Abstract
Objective:Appropriate performance of home visits facilitates adoption of best practices at home and increased demand for facility based services.Methods:It was a cross-sectional study in which community health workers were observed conducting home visits during pregnancy. Data was collected using a structured questionnaire and the Consultant Quality Index (CQI-2 tool) on record keeping, use of job aids, counselling, client satisfaction and client enablement. Descriptive and inferential statistics were used. Relationships were determined using chi square and odds ratios.Results:The study showed significant relationships of age with good record keeping (p = 0.0001), appropriate use of job aids (p=0.0001), client satisfaction (p = 0.018) and client enablement (p = 0.001). Male CHWs were 1.6 times more likely to keep better records than females (OR 1.64 CI (1.02-2.63), while females were more likely to counsel and enable their clients OR 0.42 CI (0.25-0.71) and OR 0.29 CI (012-070) respectively when compared to men. Moreover, higher levels of education were associated with good record keeping OR 0.30 CI (0.19-0.49), p=0.0001; appropriate use of job aids OR 0.30 CI (0.15-0.61) and to appropriately counsel their clients OR 0.34 CI (0.20-0.58) than their lower literacy level counterparts. Experience of CHWs was associated with appropriate use of job aids (p = 0.049); client satisfaction (p = 0.0001) and client enablement (p = 0.032).Conclusions:Socio-demographic characteristics of community health workers affect the performance of home visits in various ways. The study also confirmed that CHWs with lower literacy levels satisfy and enable their clients effectively.
Highlights
This study investigated the effect of selected socio-demographic characteristics on the performance of home visits by Community Health workers (CHWs)
The results show no association between education level of CHWs and client satisfaction (p = 0.057) and client enablement (p = 0.726)
Sex, level of education, and experience of the community health workers affected the performance of record keeping, use of job aids, counselling on care during pregnancy, client satisfaction and client enablement
Summary
The study was undertaken in Funyula and Butula divisions of Busia District, Kenya. Busia District is south of the equator in Western Province and borders Uganda to the West. This is the area where the Division of Child and Adolescent Health conducted a pilot study on community based maternal and newborn care through the community strategy in collaboration with the African Medical and Research Foundation (AMREF)
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