Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

Abstract

BackgroundThe government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors.MethodsThe main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area’s CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed.ResultsFactors significantly associated with a lower prevalence of diarrhea among children under five were the child’s increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea.ConclusionsAlthough this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on the community, as demonstrated and promoted by appropriate health-seeking behavior and treatment for childhood diarrhea.

Prevalence of Diarrhoeal Diseases Among Children under Five Years in East African Countries from 2012–2017

“…In Kenya, according to Kawakatsu et al (2017), a total of 278 mothers were participated in the study. Of the 278 participants, 150 (54%) children had acute diarrhoea.…”

“…Children between 1 to 2 years old addressed the age as a factor associated with diarrhoeal diseases (OR 5.8) (Kawakatsu et al 2017). Also, children who received other milk during the first six months of life (bottle feeding) also had occurrence of diarrhoea (OR 3.4) (Mohamed, et al 2016).…”

“…Caregivers who are not mothers of the children are a factor associated with the occurrence of diarrhoeal diseases (OR 3.5) (Kawakatsu et al 2017). The education level of the caregivers had an association with the occurrence of diarrhoea (Kawakatsu et al 2017).…”

“…The education level of the caregivers had an association with the occurrence of diarrhoea (Kawakatsu et al 2017). Illiterate caregivers usually do not understand that milk can expire fast after diluted with water especially in warm climates (OR 1.6) (Mohamed, et al 2016).…”

A case for community health programs for sickle cell anemia in low‐ to middle‐income countries: An integrative review

“…To enhance clarity, definitions of terminology are necessary. The consensus definition of “community health program” from the literature states that this type of program is located within the community and is established to address pressing health‐related issues with the use of community health workers and resource allocation (Amazigo et al., ; Awoonor‐Williams et al., ; Grills, Robinson, & Phillip, ; Kawakatsu, Tanaka, Ogawa, Ogendo, & Honda, ; Kc et al., ; Olayo, Wafula, Aseyo, Loum, & Kaseje, ; Smith, Loder, Xiquin, & Garcia, ). LMIC is used by the World Bank and denotes the gross national income per capita for a country (World Bank, ).…”