Effectiveness of two community-based strategies on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia in Ghana

BMC Public Health

Research Article

Jayne Webster¹  Jane Bruce¹  Blanca Escribano-Ferrer²  Solomon A. Narh Bana³  Margaret Gyapong⁴  Charity Azantilow⁵  Constance Bart-Plange⁵  Roland Glover⁵  Naa-Korkor Allotey⁵  Isabella Sagoe-Moses⁶  Clement T. Narh⁷ 

[1] Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK;Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK;Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana;Dodowa Health Research Center, Ghana Health Service, Dodowa, Ghana;Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana;National Malaria Control Programme, Ghana Health Service, Accra, Ghana;Reproductive and Child Health Department, Ghana Health Service, Accra, Ghana;School of Public Health, University of Health and Allied Sciences, Ho, Volta Region, Ghana;

关键词: Home- based care;    Integrated community case management (iCCM);    Integrated Management of Childhood Illness (IMCI);    Malaria;    Diarrhoea;    Pneumonia;    Children under- five;    Prevention;    Health promotion;   

DOI  :  10.1186/s12889-017-4964-6

 received in 2017-05-04, accepted in 2017-11-29,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundGhana has developed two community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and suspected pneumonia, and to improve household and family practices: integrated Community Case Management (iCCM) and Community-based Health Planning and Services (CHPS). The objective of the study was to assess the effectiveness of iCCM and CHPS on disease knowledge and health behaviour regarding malaria, diarrhoea and pneumonia.MethodsA household survey was conducted two and eight years after implementation of iCCM in the Volta and Northern Regions of Ghana respectively, and more than ten years of CHPS implementation in both regions. The study population included 1356 carers of children under- five years of age who had fever, diarrhoea and/or cough in the two weeks prior to the interview. Disease knowledge was assessed based on the knowledge of causes and identification of signs of severe disease and its association with the sources of health education messages received. Health behaviour was assessed based on reported prompt care seeking behaviour, adherence to treatment regime, utilization of mosquito nets and having improved sanitation facilities, and its association with the sources of health education messages received.ResultsHealth education messages from community-based agents (CBAs) in the Northern Region were associated with the identification of at least two signs of severe malaria (adjusted Odds Ratio (OR) 1.8, 95%CI 1.0, 3.3, p = 0.04), two practices that can cause diarrhoea (adjusted OR 4.7, 95%CI 1.4, 15.5, p = 0.02) 0and two signs of severe pneumonia (adjusted OR 7.7, 95%CI2.2, 26.5, p = 0.01)-the later also associated with prompt care seeking behaviour (p = 0.04). In the Volta Region, receiving messages on diarrhoea from CHPS was associated with the identification of at least two signs of severe diarrhoea (adjusted OR 3.6, 95%CI 1.4, 9.0), p = 0.02). iCCM was associated with prompt care seeking behaviour in the Volta Region and CHPS with prompt care seeking behaviour in the Northern Region (p < 0.5).ConclusionsBoth iCCM and CHPS were associated with disease knowledge and health behaviour, but this was more pronounced for iCCM and in the Northern Region. HBC should continue to be considered as the strategy through which community-IMCI is implemented.

【 授权许可】

CC BY   
© The Author(s). 2017