Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy



Major Professor

Sandra J. Mixer

Committee Members

Sadie Hutson, Tami Wyatt, Paul Erwin


Each year, malaria invades and infects 300 million persons, kills up to 1 million, and 90% of deaths are among children in Sub-Saharan Africa. Malaria illness and deaths cost Africa $12 billion in lost productivity. Eighty percent of all malaria cases occur in 17 African countries; one is Kenya, where one group suffers incessantly from malaria, the Maasai. Their pastoral, indigenous lifestyle places the Maasai men, women, and children daily at malaria risk. Although malaria is preventable and treatable, high mortality and morbidity occurrence continues. Global interest in malaria care includes prevention, treatment, and eradication. The current use of generic and professional malaria care/cure practices among the Maasai culture is not known. The purpose of this qualitative, ethnonursing study was to discover, describe, and systematically analyze the meanings, expressions, and practices related to malaria care among the Maasai who reside in the Kisongo Maasai villages in the Kimana region of Southern Kenya. Interviews with 16 key and 32 general informants provided in-depth examination of the ethnohistory and culture of Maasai relevant to malaria care. The goal was to discover the emic (generic/folk) and etic (professional nursing) care practices that promote culturally congruent malaria care for the Maasai. Guided by the theory of Culture Care Diversity and Universality and ethnonursing research method, four themes were discovered. Theme 1: Malaria care is a response by the entire Maasai community to promote community well-being. Theme 2: Enkai, as creator, is in ultimate control of the cause and cure and is resourced in malaria care. Theme 3: Malaria care is a planned sequence of traditional, spiritual, and professional care/cure practices. Theme 4: The Maasai community is resolute in responding to this illness. Findings guide care decisions and actions toward malaria care that is respectful, safe, beneficial, and fits with people’s daily lives. Malaria care should be in a partnership with traditional and professional care givers. Policy implications include a need for available, accessible, and affordable quality malaria care that will promote health and well-being among the Maasai. Using the CCT was appropriate and findings contributed to the body of nursing knowledge and caring practice.

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