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Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya
BACKGROUND: Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ubiquity Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333163/ https://www.ncbi.nlm.nih.gov/pubmed/30651723 http://dx.doi.org/10.5334/ijic.3971 |
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author | Shiroya-Wandabwa, Makeba Kabue, Mark Kasungami, Dyness Wambua, Jonesmus Otieno, Dan Waka, Charles Ngindu, Augustine Ayuyo, Christine Kigondu, Sanyu Oliech, Julius Malonza, Isaac |
author_facet | Shiroya-Wandabwa, Makeba Kabue, Mark Kasungami, Dyness Wambua, Jonesmus Otieno, Dan Waka, Charles Ngindu, Augustine Ayuyo, Christine Kigondu, Sanyu Oliech, Julius Malonza, Isaac |
author_sort | Shiroya-Wandabwa, Makeba |
collection | PubMed |
description | BACKGROUND: Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya. METHODS: A pre-test/post-test single-group design was used to assess changes in knowledge and skills related to integrated community case management (iCCM) among 58 Community Health Volunteers who received a six-day iCCM clinical training and an additional 3-week clinical coaching at health facilities. Thereafter, community health extension workers and health managers provided supportive supervision over a six-month period. Skills were assessed before the six-day training, during coaching, and after six months of iCCM implementation. RESULTS: CHVs knowledge assessment scores improved from 54.5% to 72.9% after the six-day training (p < 0.001). All 58 CHVs could assess and classify fever and diarrhoea correctly after 3–6 weeks of facility-based clinical coaching; 97% could correctly identify malnutrition and 80%, suspected pneumonia. The majority correctly performed four of the six steps in malaria rapid diagnostic testing. However, only 58% could draw blood correctly and 67% dispose of waste correctly after the testing. The proportion of CHV exhibiting appropriate skills to examine for signs of illness improved from 4% at baseline to 74% after 6 months of iCCM implementation, p < 0.05. The proportion of caregivers in intervention community units who first sought treatment from a CHV increased from 2 to 31 percent (p < 0.001). CONCLUSIONS: Training and clinical coaching built CHV’s skills to manage common childhood illnesses. The CHVs demonstrated ability to follow the Kenya iCCM algorithm for decision-making on whether to treat or refer a sick child. The communities’ confidence in CHVs’ ability to deliver integrated case management resulted in modification of care-seeking behaviour. |
format | Online Article Text |
id | pubmed-6333163 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Ubiquity Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-63331632019-01-16 Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya Shiroya-Wandabwa, Makeba Kabue, Mark Kasungami, Dyness Wambua, Jonesmus Otieno, Dan Waka, Charles Ngindu, Augustine Ayuyo, Christine Kigondu, Sanyu Oliech, Julius Malonza, Isaac Int J Integr Care Research and Theory BACKGROUND: Shortages of healthcare workers is detrimental to the health of communities, especially children. This paper describes the process of capacity building Community Health Volunteers (CHVs) to deliver integrated preventive and curative package of care of services to manage common childhood illness in hard-to-reach communities in Bondo Subcounty, Kenya. METHODS: A pre-test/post-test single-group design was used to assess changes in knowledge and skills related to integrated community case management (iCCM) among 58 Community Health Volunteers who received a six-day iCCM clinical training and an additional 3-week clinical coaching at health facilities. Thereafter, community health extension workers and health managers provided supportive supervision over a six-month period. Skills were assessed before the six-day training, during coaching, and after six months of iCCM implementation. RESULTS: CHVs knowledge assessment scores improved from 54.5% to 72.9% after the six-day training (p < 0.001). All 58 CHVs could assess and classify fever and diarrhoea correctly after 3–6 weeks of facility-based clinical coaching; 97% could correctly identify malnutrition and 80%, suspected pneumonia. The majority correctly performed four of the six steps in malaria rapid diagnostic testing. However, only 58% could draw blood correctly and 67% dispose of waste correctly after the testing. The proportion of CHV exhibiting appropriate skills to examine for signs of illness improved from 4% at baseline to 74% after 6 months of iCCM implementation, p < 0.05. The proportion of caregivers in intervention community units who first sought treatment from a CHV increased from 2 to 31 percent (p < 0.001). CONCLUSIONS: Training and clinical coaching built CHV’s skills to manage common childhood illnesses. The CHVs demonstrated ability to follow the Kenya iCCM algorithm for decision-making on whether to treat or refer a sick child. The communities’ confidence in CHVs’ ability to deliver integrated case management resulted in modification of care-seeking behaviour. Ubiquity Press 2018-10-24 /pmc/articles/PMC6333163/ /pubmed/30651723 http://dx.doi.org/10.5334/ijic.3971 Text en Copyright: © 2018 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Research and Theory Shiroya-Wandabwa, Makeba Kabue, Mark Kasungami, Dyness Wambua, Jonesmus Otieno, Dan Waka, Charles Ngindu, Augustine Ayuyo, Christine Kigondu, Sanyu Oliech, Julius Malonza, Isaac Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title | Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title_full | Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title_fullStr | Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title_full_unstemmed | Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title_short | Coaching Community Health Volunteers in Integrated Community Case Management Improves the Care of Sick Children Under-5: Experience from Bondo, Kenya |
title_sort | coaching community health volunteers in integrated community case management improves the care of sick children under-5: experience from bondo, kenya |
topic | Research and Theory |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333163/ https://www.ncbi.nlm.nih.gov/pubmed/30651723 http://dx.doi.org/10.5334/ijic.3971 |
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