Treating fever in children under 5 years of age: caregiver perceptions of community health worker services in Dangme West district, Ghana

Abbey, Mercy; Bartholomew, L. Kay; Pappoe, Matilda; Borne, Bart van den

doi:10.1093/inthealth/ihv027

Cited by 5 publications

(7 citation statements)

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“…This means that CHW services have a high probability of being used if they are located closer to the communities they serve and this can be explained by the fact that proximity to the service provider has advantages including reduction in cost for transportation, waiting time and elimination of other costs associated with health seeking at health facilities; similar to findings reported by others [64] [ 10,22,39].…”

Section: Discussionsupporting

confidence: 72%

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Developing and implementing appropriate health communication messages for community based management of fevers

Abbey

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People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website.• The final author version and the galley proof are versions of the publication after peer review.• The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:

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Section: Discussionsupporting

confidence: 72%

“…Further, CHWs who are unable to adhere strictly to the patient -health worker confidentiality agreement will scare away prospective clients. The unavailability of CHWs when they are needed by community members also adversely affects the use of their services [12,30,33,39].…”

Section: General Introductionmentioning

confidence: 99%

Developing and implementing appropriate health communication messages for community based management of fevers

Abbey

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“…More than half, 59.4% of caregivers had used CHW services at least once for the management of fever in their under-fives. Further, caregivers who were exposed to the communication intervention were about four times more likely to use the services of the CHWs compared to those who were not exposed (OR = 3.79, 95% CI (2.62, 5.49)), ( P < 0.001) [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…In 2004, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) supported recommendations for the integrated community case management (ICCM) of common childhood illnesses that included malaria, pneumonia, and diarrhoea [ 7 ]. Following the recommendation, the Ghana Health Service implemented a randomized controlled trial in the Dangme West district to operationalize the approach of involving CHWs in the management of pneumonia at the community level and to assess the impact of the intervention on under – five mortality in the study district [ 16 – 19 ]. To complement this community- based trial, we adopted a systematic approach [ 20 ] to guide the planning of a multi- component health promotion program.…”

Section: Introductionmentioning

confidence: 99%

Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

et al. 2017

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BackgroundThis paper describes the development and implementation of a program to promote prompt and appropriate care seeking for fever in children under the age of five. Designed as a multicomponent program, the intervention comprises elements to influence the behavior of caregivers of children, Community Health Workers, professional health care providers and the wider community.MethodsFollowing the six fundamental steps of the Intervention Mapping protocol, we involved relevant stakeholders from the commencement of planning to program end. The IM protocol also recommends various behavior change methods to guide intervention development.ResultsThe intervention components implemented were successful in achieving program goals. For example, the intervention resulted in the primary outcome of reductions in all-cause mortality of 30% and 44%, among children treated with an antimalarial and those treated with the antimalarial plus an antibiotic respectively.Most Community Health Workers were retained on the program, with an attrition rate of 21.2% over a period of 30 months and the Community Health Workers rate of adherence to performance guidelines was high at 94.6%.ConclusionWe were able to systematically develop a theory- and evidence-based health promotion program based on the Intervention Mapping protocol. This article contributes to the response to recent calls for a more detailed description of the development of interventions and trials. The intervention mapping approach can serve as a guide for others interested in developing community- based health interventions in similar settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3957-1) contains supplementary material, which is available to authorized users.

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“…Increased utilization of CHWs in the management of malaria and other childhood infections has been comprehensively reported [ 14 – 21 ]. These reports suggest that properly supervised CHWs can lead to improved management of uncomplicated child fever cases in areas with limited health facilities, thereby reducing child mortality.…”

Section: Introductionmentioning

confidence: 99%

Temporal variation in confirmed diagnosis of fever-related malarial cases among children under-5 years by community health workers and in health facilities between years 2013 and 2015 in Siaya County, Kenya

Apat

Gachohi

Karama

et al. 2017

Malar J

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BackgroundMalaria case management continues to experience dynamic changes. Building community capacity is instrumental in both prevention and treatment of malaria. The World Health Organization (WHO) recommends utilization of well-trained and supervised community health workers (CHWs) to reduce the burden of malaria deaths among children under-5 years of age in Africa. Longitudinally-tracked information on utilization of CHWs by communities in terms of trends in diagnosis of malaria in children under-5 years of age is essential in influencing national and local malaria control policies and strategies.MethodsA desktop review was carried out of a database consisting of confirmed uncomplicated malaria cases in 10 villages using CHWs and out-patient departments of 10 health facilities in children under-five for the period of 3 years between January 2013 and December 2015. Analyses of association between the diagnosed cases and satellite-based rainfall, village and time (months and years) were carried out using a Poisson regression model.ResultsAnalysis of malaria diagnoses made by CHWs showed the following trends: (i) the incidence of reported documented malaria-positive fever cases increased with time (2013–2015) and the difference over the years was statistically significant (P < 0.001), (ii) specific village was significantly associated (P < 0.001) with reporting malaria-positive fever cases, (iii) the long-term monthly sequence starting from highest to lowest incidence of reported malaria-positive fever cases was July, May and June, March, August, April, September, November, and February, October and, finally, January, and the difference in reported malaria-positives between the months was statistically significant (P = 0.001) and (iv) none of the tested rainfall regimes (current, lagged or cumulative) was associated with reported malaria-positive fever cases during the 3-year period (P > 0.1). Looking at the number of diagnoses made at the health facilities, (i) The number of reported malaria-positive fever cases decreased with time (2013–2015) and the difference among the years was not statistically significant (P = 0.399), (ii) The long-term monthly sequence starting from highest to lowest number of reported malaria-positive fever cases was July, June, May, April, January, August, March, February, September, November, October and December, and the difference between the months was statistically significant (P < 0.001).ConclusionsCHWs have the potential to play a major role in diagnosing and treating malaria, thereby decreasing under-five children mortality. Temporally, the risk of diagnosing malaria seems predictable and this may present opportunities for policy-targeted malaria preparedness and control. The findings are expected to support policy actions that may scale-up community health services in remote rural settings.

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Treating fever in children under 5 years of age: caregiver perceptions of community health worker services in Dangme West district, Ghana

Cited by 5 publications

References 25 publications

Developing and implementing appropriate health communication messages for community based management of fevers

Developing and implementing appropriate health communication messages for community based management of fevers

Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

Temporal variation in confirmed diagnosis of fever-related malarial cases among children under-5 years by community health workers and in health facilities between years 2013 and 2015 in Siaya County, Kenya

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