Evaluating the uptake of the services of community health volunteers in managing malaria and Diahrhoea in children in Kisumu west sub county, Kisumu County

Abstract

Child mortality remains a public health burden in many settings in Africa including Kenya. In 2007, the Government of Kenya adopted community strategy to reverse the poor health outcomes and meet SDG 3. This strategy anticipates home visits by community health volunteers (CHV) to disseminate information and provide appropriate referrals. The under 5 mortality rate in Kisumu West Sub County is 45 per 1000 live births, with malaria and diarrhoea accounting for 40% of the deaths. Suboptimal healthcare worker density, and high prevalence of diarrhoea and malaria in Kisumu County necessitate the use of CHVs to enhance healthcare interventions. CHV programmes have however experienced challenges of acceptance, and resource shortage, compromising on their ability to deliver health for all. The study evaluated the association of the home visits and the utilisation of the interventions offered by the CHVs to prevent and manage malaria and diarrhoea in children. The study specifically sought to determine uptake of interventions offered by CHVs in prevention and basic management of malaria, to determine uptake of interventions offered by CHVs in prevention and basic management of diarrhoea, and to determine the role of CHVs in facilitating community dialogue and action days and the influence of these in promoting the uptake of interventions against malaria and diarrhoea in children in Kisumu West Sub County. This was a descriptive cross sectional study. A pre-tested semi structured questionnaire was administered to 398 randomly selected households from a population of 5721 households. The samples were derived from 5 community units. Key informant interviews was also conducted among community health assistants. The study reported that 31.2% of those who had been unwell consulted a CHV, 50% of those who experienced malaria symptoms were treated by a CHV as opposed to 32.8% of those who experienced diarrhoea symptoms. Additionally, 89.9% of caregivers reported that health education campaigns had been conducted in their communities. Binary logistic regression analysis reported significant associations on the distribution of mosquito nets (OR=0.174, 95%CI =0.097-0.311, p =0.001), drainage of pools (OR=0.212, 95%CI =0.053-0.853, p =0.029), malaria diagnosis and drugs given (OR=6.68, 95%CI =4.327-10.519, p =0.001) giving fluids to children experiencing diarrhoea (O R=0.249 95%CI =0.078-0.794, p =0.019), and taking caregivers through preparation of ORS (OR=0.348, 95%CI =0.200-0.605, p =0.001). This study concludes that CHVs are effective in offering health services in the community. The results inform primary care coordinators which interventions require improvement to enhance community health.