FACTORS INFLUENCING THE UTILIZATION OF MALARIA HOME-BASED MANAGEMENT IN KICUKIRO DISTRICT, RWANDA

Abstract

Malaria is still one of the most critical cause of deaths globally each year. The year of 2020 was marked by the report of 627,000 deaths and 241 million cases due to malaria. Malaria home-based management (MHBM) progress was hampered while malaria-carrying vectors are still dominant with malaria incidence increase in Rwanda. This study aimed to assess the factors associated with the utilization of MHBM program among the study participants in Kicukiro District. This cross-sectional study design included 312 study respondents who were trained community health workers and their respective health care seekers (people with malaria or febrile sick children). This sample size was obtained by Yamane sample size formula. Univariate, bivariate, and multivariate data analysis were conducted with SPSS 21 version. The significance was accepted at a p-value of 0.05 with 95%CI. Overall findings revealed that the Household MHBM high utilization was (55.8%) while 44.2% had low level of MHBM utilization among study participants in Kicukiro District. Having three or more children, seeking malaria home-based treatment to the CHWs you really know, using nearest CHW were significantly associated with the MHBM with AoR=3.133, 95% CI=1.692-5.810 and p <0.001; AoR=2.2, 95% CI= 1.202-4.223, p<0.001; AoR =4.9, 95%CI= 2.043-7.103, p<0.001. Additionally, having required materials to ease the work of CHWs which may let MHBM service seekers come, MHBM daily schedule, usual work of the CHWs which doesn’t conflict with MHBM were highly and significantly associated with MHBM utilization. Their respective adjusted odd ratios were: AoR=4.472,95% CI=2.614-9.555, p=0.007; AoR=8.787,95% CI=4.045-14.592<0.001; AoR=6.362, 95% CI, 2.252-11.158, p<0.001. This study concluded that strengthening the community health workers requires four essential strategic components. The training of community health workers to reach out the community in their respective operation areas, improving their social connection, constant reviewing and refill their required materials and finally, planning improvement in their service delivery.