Health Workers' and Managers' Perceptions of the Integrated Community Case Management Program for Childhood Illness in Malawi: The Importance of Expanding Access to Child Health Services

Callaghan-Koru, Jennifer A.; Hyder, Adnan A.; George, Asha; Gilroy, Kate; Nsona, Humphreys; Mtimuni, Angella; Bryce, Jennifer

doi:10.4269/ajtmh.2012.11-0665

Cited by 51 publications

(61 citation statements)

References 22 publications

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“…54 In the current study, the supply of amoxicillin was highly prioritized (with sufficient stock given to both facilities and CHWs) to limit stockouts and may have contributed to the perceived utility of these CHWs-they were able to perform the duties expected of them by the community.…”

Section: Discussionmentioning

confidence: 99%

Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study

Shaw

Asadhi

Owuor

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Integrated community case management (iCCM) programs that train lay community health workers (CHWs) in the diagnosis and treatment of diarrhea, malaria, and pneumonia have been increasingly adopted throughout subSaharan Africa to provide services in areas where accessibility to formal public sector health services is low. One important aspect of successful iCCM programs is the acceptability and utilization of services provided by CHWs. To understand community perceptions of the quality of care in an iCCM intervention in western Kenya, we used the Primary Care Assessment Survey to compare caregiver attitudes about the diagnosis and treatment of childhood pneumonia as provided by CHWs and facility-based health workers (FBHWs). Overall, caregivers rated CHWs more highly than FBHWs across a set of 10 domains that capture multiple dimensions of the care process. Caregivers perceived CHWs to provide higher quality care in terms of accessibility and patient relationship and equal quality care on clinical aspects. These results argue for the continued implementation and scale-up of iCCM programs as an acceptable intervention for increasing access to treatment of childhood pneumonia.

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Section: Discussionmentioning

confidence: 99%

Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study

Shaw

Asadhi

Owuor

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…In 2009, the IET conducted an assessment of the quality of care provided by HSAs through direct observation and reexamination by a gold-standard clinician 14. The assessment also included measurement of caregiver satisfaction with CCM services through a client exit interview and qualitative investigation of health workers perceptions of the CCM program 14,15. The assessment was conducted in six districts that were strong in early implementation, and results are not representative of all districts during that period, which had variable implementation.…”

Section: Methodsmentioning

confidence: 99%

Scaling Up Integrated Community Case Management of Childhood Illness: Update from Malawi

Nsona

Mtimuni

Daelmans

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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112

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The Government of Malawi (GoM) initiated activities to deliver treatment of common childhood illnesses (suspected pneumonia, fever/suspected malaria, and diarrhea) in the community in 2008. The service providers are Health Surveillance Assistants (HSAs), and they are posted nationwide to serve communities at a ratio of 1 to 1,000 population. The GoM targeted the establishment of 3,452 village health clinics (VHCs) in hard-to-reach areas by 2011. By September of 2011, 3,296 HSAs had received training in integrated case management of childhood illness, and 2,709 VHCs were functional. An assessment has shown that HSAs are able to treat sick children with quality similar to the quality provided in fixed facilities. Monitoring data also suggest that communities are using the sick child services. We summarize factors that have facilitated the scale up of integrated community case management of children in Malawi and address challenges, such as ensuring a steady supply of medicines and supportive supervision.

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“…To keep the population's confidence, CHWs may in response be tempted to adopt dangerous practices, such as administering antipyretics alone to febrile individuals. These elements support calls for carefully taking into consideration the needs of drug supply chain and the strengthening of local health systems when planning CCM interventions (Callaghan-Koru et al, 2012;Druetz et al, 2014).…”

Section: Factors Influencing the Presence Of Mechanismsmentioning

confidence: 99%

Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso

Druetz

Kadio

Haddad

et al. 2015

Social Science & Medicine

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The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers' performance is still under debate. Based on a realist perspective, a systematic review recently hypothesized that several mechanisms are associated with good performance and successful community interventions. In order to empirically investigate this hypothesis and confront it with the reality, we conducted a study in Burkina Faso, where in 2010 health authorities have implemented a national program introducing community case management of malaria. The objective was to assess the presence of the mechanisms in community health workers, and explore the influence of contextual factors. In 2012, we conducted semi-structured interviews with 35 community health workers from a study area established in two similar health districts (Kaya and Zorgho). Results suggest that they perceive most of the mechanisms, except the sense of being valued by the health system and accountability to village members. Analysis shows that drug stock-outs and past experiences of community health workers simultaneously influence the presence of several mechanisms. The lack of integration between governmental and non-governmental interventions and the overall socio-economic deprivation, were also identified as influencing the mechanisms' presence. By focusing on community health workers' agency, this study puts the influence of the context back at the core of the performance debate and raises the question of their ability to perform well in scaled-up anti-malaria programs.

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Health Workers' and Managers' Perceptions of the Integrated Community Case Management Program for Childhood Illness in Malawi: The Importance of Expanding Access to Child Health Services

Cited by 51 publications

References 22 publications

Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study

Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study

Scaling Up Integrated Community Case Management of Childhood Illness: Update from Malawi

Do community health workers perceive mechanisms associated with the success of community case management of malaria? A qualitative study from Burkina Faso

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