Mothers as first responders: Health-seeking and medicine use for childhood illness in Pakistan

Caring for children is often seen as a mother's duty, and managing childhood illness depends on caregivers' health literacy and socioeconomic status. We examined mothers' healthcare decisions and medication use for children in rural and urban Sargodha, Pakistan. We conducted semi-structured interviews with 20 mothers and four FGDs (two rural, two urban) with 38 mothers. We transcribed the audio recordings and used inductive thematic analysis to identify three themes: mothers' roles in healthcare-seeking, medication practices, and alternative treatments. Mothers were the primary decision-makers for their children's healthcare in both settings. Rural mothers faced greater barriers to healthcare access than urban mothers, including transportation difficulties, financial constraints, and limited recognition of childhood illnesses, leading to delays in seeking care. Self-medication, home remedies, and spiritual healing were common across both settings. Culturally appropriate health education may improve mothers' recognition of serious childhood illness, promote appropriate medication use, and encourage timely healthcare-seeking.