Institutional support to community health workers using integrated management of childhood illness program in Rwanda
DOI:
https://doi.org/10.5216/ree.v23.61603Keywords:
Community Health Workers, Integrated Management of Childhood Illness, RwandaAbstract
The objective was to explore the support given to community health workers who use the integrated management of childhood illness (IMCI) approach and describe the supervision given to them. A non-experimental, exploratory, descriptive, quantitative design was used for this study. Data were collected using a structured questionnaire; 305 were interviewed (30% sample). The data were double entered, cleaned, and analyzed using Statistics Package of Social Sciences (SPSS) 19. Support and supervision in Rwanda are provided by the base institution and by supervisors. CHWs often had a shortage of drugs and equipment (63.3%) and 87.5% have experienced run out of equipment, medicines, and consumables. This created barriers to caring for sick children. To improve institutional support for community health workers, regular and continuous supportive supervision and supplies are essential.
Downloads
References
You D, Hug L, Ejdemyr S, Idele P, Hogan D, Mathers C, et al. Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation. Lancet [Internet]. 2015 [cited 2021 dec 02];386(10010):2275-86. Available from: https://doi.org/10.1016/S0140-6736(15)00120-8.
Boschi-Pinto C, Dilip TR, Costello A. Association between community management of pneumonia and diarrhoea in high-burden countries and the decline in under-five mortality rates: an ecological analysis. BMJ Open [Internet]. 2017 [cited 2021 dec 02];7(2):e012639. Available from: http://dx.doi.org/10.1136/bmjopen-2016-012639.
Manzi A, Mugunga JC, Iyer HS, Magge H, Nkikabahizi F, Hirschhorn LR. Economic evaluation of a mentorship and enhanced supervision program to improve quality of integrated management of childhood illness care in rural Rwanda. PLoS ONE [Internet]; 2018 [cited 2021 dec 02];13(3): e0194187. Available from: https://doi.org/10.1371/journal.pone.0194187.
Ministry of Health, Republic of Rwanda. Fourth health sector strategic plan July 2018 – June 2024 [Internet]. Kigali: Ministry of Health (RW); 2018 [cited 2021 dec 02]. Available from: https://www.childrenandaids.org/sites/default/files/2018-05/Rwanda_Nat%20Health%20Sector%20Plan_2018-2024.pdf.
Bigirimana JB. Timely access to maternal, neonatal and child healthcare for rural communities in Rwanda: the role of community health workers [dissertation]. Ontario (CA): University of Western Ontario Electronic; 2019 [cited 2021 dec 02]. Available from: https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=8792&context=etd.
Musabyimana A, Ruton H, Gaju E, Berthe A, Grépin KA, Ngenzi J, et al. Assessing the perspectives of users and beneficiaries of a community health worker mHealth tracking system for mothers and children in Rwanda. PLoS ONE [Internet]. 2018 [cited 2021 dec 02];13(6):e0198725. Available from: https://doi.org/10.1371/journal.pone.0198725.
Sartorius B, Sartorius K, Green R, Lutge E, Scheelbeek P, Tanser F, et al. Spatial-temporal trends and risk factors for undernutrition and obesity among and obesity among children (<5 years) in South Africa, 2008-2017: findings from a nationally representative longitudinal panel survey. BMJ Open [Internet]. 2020 [cited 2021 dec 02];10(4):e034476. Available from: https://doi.org/10.1136/bmjopen-2019-034476.
Amouzou A, Hazel E, Shaw B, Miller NP, Tafesse M, Mekonnen Y, et al. Effects of the integrated community case management of childhood illness strategy on child mortality in Ethiopia: a cluster randomized trial. Am J Trop Med Hyg [Internet]. 2016 [cited 2021 dec 02];94(3):596-604. Available from: https://doi.org/10.4269/ajtmh.15-0586.
Black RE, Taylor CE, Arole S, Bang A, Bhutta ZA, Chowdhury AMR, et al. Comprehensive review of the evidence regarding the effectiveness of community–based primary health care in improving maternal, neonatal and child health: 8. summary and recommendations of the Expert Panel. J Glob Health [Internet]. 2017 [cited 2021 dec 02];7(1):010908. Available from: https://doi.org/10.7189/jogh.07.010908.
Oliphant NP, Manda S, Daniels K, Odendaal WA, Besada D, Kinney M, et al. Integrated community case management of childhood illness in low- and middle-income countries. Cochrane Database Syst Rev [Internet]. 2021 [cited 2021 dec 02];2(2):CD012882. Available from: https://doi.org/10.1002/14651858.CD012882.pub2.
Nass SS, Isah MB, Sani A. Effect of integrated supportive supervision on the quality of health-care service delivery in Katsina state, Northwest Nigeria. Health Serv Res Manag Epidemiol [Internet]. 2019 [cited 2021 dec 02];6: 2333392819878619. Available from: https://doi.org/10.1177/2333392819878619.
Bosch‐Capblanch X, Garner PA. Primary health care supervision in developing countries. Trop Med Int Health [Internet]. 2008 [cited 2021 dec 02];13(3):369-83. Available from: https://doi.org/10.1111/j.1365-3156.2008.02012.x.
Hussein S, Farhood H. Assessment of knowledge and practical skills among integrated management of neonatal and childhood illness program healthcare personnel in primary healthcare centers. Medical Journal of Babylon [Internet]. 2019 [cited 2021 dec 02];16(4):351-6. Available from: https://doi.org/10.4103/mjbl.mjbl_50_19.
Moridiyat OAA. The role of supportive supervision in enhancing and sustaining health education in home management and prevention of malaria among mothers of under-five children. International Journal of Nursing and Midwifery [Internet]. Academic Journals; 2017 May 30;9(5):53-7. Available from: https://doi.org/10.5897/ijnm2017.0260.
Reñosa MD, Dalglish S, Bärnighausen K, McMahon S. Key challenges of health care workers in implementing the integrated management of childhood illnesses (IMCI) program: a scoping review. Glob Health Action [Internet]. 2020 [cited 2021 dec 02];13(1):1732669. Available from: https://doi.org/10.1080/16549716.2020.1732669.
Olaniran A, Madaj B, Bar-Zev S, Broek NVD. The roles of community health workers who provide maternal and newborn health services: case studies from Africa and Asia BMJ Global Health 2019;4:e001388. Available from: https://doi.org/10.1136/bmjgh-2019-001388.
Knoema. Ruanda - Taxa de mortalidade infantile [Internet]. New York: Knoema Corporation; c2021 [cited 2021 dec 02]. Available from: https://knoema.com/atlas/Rwanda/topics/Demographics/Mortality/Infant-mortality-rate.
National Institute of Statistics of Rwanda; Ministry of Finance and Economic Planning; Ministry of Health; The DHS Program, ICF International. Rwanda Demographic and Health Survey 2014-15 [Internet]. Kigali (RW): National Institute of Statistics of Rwanda; 2016 [cited 2021 dec 02]. Available from: https://dhsprogram.com/pubs/pdf/FR316/FR316.pdf.
Burns N, Grove SK. The practice of nursing research: conduct, critic and utilization. USA: Elsevier; 2005.
Brink H. Fundamental of research methodology for health care professionals. Cape Town: Juta and Co; 2006.
Boschi-Pinto C, Labadie G, Dilip TR, Oliphant N, Dalglish SL, Aboubaker S, et al. Global implementation survey of Integrated Management of Childhood Illness (AIDPI): 20 years on. BMJ Open [Internet]. 2018 [cited 2021 dec 02];8(7):e019079. Available from: https://doi.org/10.1136/bmjopen-2017-019079.
Scott K, Beckham SW, Gross M, Payiro G, Rao KD, Cometto G, et al. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Hum Resour Health [Internet]. 2018 [cited 2021 dec 02];16(1):39. Available from: https://doi.org/10.1186/s12960-018-0304-x.
Ballard M, Montgomery P. Systematic review of interventions for improving the performance of community health workers in low income and middle-income countries. BMJ Open [Internet]. 2017 [cited 2021 dec 02];7(10):e014216. Available from: https://doi.org/10.1136/bmjopen-2016-014216.
Donabedian A. The Quality of Care: How Can It Be Assessed? JAMA [Internet]. 1988 [cited 2021 dec 02];260(12):1743-8. Available from: https://doi.org/10.1001/jama.1988.03410120089033.
World Health Organization. WHO guideline on health policy and system support to optimize community health worker programmes [Internet]. Geneva: World Health Organization; 2018 [cited 2021 dec 02]. Available from: https://apps.who.int/iris/bitstream/handle/10665/275474/9789241550369-eng.pdf?ua=1.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Revista Eletrônica de Enfermagem
This work is licensed under a Creative Commons Attribution 4.0 International License.
