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マラリアの制御と撲滅

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Acceptability and Utilization of Community Health Workers after the Adoption of the Integrated Community Case Management Policy in Kabarole District in Uganda

Abstract

Muhumuza Gerald, Mutesi Caroline, Mutamba Fred, Ampuriire Patience  and Nangai Charles

Background Malaria, pneumonia and diarrhea remains to be the major causes of morbidity and mortality among children in Uganda. To address such challenges, the government adopted a national policy on Integrated Community Case Management (ICCM) for malaria, pneumonia and diarrhea in 2010. The aim of this study was to assess household access, utilization and acceptability of ICCM services in Kabarole District. Methods A cross sectional household survey was conducted amongst caretakers of children below 5 years of age and a total of 384 respondents were interviewed about distance from nearest health facility and community health worker, socio-demographic characteristics, type of housing, history of fever, health-seeking behavior, perceptions of quality and utilization of ICCM services. Data was cleaned, coded and analysed using STATA 14.0 to produce results. Results Most 53.1% of the studied children were males and their age ranged from 1-52 months. Nearly all the care takers, 97.1% (373/384) had utilized health services for their children in the three proceeding months to the study and only 27.3% (102/373) had utilized ICCM services. Trust in CHWs (AOR 0.85, 95%CI [0.641-1.135]), level of awareness (AOR 0.73, 95%CI [0.538-0.979]) and distance (≤1km) to CHWs (AOR 1.65, 95%CI [1.075-2.522]) are positively associated with the utilisation of ICCM services. Conclusion The implementation of ICCM policy in kabarole has been an effective approach in increasing the utilization of malaria, diarrhea and pneumonia treatment services and hence increasing access to health services at community level. Trust in the CHWs, level of community awareness and distance to the CHWs are positively associated with the utilisation of ICCM services

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