Knowledge and practice of health extension workers on drug provision for childhood illness in west Gojjam, Amhara, Northwest Ethiopia

Abstract

Background: The HEP was established decades ago to address preventive, promotive and selective curative services through Health Extension Workers (HEWs). However, knowledge and practice of HEWs on drug provision for childhood illnesses such as diarrhea, fever, and/or acute respiratory infection have not been well studied. This study aimed to assess the knowledge and practice of HEWs on drug provision for childhood illnesses. Methods: An institutional-based cross-sectional study was conducted among 389 rural HEWs. The districts were selected by using simple random sampling technique, and all the HEWs in the districts were included in the study. Bivariable and multivariable logistic regressions were performed to see the association between knowledge and practice of HEWs on drug provision with the response variables. Results: The study revealed that 57.5 and 66.8% of HEWs had good knowledge and practice on drug provision for childhood illnesses, respectively. Having college diploma (AOR = 5.59; 95% CI: 1.94, 16.11), 7-9 years (AOR = 2.7; 95% CI: 1.3, 5.5) and 10-12 years (AOR = 2.7; 95% CI: 1.4, 5.4) of experiences, being supervised quarterly (AOR = 0.24; 95% CI: 0.13, 0.47) and biannually (AOR = 0.11; 95% CI: 0.04, 0.30), and having national guideline (AOR = 0.22; 95% CI: 0.06, 0.90) were factors significantly associated with good knowledge. In addition, having college diploma (AOR =3.1; 95% CI: 1.1, 8.8), not receiving refreshment training (AOR = 0.31; 95% CI: 0.11, 0.91), being supervised biannually (AOR = 0.32, 95% CI: 0.13, 0.80), and not having national guideline (AOR = 0.16, 95% CI: 0.04, 0.60) were factors significantly associated with good practice. Conclusion: The study indicated that a considerable number of HEWs had poor knowledge and practice on drug provision. Socio-demographic factors such as educational status, and work experience; and health systems and support related factors such as training, supervision, and availability of national guidelines, and training had a significant association with HEWs' knowledge and practice on drug provision. Therefore, designing appropriate strategy and providing refreshment training, and improving supervision and availability of national guidelines for HEWs might improve the knowledge and practice of HEWs on drug provision.

Health postservice readiness and use of preventive and curative services for suspected childhood pneumonia in Ethiopia: a cross-sectional study

“…Inadequate preparedness and low service quality at the primary healthcare level reduce parents’ trust and utilisation of health services 11 19–21. In Ethiopia, the low utilisation of iCCM services was also attributed to absent supervision and refresher training of health extension workers 22–27. We have earlier shown that a substantial proportion of caregivers were not aware of pneumonia-related health services and, therefore, less likely to seek care when their children got sick or get their children immunised 28 29.…”

Implementation of the ‘Optimising the Health Extension Program’ Intervention in Ethiopia: A Process Evaluation Using Mixed Methods

“…We only have data from implementers' perspective, and it would be beneficial to have data from the HEWs themselves. In other studies, HEWs' lack of motivation has been due to a lack of skills and competing activities for which they were more closely monitored or supervised [35][36][37]. In line with this, a study that looked at implementation fidelity of initiatives to improve infant and young child feeding in Ethiopia reported that, while fidelity in the training of HEWs was high, gaps remained in cascading activities by HEWs to beneficiaries.…”

Perception of men perpetrators of violence about paternity

“…In the narratives, the male perception of a provider who spends his time working, ensuring the provision of food and clothing for his children contrasts with the necessity for interaction and, consequently, affective bonds, pointed out in studies in Brazil and Ethiopia, where gender stereotypes influence the male understanding of paternity and, therefore, describe models of paternal absence related to affective bonds (25)(26) . This perception of paternity, although not the only one existing in our society, is the most reported in other research and often the most reproduced among the male population.…”