Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone
| Autor: | William R. Brieger, Augustin Kabano, Fatu Yumkella, Peter Bangura, Lawrence H. Moulton, Alyssa Sharkey, Aisha I. Yansaneh, Theresa Diaz, Asha George |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Diarrhea Male Volunteers Health (social science) Adolescent 030231 tropical medicine Population Context (language use) Sierra Leone Sierra leone Interviews as Topic Young Adult 03 medical and health sciences 0302 clinical medicine Environmental health Health care Humans Medicine 030212 general & internal medicine education Qualitative Research Community Health Workers education.field_of_study business.industry Child Health Public Health Environmental and Occupational Health Infant Focus Groups Middle Aged Health Surveys Focus group Malaria Cross-Sectional Studies Child Preschool Community health Female Rural Health Services Rural area business Utilization rate |
| Zdroj: | Journal of Community Health. 41:376-386 |
| ISSN: | 1573-3610 0094-5145 |
| DOI: | 10.1007/s10900-015-0107-0 |
| Popis: | In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone. |
| Databáze: | OpenAIRE |
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