Effects of community health volunteers on infectious diseases of children under five in Volta Region, Ghana: study protocol for a cluster randomized controlled trial

Abstract

BackgroundIn many low- and middle-income countries, community health volunteers (CHVs) are employed as a key element of the public health system in rural areas with poor accessibility. However, few studies have assessed the effectiveness of CHVs in improving child health in sub-Saharan Africa through randomized controlled trials. The present study aims to measure the impact of health promotion and case management implemented by CHVs on the health of under-5 children in Ghana.Methods/DesignThis study presents the protocol of a cluster-randomized controlled trial assessing the impacts of CHVs, in which the community was used as the randomization unit. A phase-in design will be adopted, and the intervention arm will be implemented in the intervention arm during the first phase and in the control arm during the second phase. The key intervention is the deployment of CHVs, who provide health education, provide oral rehydration solutions and zinc tablets to children with diarrhea, and diagnose malaria using a thermometer and a rapid diagnostic test kit during home visits. The primary endpoints of the study are the prevalence of diarrhea and fever/malaria in children under 5 years of age, as well as the proportion of affected children receiving case management for diarrhea and malaria. The first and second rounds of household surveys to collect data will be conducted in the first phase, and the final round will be conducted during the second phase.DiscussionWith growing attention paid to the roles of CHVs as an essential part of the community health system in low-income countries, this study will contribute valuable information to the body of knowledge on the effects of CHVs.Trial registration ISRCTN49236178. (June 16th, 2015)Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3991-z) contains supplementary material, which is available to authorized users.

Meteorological and social conditions contribute to infectious diarrhea in China

“…The positive influence of those factors may owe to their improvement of sanitation and hygiene, as infectious diarrhea could be easily caused by contaminated food 43 , 99 – 101 , bad sanitation environment 54 and poor health situation 45 , 46 . Those risk factors of infectious diarrhea can be mitigated by health intervene, like a good habit of hand washing 54 , 102 , appropriate food interventions 47 , 102 , a relatively rapid diagnose/solution 103 and more medical technicians 41 . Increasing the quantity of CDCP, HSI and HT provide more health education for public and more professional treatments of patients 103 , 104 .…”

“…Those risk factors of infectious diarrhea can be mitigated by health intervene, like a good habit of hand washing 54 , 102 , appropriate food interventions 47 , 102 , a relatively rapid diagnose/solution 103 and more medical technicians 41 . Increasing the quantity of CDCP, HSI and HT provide more health education for public and more professional treatments of patients 103 , 104 . Thus more resource of public health results in more effective diarrhea prevention.…”

Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts

“…Community members, specifically neighbours, family members, and friends, are other common sources of information in countries such as the Philippines, China, Mozambique, and Nigeria, where more than 70% of respondents to a recent survey identified them as key informants (Dawaki et al, 2015;Rassi et al, 2016;Ferlyn et al, 2015;Zeng et al, 2011). CHWs are generally defined as nonprofessional lay health workers, who are originally from the community, and who are requested to provide promotional, preventive, and sometimes even curative health care services to their own community (Ma et al, 2017). The use of CHWs in Nigeria to disseminate information on tuberculosis has improved overall knowledge and attitudes of the community about the disease (Balogun et al, 2015).…”

Evaluating the impact of community health volunteer home visits on child diarrhea and fever in the Volta Region, Ghana: A cluster-randomized controlled trial

“…We conducted a cluster-randomized controlled trial in 40 communities (villages) of the Ketu South District in the Volta Region, Ghana, between February 1, 2015 and September 20, 2016 (ISRCTN49236178) [14]. The baseline survey, and recruitment of caregivers (mother or primary female caregiver) and under-5 children, began on April 18, 2015, and the trial was registered on June 16, 2015.…”

“…The training also aimed to teach skills to properly conduct home visits and provide health education using 10 key messages, malaria tests using a rapid diagnostic test (RDT), ORS, and referral of patients to their supervisor. Refresher training was undertaken every month by the DHMT members and CHNs [14]. After the training, community leaders, together with DHMT officials, held community meetings to introduce the CHVs and to publicly declare the CHVs’ roles and position.…”