Abstract
<jats:p>Introduction: Uganda has the highest number of Malaria cases in East and Southern Africa and accounted for 3% of deaths in 2020. This calls for prevention, early diagnosis and treatment of Malaria most especially among children whose condition can progress to severe Malaria within 24 hours. While numerous interventions have been put into place to prevent malaria transmission, delays in diagnosis and treatment of Malaria when ill can lead to further mortality. Therefore, factors associated with delayed access of care among children under five with malaria and their outcomes need to be explored. Methods: A cross sectional study was carried out. The target population was parents/caretakers to children under five with malaria at Mbale Regional Referral Hospital. A consecutive sampling technique was used on the target population. Quantitative data was collected using researcher administered questionnaires designed consistent with the research objectives. Collected data was analyzed using STATA version 15. Results: Among the 216 children under five admitted at Mbale regional referral hospital with Malaria, 59.26% received care from a health facility 24 hours after symptom onset. The most significant predictors of delay in seeking care were the caregiver/ parent having attained tertiary education (AOR=7.1, p value=0.02) and initially implementing other measures other than giving medication/herbs before taking a child to the health center (AOR=4.1, p value=0.00). Conclusion: Despite the numerous interventions put into place to curb the spread of malaria and to manage malaria, delayed access of care remains a significant contributor to the adverse effects of malaria among children under five. Health education on the impact of delayed access of care should be intensified at all levels of healthcare.</jats:p>