, Benin. Data collected from mothers using a digitised questionnaire were used to classify knowledge, attitudes and practices as "good" or "insufficient" based on the mean scores obtained. Determinants of healthcare-seeking were explored using univariate and multivariate regression at a 5% significance level. Results: The majority of the 208 mothers (92.79%) had good knowledge about malaria, and 100% exhibited positive attitudes towards its prevention. However, only 66.83% actually adopted good practices. After adjustment, the variables that remained significantly associated with healthcare-seeking were: knowledge of malaria transmission modes (OR= 4.64; 95% CI= [1.03-20.90]), and mother’s occupation such as trader (OR=0.37; 95% CI= [0.18-0.75]), farmer (OR= 0.27; 95% CI= [0.09-0.82]) and craftswoman (OR= 0.23; 95% CI= [0.08-0.65]). Conclusion: Although the overall level of knowledge and attitudes among mothers is satisfactory, it does not yet translate into sustained, positive practices against malaria. Strengthening health education and promoting continuous behavioural support appear essential to enhance malaria control for children under five in Benin.