Abstract
BackgroundIn some areas of Uganda, village health workers (VHW) deliver Integrated Community Case Management (iCCM) care, providing initial assessment of children under 5 years of age as well as protocol-based treatment of malaria, pneumonia, and diarrhoea for eligible patients. Little is known about community perspectives on or satisfaction with iCCM care. This study examines usage of and satisfaction with iCCM care as well as potential associations between these outcomes and time required to travel to the household’s preferred health facility.MethodsA cross-sectional household survey was administered in a rural subcounty in western Uganda during December 2016, using a stratified random sampling approach in villages where iCCM care was available. Households were eligible if the household contained one or more children under 5 years of age.ResultsA total of 271 households across 8 villages were included in the final sample. Of these, 39% reported that it took over an hour to reach their preferred health facility, and 73% reported walking to the health facility; 92% stated they had seen a VHW for iCCM care in the past, and 55% had seen a VHW in the month prior to the survey. Of respondents whose households had sought iCCM care, 60% rated their overall experience as “very good” or “excellent,” 97% stated they would seek iCCM care in the future, and 92% stated they were “confident” or “very confident” in the VHW’s overall abilities. Longer travel time to the household’s preferred health facility did not appear to be associated with higher propensity to seek iCCM care or higher overall satisfaction with iCCM care.ConclusionsIn this setting, community usage of and satisfaction with iCCM care for malaria, pneumonia, and diarrhoea appears high overall. Ease of access to facility-based care did not appear to impact the choice to access iCCM care or satisfaction with iCCM care.
Highlights
In some areas of Uganda, village health workers (VHW) deliver Integrated Community Case Manage‐ ment care, providing initial assessment of children under 5 years of age as well as protocol-based treatment of malaria, pneumonia, and diarrhoea for eligible patients
Other studies have examined satisfaction with homebased fever or pneumonia management alone rather than Integrated Community Case Manage‐ ment (iCCM); one study in Ghana demonstrates that a majority of caregivers rated home-based management of fever by a VHW as “good” or “excellent” [3], while another study in Kenya describes caregivers’ expressed preference for home-based pneumonia care over facility-based care [4]
This study examines usage of and satisfaction with iCCM care overall, as well as respondents’ confidence in VHWs’ ability to manage each of the three conditions
Summary
In some areas of Uganda, village health workers (VHW) deliver Integrated Community Case Manage‐ ment (iCCM) care, providing initial assessment of children under 5 years of age as well as protocol-based treatment of malaria, pneumonia, and diarrhoea for eligible patients. VHWs deliver Integrated Community Case Management (iCCM) care, providing initial assessment. In 2014, an iCCM Child Health and Nutrition Research Initiative Advisory Group, in collaboration with the Community Case Management Operational Research Group, systematically identified “global research gaps and resource priorities for [iCCM]” [1]. A study in Pakistan of home-based pneumonia and diarrhoea care described very low use of and confidence in community health workers to provide care for these conditions [5]
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