scholarly journals Implementation of community case management of malaria in malaria endemic counties of western Kenya: are community health volunteers up to the task in diagnosing malaria?

2021 ◽  
Author(s):  
Enock Oburi Marita ◽  
Bernard Langat ◽  
Teresa Kinyari ◽  
Patrick Igunza ◽  
Donald Apat ◽  
...  
Keyword(s):  
Case Management ◽  
Community Health ◽  
Malaria Diagnosis ◽  
Medical Laboratory ◽  
Cluster Sampling ◽  
Community Case Management ◽  
Kappa Score ◽  
Perfect Agreement ◽  
Predictive Values ◽  
Community Health Volunteers

Abstract BackgroundCommunity case management of malaria (CCMm) is an equity-focused strategy that complements and extends the reach of health services by providing timely and effective management of malaria to populations with limited access to facility-based healthcare. In Kenya, CCMm involves the use of malaria rapid diagnostic tests (mRDT) and treatment of confirmed uncomplicated malaria cases with artemether lumefantrine (AL) by community health volunteers (CHVs). The test positivity rate (TPR) from CCMm reports collected by the Ministry of Health in 2018 was twofold compared to facility-based reports for the same period. This necessitated the need to evaluate the performance of CHVs in conducting malaria RDTs.MethodThe study was conducted in four counties within the malaria lake endemic zone in Kenya with a malaria prevalence in 2018 of 27%; the national prevalence of malaria was 8%. Multi-stage cluster sampling and random selection were used. Results from 200 malaria RDTs performed by CHVs were compared with test results obtained by experienced medical laboratory technicians (MLT) performing the same test under the same conditions. Blood slides prepared by the MLTs were examined microscopically later as a backup check of the results. A kappa score was calculated to assess level of agreement. Sensitivity, specificity, positive and negative predictive values were calculated to determine diagnostic accuracy.ResultsThe median age of CHVs was 46 (IQR: 38, 52) with a range [26, 73] years. Females were 72% of the CHVs. Test positivity rates for MLTs was 42% and for CHVs was 41%. The kappa score was 0.89 indicating an almost perfect agreement in mRDT results between CHVs and MLTs. The overall sensitivity and specificity between the CHVs and MLTs were 95.0% (95% CI: (87.7, 98.6) and 94.0% (95% CI; 88.0, 97.5) respectively.ConclusionEngaging CHVs to diagnose malaria cases under CCMm yielded results which compared well with results of qualified experienced laboratory personnel. CHVs can reliably continue to offer malaria diagnosis in the community setting.

scholarly journals Determinants of quality in home-based management of malaria by community health volunteers in rural Kenya

2021 ◽  
Vol 15 (07) ◽  
pp. 897-903
Author(s):  
Enock Oburi Marita ◽  
Richard Gichuki ◽  
Elda Watulo ◽  
Sylla Thiam ◽  
Sarah Karanja
Keyword(s):  
Community Health ◽  
World Health ◽  
Categorical Variables ◽  
Quality Of Services ◽  
Community Case Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Community Health Volunteers ◽  
Better Than

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.

scholarly journals Contribution of Community Health Workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.

2021 ◽  
Author(s):  
Fred Bagenda ◽  
Andrew Christopher Wesuta ◽  
Geren Stone ◽  
Moses Ntaro ◽  
Palka Patel ◽  
...  
Keyword(s):  
Case Management ◽  
Community Health ◽  
Community Health Workers ◽  
Management Strategy ◽  
Health Workers ◽  
Community Case Management ◽  
Integrated Community Case Management ◽  
Children Under Five ◽  
Under Five ◽  
Common Illnesses

Abstract Introduction The control of malaria, pneumonia, and diarrhea is important for the reduction in morbidity and mortality among children under five years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers to address this challenge. The extent and trend of these three conditions managed by the Community Health Workers are not well documented. This study was done to document Community Health Workers’ contribution towards treatment and the trends of the three common illnesses in Bugoye Sub-County in rural Uganda.

scholarly journals Needs Assessment of Community Health Workers to enhance efficient delivery of their services for Community Case Management of Malaria in Kenya

2021 ◽  
Author(s):  
Michelle D. S. Boakye ◽  
Collins J. Owek ◽  
Elizabeth Oluoch ◽  
Sefa Bonsu Atakora ◽  
Juddy Wachira ◽  
...  
Keyword(s):  
Case Management ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Community Case Management ◽  
Group Discussions ◽  
Key Informants ◽  
Efficient Delivery ◽  
Study Participants ◽  
Depth Interviews

Abstract BackgroundMalaria continues to be the leading cause of morbidity and mortality in Africa. Community Case Management of malaria (CCMm) through engaging Community Health Workers (CHWs) to effectively address management of malaria cases in some endemic communities was explored in this study. We assessed the needs of CHWs that would help sustain and retain their services to enhance the efficient delivery of CCMm. MethodsData on the needs of CHWs was gathered through a qualitative study consisting of in-depth interviews and focus group discussions (FGDs) conducted among study participants in five districts in western Kenya using a semi-structured questionnaire. The study participants comprised of 100 CHWs, 100 mothers of children under five years and 25 key informants made up of public health officers and clinicians involved in the CCMm. The interviews were conducted in English and Swahili or Dholuo, the local language. The recorded audio interviews were transcribed later. The analysis was done using NVivo version 7 software and transcripts were coded after which themes related to the objectives of the study were identified.ResultsAll the study participants recognized the need to train and update CHWs on their work as well as remunerating them for their services to enhance efficient delivery of services. The CHWs on their part perceived the provision of gloves, RDTs, lancets, cotton wool and ethanol, bins (to dispose of RDTs and lancets), together with drugs for treating clients as their essential needs to undertake CCMm in the communities. Other logistical needs and incentives mentioned by CHWs and key informants for the successful delivery of CCMm included: gumboots, raincoats, torch lights, mobile phones, means of transportation (bicycles and motorbikes), uniforms and ID cards for identification. ConclusionCHWs would perform tasks better and their services retained for a sustainable CCMm if properly incentivized, offered refresher trainings (and updates) on malaria and equipped with the requisite tools identified in this study.

scholarly journals Drugs for some but not all: inequity within community health worker teams during introduction of integrated community case management

2014 ◽  
Vol 14 (Suppl 1) ◽  
pp. S1 ◽  
Author(s):  
Hannah Faye G Mercader ◽  
Teddy Kyomuhangi ◽  
Denise L Buchner ◽  
Jerome Kabakyenga ◽  
Jennifer L Brenner
Keyword(s):  
Case Management ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Community Case Management ◽  
Integrated Community Case Management
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