Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya
Introduction: Kenya adopted the World Health Organization’s recommendation of community case management of malaria (CCMM) in 2012. Trained community health volunteers (CHVs) provide CCMM but information on quality of services is limited. This study aimed to establish determinants of quality of serv...
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The Journal of Infection in Developing Countries
2021-07-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/13565 |
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| author | Enock Oburi Marita Richard Gichuki Elda Watulo Sylla Thiam Sarah Karanja |
| author_facet | Enock Oburi Marita Richard Gichuki Elda Watulo Sylla Thiam Sarah Karanja |
| author_sort | Enock Oburi Marita |
| collection | DOAJ |
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Introduction: Kenya adopted the World Health Organization’s recommendation of community case management of malaria (CCMM) in 2012. Trained community health volunteers (CHVs) provide CCMM but information on quality of services is limited. This study aimed to establish determinants of quality of service of CCMM conducted by CHVs.
Methodology: A cross-sectional survey was conducted in November 2016 in Bungoma County, Kenya. Data were collected through observing CHVs perform routine CCMM and through interviews of CHVs using structured questionnaires. A ≥ 75% score was considered as quality provision. Descriptive statistics were performed to describe basic characteristics of the study, followed by Chi-Square test and binary logistic regression to examine the differences and associations between the categorical variables.
Results: A total of 147 CHVs participated; 62% of CHVs offered quality services. There was a direct association between quality of services and stock-outs of artemether-lumefantrine (AL), stock-outs of malaria rapid diagnostic tests (RDT) and support supervision. CHVs who were supervised during the year preceding the assessment were four times more likely to perform better than those not supervised (uOR 4.2, 95% CI: 1.38-12.85). CHVs with reliable supplies of AL and RDT kits performed three times better than those who experienced stock outs (uOR = 3.2, 95% CI: 1.03-10.03 and 3.3, 95% CI: 1.63-6.59 respectively). Biosafety and documentation were the most poorly performed.
Conclusions: The majority of CHVs offered quality CCMM services despite safety gaps. Safety, continuous supplies of RDT, AL and supervision are essential for quality performance by CHV in delivering CCMM.
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| format | Article |
| id | doaj-art-da3fe7ddcce049858c79aa0e61dc43f7 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-da3fe7ddcce049858c79aa0e61dc43f72025-08-20T02:27:07ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-07-01150710.3855/jidc.13565Determinants of quality in home-based management of malaria by community health volunteers in rural KenyaEnock Oburi Marita0Richard Gichuki1Elda Watulo2Sylla Thiam3Sarah Karanja4Amref Health Africa in KenyaAmref Health Africa in KenyaDeutsche Stiftung Weltbevölkerung (DSW)Sunu Sante Consulting, Dakar, SenegalAmref Health Africa in Kenya Introduction: Kenya adopted the World Health Organization’s recommendation of community case management of malaria (CCMM) in 2012. Trained community health volunteers (CHVs) provide CCMM but information on quality of services is limited. This study aimed to establish determinants of quality of service of CCMM conducted by CHVs. Methodology: A cross-sectional survey was conducted in November 2016 in Bungoma County, Kenya. Data were collected through observing CHVs perform routine CCMM and through interviews of CHVs using structured questionnaires. A ≥ 75% score was considered as quality provision. Descriptive statistics were performed to describe basic characteristics of the study, followed by Chi-Square test and binary logistic regression to examine the differences and associations between the categorical variables. Results: A total of 147 CHVs participated; 62% of CHVs offered quality services. There was a direct association between quality of services and stock-outs of artemether-lumefantrine (AL), stock-outs of malaria rapid diagnostic tests (RDT) and support supervision. CHVs who were supervised during the year preceding the assessment were four times more likely to perform better than those not supervised (uOR 4.2, 95% CI: 1.38-12.85). CHVs with reliable supplies of AL and RDT kits performed three times better than those who experienced stock outs (uOR = 3.2, 95% CI: 1.03-10.03 and 3.3, 95% CI: 1.63-6.59 respectively). Biosafety and documentation were the most poorly performed. Conclusions: The majority of CHVs offered quality CCMM services despite safety gaps. Safety, continuous supplies of RDT, AL and supervision are essential for quality performance by CHV in delivering CCMM. https://jidc.org/index.php/journal/article/view/13565Community Case Management of MalariaCommunity Health VolunteersCHV Quality Service Provision |
| spellingShingle | Enock Oburi Marita Richard Gichuki Elda Watulo Sylla Thiam Sarah Karanja Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya Journal of Infection in Developing Countries Community Case Management of Malaria Community Health Volunteers CHV Quality Service Provision |
| title | Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya |
| title_full | Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya |
| title_fullStr | Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya |
| title_full_unstemmed | Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya |
| title_short | Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya |
| title_sort | determinants of quality in home based management of malaria by community health volunteers in rural kenya |
| topic | Community Case Management of Malaria Community Health Volunteers CHV Quality Service Provision |
| url | https://jidc.org/index.php/journal/article/view/13565 |
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