Abstract
Background. The efficacy of artemisinin-based combination therapy (ACT) and rectal artesunate for severe malaria in children is proven. However, acceptability of a package of interventions that included use of malaria rapid diagnostic tests (RDTs), ACTs, and rectal artesunate when provided by community health workers (CHWs) is uncertain. This study assessed acceptability of use of CHWs for case management of malaria using RDTs, ACTs, and rectal artesunate.Methods. The study was carried out in Burkina Faso, Nigeria, and Uganda in 2015 toward the end of an intervention using CHWs to provide diagnosis and treatment. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with parents of sick children, community leaders, and health workers to understand whether they accepted the package for case management of malaria using CHWs. Transcripts from FGDs and KII recordings were analyzed using content analysis. The findings were described, interpreted, and reported in the form of narratives.Results. Treatment of malaria using the CHWs was acceptable to caregivers and communities. The CHWs were perceived to be accessible, diligent, and effective. There were no physical, social, or cultural barriers to accessing the CHWs’ services. Respondents were extremely positive about the intervention and were concerned that CHWs had limited financial and nonfinancial incentives that would reduce their motivation and willingness to continue.Conclusions. Treatment of malaria using CHWs was fully accepted. CHWs should be compensated, trained, and well supervised.Clinical Trials Registration. ISRCTN13858170.
Highlights
MethodsThe study was carried out in Burkina Faso, Nigeria, and Uganda in 2015 toward the end of an intervention using community health workers (CHWs) to provide diagnosis and treatment
The efficacy of artemisinin-based combination therapy (ACT) and rectal artesunate for severe malaria in children is proven
Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with parents of sick children, community leaders, and health workers to understand whether they accepted the package for case management of malaria using community health workers (CHWs)
Summary
The study was carried out in Burkina Faso, Nigeria, and Uganda in 2015 toward the end of an intervention using CHWs to provide diagnosis and treatment. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with parents of sick children, community leaders, and health workers to understand whether they accepted the package for case management of malaria using CHWs. Transcripts from FGDs and KII recordings were analyzed using content analysis. In Nigeria, 33 randomly selected communities from 2 rural health districts of the Ona-Ara local government area (LGA) constituted the study sites. In Uganda, the study sites were Kayunga and Sheema, in the subcounties of Busaana and Kyangyenyi. In Burkina Faso, 45 villages were chosen in the health area of Sidéradougou, Mangodara District [17]
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