Enhancing Patient Bonding to Improve Malaria Treatment Experiences in Sustainable Healthcare Systems of Emerging Economies
DOI:
https://doi.org/10.26437/yvmt8x73Keywords:
Healthcare. malaria treatment. patient bonding. patient-centred care. sustainabilityAbstract
Purpose: The purpose of this study is to examine patients’ perspectives on bonding dimensions and their role in facilitating healthcare delivery within a university clinic in Ghana. Specifically, it explores how patient bonding enhances healthcare experiences during the malaria treatment journey.
Design/Methodology/Approach: A qualitative research design was adopted, employing a semi-structured interview guide to elicit in-depth insights from participants. Data were collected from 25 patients who had had malaria in the last year, and the saturation point occurred when the 25 patients were interviewed at a university clinic in Ghana and analysed thematically.
Research Limitation: The research relies on qualitative data gathered from a limited sample of patients in a university. This constraint may limit the generalisability of the findings to service sectors where different cultural, economic, or operational factors may influence service delivery dynamics.
Findings: Four main themes emerged: Quality treatment process, Service package, Word-of-Mouth communication, and Service encounter confidentiality. Nine sub-themes emerged, highlighting how bonding dimensions shape patients’ treatment experiences. The findings indicate that strong relational bonding between patients and providers influences treatment experiences and supports sustainable healthcare delivery in emerging economies such as Ghana.
Practical Implication: The study reinforces the World Health Organisation’s Test, Treat, and Track strategy by demonstrating that instrumental support, such as streamlined service delivery, effectively reduces structural barriers to adherence to malaria treatment.
Social Implication: Policies should move beyond a narrow biomedical focus to encompass the social and interpersonal factors that shape treatment adherence and health-seeking behaviour.
Originality/Value: The study identifies several novel variables that extend Social Support Theory and Patient-Centred Care, including quality treatment, comprehensive service packages, word-of-mouth communication, and service encounter confidentiality. These variables introduce structural, relational, and community-based dimensions that enhance patient-provider bonding and treatment adherence in malaria care contexts.
References
Abdul Rahim, F. A., Mahmud, M. A. F., Abdul Mutalip, M. H., Yoep, N., Aminuddin, M. A. H., & Mohd Ngesom, A. M. (2025). A scoping review of community knowledge in malaria prevention and control programmes. PLoS One, 20(7), e0328703. DOI: https://doi.org/10.1371/journal.pone.0328703
Adum, P., Agyare, V. A., Owusu-Marfo, J., & Agyeman, Y. N. (2023). Knowledge, attitude and practices of malaria preventive measures among mothers with children under five years in a rural setting of Ghana. Malaria Journal, 22(1), 268. DOI: https://doi.org/10.1186/s12936-023-04702-3
Agyapong, K., Iddris, F., Mensah Kparl, E., & Mensah, P. O. (2025). Unlocking wellness: the power of co-creation in transforming healthcare engagement for patient well-being in malaria treatment process. Services Marketing Quarterly, 46(1-2), 83-111. DOI: https://doi.org/10.1080/15332969.2024.2448070
Akthar, N., Nayak, S., & Pai, Y. (2024). A cross-sectional study on exploring the antecedents of patient’s revisit intention: Mediating role of trust in the hospital among patients in India. F1000Research, 12, 75. DOI: https://doi.org/10.12688/f1000research.128220.3
Alhammad, N., Alajlani, M., Abd-Alrazaq, A., Epiphaniou, G., & Arvanitis, T. (2024). Patients’ perspectives on the data confidentiality, privacy, and security of mHealth apps: systematic review. Journal of Medical Internet Research, 26, e50715. DOI: https://doi.org/10.2196/50715
Alum, E. U., Ainebyoona, C., Egwu, C. O., Onohuean, H., Ugwu, O. P. C., Uti, D. E., ... & Echegu, D. A. (2025). Mitigation of Malaria in Sub-Saharan Africa through Vaccination: A Budding Road Map for Global Malaria Eradication. Ethiopian Journal of Health Sciences, 35(3). DOI: https://doi.org/10.4314/ejhs.v35i3.9
Al-Worafi, Y. M. (2023). Patient Care Related Issues in the Developing Countries: Diagnosis. In Handbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research (pp. 1-21). Cham: Springer International Publishing. DOI: https://doi.org/10.1007/978-3-030-74786-2_242-1
Al-Worafi, Y. M. (2024). Malaria management in developing countries. In Handbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research (pp. 1-40). Cham: Springer International Publishing. DOI: https://doi.org/10.1007/978-3-030-74786-2_60-1
Ampomah, I. G., Devine, S., Ampomah, G. A., & Emeto, T. I. (2025). Exploring the contribution of integrated healthcare practices to malaria control in Ghana: perspectives of medical herbalists. BMC complementary medicine and therapies, 25(1), 11. DOI: https://doi.org/10.1186/s12906-025-04746-9
Anderson, S. T., Nasr, L., & Rayburn, S. W. (2018). Transformative service research and service
design: synergistic effects in healthcare. Service Industries Journal, 38(1/2), 99-113.
Battle, L., & Heer, J. (2019, June). Characterizing exploratory visual analysis: A literature review and evaluation of analytic provenance in tableau. In Computer graphics forum (Vol. 38, No. 3, pp. 145-159). DOI: https://doi.org/10.1111/cgf.13678
Bennett, A., Avanceña, A. L., Wegbreit, J., Cotter, C., Roberts, K., & Gosling, R. (2017). Engaging the private sector in malaria surveillance: a review of strategies and recommendations for elimination settings. Malaria Journal, 16(1), 252. DOI: https://doi.org/10.1186/s12936-017-1901-1
Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: a comprehensive review. Cureus, 15(10). DOI: https://doi.org/10.7759/cureus.47731
Bingham, A. J. (2023). From data management to actionable findings: A five-phase process of qualitative data analysis. International Journal of Qualitative Methods, 22, 16094069231183620. DOI: https://doi.org/10.1177/16094069231183620
Bitner, M. J. (1990). Evaluating Service Encounters: The Effects of Physical Surroundings and Employee Responses. Journal of Marketing, 54(2), 69. DOI: https://doi.org/10.1177/002224299005400206
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., ... & Pomey, M. P. (2018). Engaging patients to improve quality of care: a systematic review. Implementation Science, 13, 1-22. DOI: https://doi.org/10.1186/s13012-018-0784-z
Bonciani, M., Schäfer, W., Barsanti, S., Heinemann, S., & Groenewegen, P. P. (2018). The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries. BMC Health Services Research, 18(1), 132. DOI: https://doi.org/10.1186/s12913-018-2913-4
Bradshaw, J., Siddiqui, N., Greenfield, D., & Sharma, A. (2022). Kindness, listening, and connection: patient and clinician key requirements for emotional support in chronic and complex care. Journal of Patient Experience, 9, 23743735221092627. DOI: https://doi.org/10.1177/23743735221092627
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in DOI: https://doi.org/10.1191/1478088706qp063oa
Psychology, 3(2), 77-101.
Bruxvoort, K., Goodman, C., Kachur, S. P., & Schellenberg, D. (2014). How patients take malaria treatment: a systematic review of the literature on adherence to antimalarial drugs. PloS one, 9(1), e84555. DOI: https://doi.org/10.1371/journal.pone.0084555
Cantor, M. N., & Thorpe, L. (2018). Integrating data on social determinants of health into electronic health records. Health Affairs, 37(4), 585-590. DOI: https://doi.org/10.1377/hlthaff.2017.1252
Chang, C. W., Huang, H. C., Wang, S. J., & Lee, H. (2021). Relational bonds, customer engagement, and service quality. The Service Industries Journal, 41(5-6), 330-354. DOI: https://doi.org/10.1080/02642069.2019.1611784
Chen, L. H., Chen, C. H., Loverio, J. P., Wang, M. J. S., Lee, L. H., & Hou, Y. P. (2024). Examining soft and hard attributes of health care service quality and their impacts on patient satisfaction and loyalty. Quality Management in Healthcare, 33(3), 176-191. DOI: https://doi.org/10.1097/QMH.0000000000000420
Chung, R. J., Lee, J. B., Hackell, J. M., & Alderman, E. M. (2024). Confidentiality in the care of adolescents: Technical report. Pediatrics, 153(5), e2024066327. DOI: https://doi.org/10.1542/peds.2024-066327
Dhiman, S. (2019). Are malaria elimination efforts on right track? An analysis of gains achieved and challenges ahead. Infectious Diseases of Poverty, 8, 1-19. DOI: https://doi.org/10.1186/s40249-019-0524-x
Drossman, D. A., & Ruddy, J. (2020). Improving patient-provider relationships to improve health care. Clinical Gastroenterology and Hepatology, 18(7), 1417-1426. DOI: https://doi.org/10.1016/j.cgh.2019.12.007
Eton, D. T., Ridgeway, J. L., Linzer, M., Boehm, D. H., Rogers, E. A., Yost, K. J., ... & Anderson, R. T. (2017). Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions. Patient Preference and Adherence, 1635-1646. DOI: https://doi.org/10.2147/PPA.S145942
Faiyazuddin, M., Rahman, S. J. Q., Anand, G., Siddiqui, R. K., Mehta, R., Khatib, M. N., ... & Sah, R. (2025). The impact of artificial intelligence on healthcare: a comprehensive review of advancements in diagnostics, treatment, and operational efficiency. Health Science Reports, 8(1), e70312. DOI: https://doi.org/10.1002/hsr2.70312
Fan, H., Lederman, R., Smith, S. P., & Chang, S. (2014). How trust is formed in online health communities: a process perspective. Communications of the Association for Information Systems, 34(1), 28. DOI: https://doi.org/10.17705/1CAIS.03428
Firdaus, M. H., Puteh, S. E. W., Sutan, R., & Manaf, M. R. A. (2025). E ectiveness of family health education in malaria elimination programmes: a scoping. Constraints, 5(11), 12. DOI: https://doi.org/10.1186/s12936-025-05371-0
Francis, J. J., Johnston, M., Robertson, C., Glidewell, L., Entwistle, V., Eccles, M. P., &
Grimshaw, J. M. (2010). What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychology and Health, 25(10), 1229. DOI: https://doi.org/10.1080/08870440903194015
Gohar, A. N., Abdelmawgoud, S. A., & Farhan, M. S. (2022). A patient-centric healthcare framework reference architecture for better semantic interoperability based on blockchain, cloud, and IoT. IEEE Access, 10, 92137-92157. DOI: https://doi.org/10.1109/ACCESS.2022.3202902
Greenfield, B. H., & Jensen, G. M. (2010). Understanding the lived experiences of patients: application of a phenomenological approach to ethics. Physical Therapy, 90(8), 1185-1197. DOI: https://doi.org/10.2522/ptj.20090348
Guest, G., Namey, E., & Chen, M. (2020). A simple method to assess and report thematicsaturation in qualitative research. PLoS One, 15(5), e0232076. DOI: https://doi.org/10.1371/journal.pone.0232076
Gulumbe, B. H., Shehu, A., Abdulrahim, A., Emmerson, P., & Lawan, K. A. (2023). Advancing Malaria eradication efforts: Nigeria and Ghana embrace the Oxford Malaria vaccine as a beacon of hope. Journal of Global Health Science, 5(2). DOI: https://doi.org/10.35500/jghs.2023.5.e13
Gwaza, G., Plüddemann, A., McCall, M., & Heneghan, C. (2024). Integrated diagnosis in Africa’s low-and middle-income countries: what is it, what works, and for whom? A realist synthesis. International Journal of Integrated Care, 24(3), 20. DOI: https://doi.org/10.5334/ijic.7788
He, Z., Xu, W., Yang, Z., Shen, H., Fu, N., Huang, Y., ... & You, X. (2024). Unlocking potentials of near-field propagation: ELAA-empowered integrated sensing and communication. IEEE Communications Magazine, 62(9), 82-89. DOI: https://doi.org/10.1109/MCOM.001.2300635
Hong, H., & Oh, H. J. (2020). The effects of patient-centered communication: exploring the mediating role of trust in healthcare providers. Health communication, 35(4), 502-511 DOI: https://doi.org/10.1080/10410236.2019.1570427
House, J. S. (1987, December). Social support and social structure. In Sociological forum (Vol. 2, No. 1, pp. 135-146). Dordrecht: Kluwer Academic Publishers. DOI: https://doi.org/10.1007/BF01107897
Kara, T., & Tugrul, T. (2024). The effects of relationship quality and duration on negative word-of-mouth after a low-contact service failure. Journal of Consumer Satisfaction, Dissatisfaction and Complaining Behavior, 37(1), 33-50.
Kardas, P. (2024). From non-adherence to adherence: can innovative solutions resolve a longstanding problem?. European Journal of Internal Medicine, 119, 6-12. DOI: https://doi.org/10.1016/j.ejim.2023.10.012
Kirillova, K., & Chan, J. (2018). “What is beautiful we book”: hotel visual appeal and expected service quality. International Journal of Contemporary Hospitality Management, 30(3), 1788-1807. DOI: https://doi.org/10.1108/IJCHM-07-2017-0408
Kirimlioglu, N. (2017). The right to privacy" and the patient views in the context of the personal data protection in the field of health. Biomedical Research, 28(4), 1464-1471.
Kisekka, V., & Giboney, J. S. (2018). The effectiveness of health care information technologies: evaluation of trust, security beliefs, and privacy as determinants of health care outcomes. Journal of Medical Internet Research, 20(4), e9014. DOI: https://doi.org/10.2196/jmir.9014
Kišjuhas, A. (2024). What holds society together? Emotions, social ties, and group solidarity in leisure interaction rituals. Leisure Studies, 43(3), 363-377. DOI: https://doi.org/10.1080/02614367.2023.2183979
Krolikowska-Adamczyk, E., & Kuenzel, S. (2024). An attachment theory perspective of professional service providers' social bonds with their clients. Industrial Marketing Management, 118, 136-147. DOI: https://doi.org/10.1016/j.indmarman.2024.02.009
Lewis, A. K., Harding, K. E., Snowdon, D. A., & Taylor, N. F. (2018). Reducing wait time from referral to first visit for community outpatient services may contribute to better health outcomes: a systematic review. BMC Health Services Research, 18, 1-14. DOI: https://doi.org/10.1186/s12913-018-3669-6
Lopes, S. C., Mugizi, R., Pires, J. E., David, F., Martins, J., Dimbu, P. R., ... & Allan, R. (2020). Malaria test, treat and track policy implementation in Angola: a retrospective study to assess the progress achieved after 4 years of programme implementation. Malaria Journal, 19(1), 262. DOI: https://doi.org/10.1186/s12936-020-03338-x
Ndambo, M. K., Bærøe, K., Phiri, K. S., Chiumia, I. K., Teig, I. L., Robberstad, B., ... & Manda-Taylor, L. (2025). Conceptualizing the implementation of post-discharge malaria chemoprevention in Malawi using a co-design approach. Malaria Journal, 24(1), 51. DOI: https://doi.org/10.1186/s12936-025-05265-1
Nkrumah, D., Nketia, R. I., Turkson, B. K., & Komlaga, G. (2024). Malaria: Epidemiology, Life Cycle of Parasite, Control Strategies and Potential Drug Screening Techniques. DOI: https://doi.org/10.5772/intechopen.1007804
Mace, K. E., Lucchi, N. W., & Tan, K. R. (2021). Malaria Surveillance — United States, 2017. MMWR Surveillance Summaries, 70(2), 1-35. DOI: https://doi.org/10.15585/mmwr.ss7002a1
Mao, W., Cooke, R., Silimperi, D., Hodges, E. U., Ortiz, E., & Udayakumar, K. (2023). Scaling malaria interventions: bottlenecks to malaria elimination. BMJ Global Health, 8(11), e013378. DOI: https://doi.org/10.1136/bmjgh-2023-013378
McIlveen, P., McGregor-Bayne, H., Alcock, A., & Hjertum, E. (2003). Evaluation of a semi-structured career assessment interview derived from systems theory framework. Australian Journal of Career Development, 12(3), 33-41. DOI: https://doi.org/10.1177/103841620301200306
Mezmir, E. A. (2020). Qualitative data analysis: An overview of data reduction, data display, and interpretation. Research on Humanities and Social Sciences, 10(21), 15-27.
Miles, M., & Huberman, H. (1994). Qualitative data analysis (2nd ed.). Thousand Oaks, California: Sage Publications Inc.
O'Toole, G. (2024). Communication-E-Book: Core Interpersonal Skills for Healthcare Professionals. Elsevier Health Sciences.
Paul, J., Khatri, P., & Kaur Duggal, H. (2024). Frameworks for developing impactful systematic literature reviews and theory building: what, why and how?. Journal of Decision Systems, 33(4), 537-550. DOI: https://doi.org/10.1080/12460125.2023.2197700
Pauli, G., Martin, S., & Greiling, D. (2023). The current state of research of word-of-mouth in the health care sector. International Review on Public and Nonprofit Marketing, 20(1), 125-148. DOI: https://doi.org/10.1007/s12208-022-00334-6
Pucca, M. B., de Sousa, T. N., Cardoso de Melo, G., & Viana, G. M. R. (2024). Challenges for diagnosis, treatment, and elimination of malaria. Frontiers in Tropical Diseases, 5, 1394693. DOI: https://doi.org/10.3389/fitd.2024.1394693
Rashid, M., & Sharma, M. (2025). AI‐Assisted Diagnosis and Treatment Planning—A Discussion of How AI Can Assist Healthcare Professionals in Making More Accurate Diagnoses and Treatment Plans for Diseases. AI in Disease Detection: Advancements and Applications, 313-336. DOI: https://doi.org/10.1002/9781394278695.ch14
Rathert, C., Mittler, J. N., & Lee, Y. S. (2022). Patient–provider therapeutic connections to improve health care: Conceptual development and systematic review of patient measures. Health Care Management Review, 47(4), 317-329. DOI: https://doi.org/10.1097/HMR.0000000000000339
Robinson, C. A. (2016). Trust, health care relationships, and chronic illness: a theoretical coalescence. Global Qualitative Nursing Research, 3, 2333393616664823. DOI: https://doi.org/10.1177/2333393616664823
Skjott Linneberg, M., & Korsgaard, S. (2019). Coding qualitative data: A synthesis guiding the novice. Qualitative Research Journal, 19(3), 259-270. DOI: https://doi.org/10.1108/QRJ-12-2018-0012
Smoyer, A. B., Rosenberg, A., & Blankenship, K. M. (2014). Setting the stage: Creating study sites that promote the safety and dignity of research participants. Social Work Research, 38(3), 178-183. DOI: https://doi.org/10.1093/swr/svu019
Sousa, B. M., & Alves, G. M. (2019). The role of relationship marketing in behavioural intentions of medical tourism services and guest experiences. Journal of Hospitality and Tourism Insights, 2(3), 224-240. DOI: https://doi.org/10.1108/JHTI-05-2018-0032
Stewart, M., Ryan, B. L., & Bodea, C. (2011). Is patient-centred care associated with lower diagnostic costs?. Healthcare Policy, 6(4), 27. DOI: https://doi.org/10.12927/hcpol.2011.22393
Street, A., & Smith, P. (2021). How can we make valid and useful comparisons of different health care systems?. Health Services Research, 56(Suppl 3), 1299. DOI: https://doi.org/10.1111/1475-6773.13883
Sylvester, B., Gasarasi, D. B., Aboud, S., Tarimo, D., Massawe, S., Mpembeni, R., & Swedberg, G. (2018). Prenatal Exposure to Plasmodium Falciparum Lowers Humoral Responses during Clinical Malaria Episodes. African Journal of Applied Research, 4(1), 52-61.
Taheri, B., Chalmers, D., Wilson, J., & Arshed, N. (2021). Would you really recommend it? Antecedents of word-of-mouth in medical tourism. Tourism Management, 83, 104209. DOI: https://doi.org/10.1016/j.tourman.2020.104209
Tran, D. M. T., & Silvestri-Elmore, A. (2021). Healthcare-seeking behaviours in college students and young adults: a review. Journal of Research in Nursing, 26(4), 320-338. DOI: https://doi.org/10.1177/1744987120951594
Turkstani, H. A., Almutawah, F. N., AlZamel, N. A., Zaid, M., Alshammari, A. A. A., Algharbi, M. T., ... & Aljuwayed11, N. H. (2025). Privacy and Confidentiality in Healthcare: Best Practices for Protecting Patient Information. Journal of Healthcare Sciences, 05(01):49-54. DOI: https://doi.org/10.52533/JOHS.2025.50106
VandeVusse, A., Mueller, J., & Karcher, S. (2022). Qualitative data sharing: Participant understanding, motivation, and consent. Qualitative Health Research, 32(1), 182-191. DOI: https://doi.org/10.1177/10497323211054058
Willig, C. (2001). Introducing Qualitative Research in Psychology, Buckingham: Open University Press.
Winskill, P., Walker, P. G., Cibulskis, R. E., & Ghani, A. C. (2019). Prioritizing the scale-up of interventions for malaria control and elimination. Malaria Journal, 18(1), 122. DOI: https://doi.org/10.1186/s12936-019-2755-5
Wittink, H., & Oosterhaven, J. (2018). Patient education and health literacy. Musculoskeletal Science and Practice, 38, 120-127. DOI: https://doi.org/10.1016/j.msksp.2018.06.004
Wolf, J. A., Niederhauser, V., Marshburn, D., & LaVela, S. L. (2021). Reexamining “Defining Patient Experience”: the human experience in healthcare. Patient Experience Journal, 8(1), 16-29. DOI: https://doi.org/10.35680/2372-0247.1594
World Health Organization (2020). World malaria report 2020: 20 years of global progress and challenges. World Health Organization.
World Health Organization. (2024). Global malaria programme operational strategy 2024-2030. World Health Organization.
World Health Organization. (2024). Global patient safety report 2024. World Health Organization.
Zainal, H., Hui, X. X., Thumboo, J., Fong, W., & Yong, F. K. (2024). Patients’ expectations of doctors’ clinical competencies in the digital health care era: qualitative semistructured interview study among patients. JMIR Human Factors, 11, e51972. DOI: https://doi.org/10.2196/51972
Zibrowski, E., Shepherd, L., Booth, R., Sedig, K., & Gibson, C. (2019). A qualitative study of the theory behind the chairs: balancing lean-accelerated patient flow with the need for privacy and confidentiality in an emergency medicine setting. JMIR human factors, 6(1), e11714. DOI: https://doi.org/10.2196/11714
Downloads
Published
Issue
Section
License
Copyright (c) 2026 AFRICAN JOURNAL OF APPLIED RESEARCH
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
By submitting and publishing your articles in the African Journal of Applied Research, you agree to transfer the copyright of the Article from the authors to the Journal ( African Journal of Applied Research).
