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Table 2 Category, practical implications, and consequences of providers’ instructions

From: Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study

Category Practical implications Negative consequence
Dogmatic (conventional) Giving 1st dose at the health facility ·Takes first dose on empty stomach
   ·No assurance of safe water to take the dose at the facility
  Following the 0, 8, 24, 36, 48, 60 hourly schedule ·Midnight doses
   ·Difficult where people have no reminders
Pragmatic (contextual) Starting first dose when caretakers reach home Delay in starting treatment
  Giving 3rd and subsequent doses in the morning 1200 am and evening 1200 pm regardless of when the first dose was given ·Shortening the period between 1st and 3rd dose
   ·Completing treatment several hours prior scheduled time
  Defer administering first dose until night time 10.00 pm so that the 3rd and subsequent doses would be given in the morning 12.00 am and evening 12.00 pm Delay in starting treatment