Date of Conferral



Doctor of Public Health (DrPH)


Health Services


Aimee E. Ferraro


Approximately 21 million individuals suffer from typhoid fever (TF) globally, and most outbreaks occur in Southeast Asia. The incidence of TF is high in Pakistan, particularly in low socioeconomic areas, and a new drug-resistant strain makes it difficult to control the spread of TF. There is a pressing need for up-to-date and accurate data regarding the attitudes, beliefs, and habits leading to the spread of TF infection among individuals living in low socioeconomic areas of Pakistan. This qualitative, phenomenological study was grounded in the health belief model and explored factors that influence the spread of TF among women of childbearing age in Gujranwala, Pakistan. Women of child-bearing age are essential to study because they are usually neglected, and other family members control their treatment. Semistructured interviews were conducted with 10 women, aged 18 to 45 years, via telephone. Responses were transcribed and translated to English and analyzed according to Creswell’s qualitative data analysis methods. Eight themes were revealed by the data: ignorance and mistrust, local practices, faith in biomedicine, obstacles to treatment and medical services, environmental barriers, life constraints, perception of risk, and gender issues. Most participants experienced multiple episodes of TF and prolonged sickness, relied on home remedies instead of visiting the government hospital, had limited knowledge of symptoms, prevention practices and treatment for TF, and reported lack of access to clean, filtered water. Findings from this study can impact social change by identifying factors that influence the spread of TF in targeted areas and informing potential TF education and awareness campaigns for low socioeconomic areas of Pakistan.