Integrated community case management and community-based health planning and services: a cross sectional study onthe effectiveness of the national implementation for the treatment of malaria, diarrhoea and pneumonia

Malaria Journal

Research

Jayne Webster¹  Jane Bruce¹  Blanca Escribano Ferrer²  Margaret Gyapong³  Solomon A. Narh- Bana³  Constance Bart-Plange⁴  Roland Glover⁴  Keziah Malm⁴  Naa-KorKor Allotey⁴  Isabella Sagoe-Moses⁵  Clement T. Narh⁶ 

[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;Dodowa Health Research Center, Ghana Health Service, Dodowa, Ghana;Dodowa Health Research Center, Ghana Health Service, Dodowa, 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, Hohoe, Volta Region, Ghana;

关键词: Home-based care;    Community-based care;    Integrated community case management (iCCM);    Integrated management of childhood illness (IMCI);    Malaria;    Diarrhoea;    Pneumonia;    Children under-five;   

DOI  :  10.1186/s12936-016-1380-9

 received in 2016-02-11, accepted in 2016-06-09,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundGhana has developed two main community-based strategies that aim to increase access to quality treatment for malaria, diarrhoea and pneumonia: the Home-based Care (HBC) and the Community-based Health Planning and Services (CHPS). The objective was to assess the effectiveness of HBC and CHPS on utilization, appropriate treatment given and users’ satisfaction for the treatment of malaria, diarrhoea and pneumonia.MethodsA household survey was conducted 2 and 8 years after implementation of HBC in the Volta and Northern Regions of Ghana, respectively. The study population was carers of children under-five who had fever, diarrhoea and/or cough in the last 2 weeks prior to the interview. HBC and CHPS utilization were assessed based on treatment-seeking behaviour when the child was sick. Appropriate treatment was based on adherence to national guidelines and satisfaction was based on the perceptions of the carers after the treatment-seeking visit.ResultsHBC utilization was 17.3 and 1.0 % in the Volta and Northern Regions respectively, while CHPS utilization in the same regions was 11.8 and 31.3 %, with large variation among districts. Regarding appropriate treatment of uncomplicated malaria, 36.7 % (n = 17) and 19.4 % (n = 1) of malaria cases were treated with ACT under the HBC in the Volta and Northern Regions respectively, and 14.7 % (n = 7) and 7.4 % (n = 26) under the CHPS in the Volta and Northern Regions. Regarding diarrhoea, 7.6 % (n = 4) of the children diagnosed with diarrhoea received oral rehydration salts (ORS) or were referred under the HBC in the Volta Region and 22.1 % (n = 6) and 5.6 % (n = 8) under the CHPS in the Volta and Northern Regions. Regarding suspected pneumonia, CHPS in the Northern Region gave the most appropriate treatment with 33.0 % (n = 4) of suspected cases receiving amoxicillin. Users of CHPS in the Volta Region were the most satisfied (97.7 % were satisfied or very satisfied) when compared with those of the HBC and of the Northern Region.ConclusionsHBC showed greater utilization by children under-five years of age in the Volta Region while CHPS was more utilized in the Northern Region. Utilization of HBC contributed to prompt treatment of fever in the Volta Region. Appropriate treatment for the three diseases was low in the HBC and CHPS, in both regions. Users were generally satisfied with the CHPS and HBC services.

【 授权许可】

CC BY   
© The Author(s) 2016