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Published in: Malaria Journal 1/2006

Open Access 01-12-2006 | Research

Consumers stated and revealed preferences for community health workers and other strategies for the provision of timely and appropriate treatment of malaria in southeast Nigeria

Authors: Obinna Onwujekwe, Nkem Dike, Juliana Ojukwu, Benjamin Uzochukwu, Nkoli Ezumah, Elvis Shu, Paul Okonkwo

Published in: Malaria Journal | Issue 1/2006

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Abstract

Background

The African Heads of State meeting in Abuja, Nigeria on Roll Back Malaria adopted effective treatment of malaria nearer the home as one of the strategies for malaria control in Africa. A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers (CHWs). There is paucity of information about people's actual preferences for CHWs and how stated preferences relates to revealed preferences for both the CHW strategy and other strategies for improving the timeliness of malaria treatment in not only Nigeria but in many malaria endemic countries.

Objectives

To determine peoples' stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers (CHW) strategy in their community.

Methods

A prospective study was undertaken in a rural malaria holo-endemic Nigerian community. A questionnaire was used to collect information on health-seeking from householders before (first survey) and after (second survey) implementation of a CHW malaria treatement strategy.

Results

The consumers mostly preferred the CHW strategy over self-treatment in the homes and other strategies of treatment. The use of community health workers (CHWs) increased from 0% to 26.1% (p < 0.05), while self-treatment in the homes decreased from 9.4% to 0% (p < 0.05) after the implementation of the CHW strategy. Use of patent medicine dealers also decreased from 44.8% to 17.9% (p < 0.05) after CHW strategy was implemented.

Conclusion

Community health workers can be used to improve and ensure timely and appropriate treatment of malaria. The CHW strategy could also be sustained since it was preferred and used by consumers over self-treatment in the homes as well as other strategies for improving treatment. Hence, the CHW strategy is a feasible and promising method of improving home-management of uncomplicated malaria.
Literature
1.
go back to reference WHO: African summit on Roll Back Malaria, Abuja, Nigeria. 2000, WHO/CDS/RBM/2000.17. Geneva: WHO WHO: African summit on Roll Back Malaria, Abuja, Nigeria. 2000, WHO/CDS/RBM/2000.17. Geneva: WHO
2.
go back to reference Kager PA: Malaria control: constraints and opportunities. Trop Med Int Health. 2002, 7: 1042-1046. 10.1046/j.1365-3156.2002.00981.x.CrossRefPubMed Kager PA: Malaria control: constraints and opportunities. Trop Med Int Health. 2002, 7: 1042-1046. 10.1046/j.1365-3156.2002.00981.x.CrossRefPubMed
3.
go back to reference Bloland PB, Kachur SP, Williams HA: Trends in antimalarial drug deployment in sub-Saharan Africa. J Exp Biol. 2003, 206: 3761-3769. 10.1242/jeb.00637.CrossRefPubMed Bloland PB, Kachur SP, Williams HA: Trends in antimalarial drug deployment in sub-Saharan Africa. J Exp Biol. 2003, 206: 3761-3769. 10.1242/jeb.00637.CrossRefPubMed
4.
go back to reference Moerman F, Lengeler C, Chimumbwa J, Talisuna A, Erhart A, Coosemans M, D'Alessandro U: The contribution of healthcare services to a sound and sustainable malaria control policy. Lancet Infect Dis. 2003, 3: 99-102. 10.1016/S1473-3099(03)00518-8.CrossRefPubMed Moerman F, Lengeler C, Chimumbwa J, Talisuna A, Erhart A, Coosemans M, D'Alessandro U: The contribution of healthcare services to a sound and sustainable malaria control policy. Lancet Infect Dis. 2003, 3: 99-102. 10.1016/S1473-3099(03)00518-8.CrossRefPubMed
5.
go back to reference Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE: Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plann. 2005, 20: 199-212. 10.1093/heapol/czi027.CrossRef Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE: Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plann. 2005, 20: 199-212. 10.1093/heapol/czi027.CrossRef
6.
go back to reference WHO: 2004, Manual for home treatment, Geneva: WHO WHO: 2004, Manual for home treatment, Geneva: WHO
7.
go back to reference Winch PJ, Leban K, Casazza L, Walker L, Pearcy K: An implementation framework for household and community integrated management of childhood illness. Health Policy Plann. 2002, 17: 345-353. 10.1093/heapol/17.4.345.CrossRef Winch PJ, Leban K, Casazza L, Walker L, Pearcy K: An implementation framework for household and community integrated management of childhood illness. Health Policy Plann. 2002, 17: 345-353. 10.1093/heapol/17.4.345.CrossRef
8.
go back to reference Onwujekwe OE, Akahara C, Uzochukwu B, Shu E: Should we really be promoting home or community-based malaria treatment? Insights from a study in Southeast Nigeria on the treatment of child-hood malaria. Journal College of Medicine, Nigeria. 2003, 8: 20-22. Onwujekwe OE, Akahara C, Uzochukwu B, Shu E: Should we really be promoting home or community-based malaria treatment? Insights from a study in Southeast Nigeria on the treatment of child-hood malaria. Journal College of Medicine, Nigeria. 2003, 8: 20-22.
9.
go back to reference Berman PA, Gwatkin DR, Burger SE: Community-based health workers: head start or false start towards health for all?. Soc Sci Med. 1987, 25: 443-459. 10.1016/0277-9536(87)90168-7.CrossRefPubMed Berman PA, Gwatkin DR, Burger SE: Community-based health workers: head start or false start towards health for all?. Soc Sci Med. 1987, 25: 443-459. 10.1016/0277-9536(87)90168-7.CrossRefPubMed
10.
go back to reference Lehmann U, Friedman I, Sanders D: Review of the Utilisation and Effectiveness of Community-Based Health Workers in Africa. 2004, A Joint Learning Initiative: Human Resources for Health and Development Working Paper 4-1 Lehmann U, Friedman I, Sanders D: Review of the Utilisation and Effectiveness of Community-Based Health Workers in Africa. 2004, A Joint Learning Initiative: Human Resources for Health and Development Working Paper 4-1
11.
go back to reference Kahssay H, Taylor M: Community Health Workers. The Way Forward. 1998, Geneva, WHO Kahssay H, Taylor M: Community Health Workers. The Way Forward. 1998, Geneva, WHO
12.
go back to reference Love MB, Gardner K: The Emerging Role of the Community Health Worker in California. 1992, Health Promotion Section, California Department of Health Services Love MB, Gardner K: The Emerging Role of the Community Health Worker in California. 1992, Health Promotion Section, California Department of Health Services
13.
go back to reference Lariosa TR: The role of community health workers in malaria control in the Philippines. Southeast Asian J Trop Med Public Health. 1992, 23: 30-35.PubMed Lariosa TR: The role of community health workers in malaria control in the Philippines. Southeast Asian J Trop Med Public Health. 1992, 23: 30-35.PubMed
14.
go back to reference Mayxay M, Newton PN, Yeung S, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ: Short communication: An assessment of the use of malaria rapid tests by village health volunteers in rural Laos. Trop Med Int Health. 2004, 9: 325-329. 10.1111/j.1365-3156.2004.01199.x.CrossRefPubMed Mayxay M, Newton PN, Yeung S, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ: Short communication: An assessment of the use of malaria rapid tests by village health volunteers in rural Laos. Trop Med Int Health. 2004, 9: 325-329. 10.1111/j.1365-3156.2004.01199.x.CrossRefPubMed
15.
go back to reference Okanurak K, Ruebush TK: Village-based diagnosis and treatment of malaria. Acta Tropica. 1996, 61: 157-167. 10.1016/0001-706X(95)00115-U.CrossRefPubMed Okanurak K, Ruebush TK: Village-based diagnosis and treatment of malaria. Acta Tropica. 1996, 61: 157-167. 10.1016/0001-706X(95)00115-U.CrossRefPubMed
16.
go back to reference Batega DW, Greer GJ, Plowman BA: Home-based management of fever strategy in Uganda: assessment of implementation and operation at district and community levels. 2004, Arlington. VA: Ministry of Health (Uganda). WHO and BASICS for the United States Agency for International Development, Quoted in Batega DW, Greer GJ, Plowman BA: Home-based management of fever strategy in Uganda: assessment of implementation and operation at district and community levels. 2004, Arlington. VA: Ministry of Health (Uganda). WHO and BASICS for the United States Agency for International Development, Quoted in
17.
go back to reference Winch P, Bagayoko A, Diawara A, Kane M, Thiero F, Gilroy K, Daou Z, Berthe Z, Swedberg E: Increases in correct administration of chloroquine in the home and referral of sick children to health facilities through a community-based intervention in Bougouni District, Mali. Trans R Soc Trop Med Hyg. 2003, 97: 481-490. 10.1016/S0035-9203(03)80001-9.CrossRefPubMed Winch P, Bagayoko A, Diawara A, Kane M, Thiero F, Gilroy K, Daou Z, Berthe Z, Swedberg E: Increases in correct administration of chloroquine in the home and referral of sick children to health facilities through a community-based intervention in Bougouni District, Mali. Trans R Soc Trop Med Hyg. 2003, 97: 481-490. 10.1016/S0035-9203(03)80001-9.CrossRefPubMed
19.
go back to reference Delacollette C, Van der Stuyft P, Molima K: Using community health workers for malaria control: experience in Zaire. Bull World Health Organ. 1996, 74: 423-430.PubMedCentralPubMed Delacollette C, Van der Stuyft P, Molima K: Using community health workers for malaria control: experience in Zaire. Bull World Health Organ. 1996, 74: 423-430.PubMedCentralPubMed
20.
go back to reference Menon A: Utilization of village health workers within a primary health care programme in The Gambia. J Trop Med Hyg. 1991, 94: 268-271.PubMed Menon A: Utilization of village health workers within a primary health care programme in The Gambia. J Trop Med Hyg. 1991, 94: 268-271.PubMed
21.
go back to reference Gebreyesus TA, Witten KH, Getachew A, Yohannes AM, Tesfay W, Minass M, Bosman A, Teklehaimanot A: The community-based malaria control programme in Tigray, northern Ethiopia. A review of programme set-up, activities, outcomes and impact. Parasitologia. 2000, 42: 255-290. Gebreyesus TA, Witten KH, Getachew A, Yohannes AM, Tesfay W, Minass M, Bosman A, Teklehaimanot A: The community-based malaria control programme in Tigray, northern Ethiopia. A review of programme set-up, activities, outcomes and impact. Parasitologia. 2000, 42: 255-290.
22.
go back to reference Greenwood BM, Bradley AK, Byass P, Greenwood AM, Snow RW, Hayes RJ, N'Jie ABH: Comparison of two strategies for control of malaria within a primary health care programme in the Gambia. Lancet. 1988, 331: 1121-1127. 10.1016/S0140-6736(88)91949-6.CrossRef Greenwood BM, Bradley AK, Byass P, Greenwood AM, Snow RW, Hayes RJ, N'Jie ABH: Comparison of two strategies for control of malaria within a primary health care programme in the Gambia. Lancet. 1988, 331: 1121-1127. 10.1016/S0140-6736(88)91949-6.CrossRef
23.
go back to reference Kidane G, Morrow RH: Teaching mothers to provide home treatment in Tigray, Ethiopia: a randomized trial. Lancet. 2000, 356: 550-555. 10.1016/S0140-6736(00)02580-0.CrossRefPubMed Kidane G, Morrow RH: Teaching mothers to provide home treatment in Tigray, Ethiopia: a randomized trial. Lancet. 2000, 356: 550-555. 10.1016/S0140-6736(00)02580-0.CrossRefPubMed
24.
go back to reference Gebreyesus TA, Witten KH, Getachew A, O'Neill K, Bosman A, Teklehaimanot A: Community-based malaria control in Tigray, northern Ethiopia. Parasitologia. 1999, 41: 367-371. Gebreyesus TA, Witten KH, Getachew A, O'Neill K, Bosman A, Teklehaimanot A: Community-based malaria control in Tigray, northern Ethiopia. Parasitologia. 1999, 41: 367-371.
25.
go back to reference Bloland PB, Ettling M: Review: Making malaria-treatment policy in the face of drug resistance. Ann Trop Med Parasitol. 1999, 93: 5-23. 10.1080/00034989958753.CrossRefPubMed Bloland PB, Ettling M: Review: Making malaria-treatment policy in the face of drug resistance. Ann Trop Med Parasitol. 1999, 93: 5-23. 10.1080/00034989958753.CrossRefPubMed
26.
go back to reference Okeibunor JC, Abiose A, Onwujekwe O, Mohamed NA, Adekeye O, Ogungbemi MK, Amazigo UV: Rapid monitoring of ivermectin treatment: will school-based surveys provide the answer?. Ann Trop Med Parasitol. 2005, 99: 771-10.1179/136485905X65143.CrossRefPubMed Okeibunor JC, Abiose A, Onwujekwe O, Mohamed NA, Adekeye O, Ogungbemi MK, Amazigo UV: Rapid monitoring of ivermectin treatment: will school-based surveys provide the answer?. Ann Trop Med Parasitol. 2005, 99: 771-10.1179/136485905X65143.CrossRefPubMed
27.
go back to reference Vlassof C: Listening to the people: improving disease control using social science approaches. Trans R Soc Trop Med Hyg. 1992, 86: 465-466. 10.1016/0035-9203(92)90067-M.CrossRef Vlassof C: Listening to the people: improving disease control using social science approaches. Trans R Soc Trop Med Hyg. 1992, 86: 465-466. 10.1016/0035-9203(92)90067-M.CrossRef
28.
go back to reference MVCU: Prevalence of malaria mobidity and mortality in Enugu state, 2001 to 2005. Malaria and Vectors Control Unit (MVCU). 2006, Ministry of Health, Enugu, Nigeria MVCU: Prevalence of malaria mobidity and mortality in Enugu state, 2001 to 2005. Malaria and Vectors Control Unit (MVCU). 2006, Ministry of Health, Enugu, Nigeria
29.
go back to reference Mumba M, Visschedijk J, van Cleeff M, Hausman B: A pilot model to analyse case management in malaria control programmes. Trop Med Int Health. 2003, 8: 544-551. 10.1046/j.1365-3156.2003.01064.x.CrossRefPubMed Mumba M, Visschedijk J, van Cleeff M, Hausman B: A pilot model to analyse case management in malaria control programmes. Trop Med Int Health. 2003, 8: 544-551. 10.1046/j.1365-3156.2003.01064.x.CrossRefPubMed
30.
go back to reference Baume C, Helitzer-Allen D, Kachur P: Patterns of care for childhood malaria in Zambia. Soc Sci Med. 2000, 51: 1491-1503. 10.1016/S0277-9536(00)00049-6.CrossRefPubMed Baume C, Helitzer-Allen D, Kachur P: Patterns of care for childhood malaria in Zambia. Soc Sci Med. 2000, 51: 1491-1503. 10.1016/S0277-9536(00)00049-6.CrossRefPubMed
31.
go back to reference Lindblade K, O'Neill D, Mathanga D, Katunga J, Wilson M: Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health. 2000, 5: 865-875. 10.1046/j.1365-3156.2000.00651.x.CrossRefPubMed Lindblade K, O'Neill D, Mathanga D, Katunga J, Wilson M: Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda. Trop Med Int Health. 2000, 5: 865-875. 10.1046/j.1365-3156.2000.00651.x.CrossRefPubMed
32.
go back to reference WHO: Strengthening the performance of community health workers in primary health care. 1989, Geneva: World Health Organization WHO: Strengthening the performance of community health workers in primary health care. 1989, Geneva: World Health Organization
33.
go back to reference Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE: Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plan. 2005, 20: 199-211. 10.1093/heapol/czi027.CrossRefPubMed Winch PJ, Gilroy KE, Wolfheim C, Starbuck ES, Young MW, Walker LD, Black RE: Intervention models for the management of children with signs of pneumonia or malaria by community health workers. Health Policy Plan. 2005, 20: 199-211. 10.1093/heapol/czi027.CrossRefPubMed
Metadata
Title
Consumers stated and revealed preferences for community health workers and other strategies for the provision of timely and appropriate treatment of malaria in southeast Nigeria
Authors
Obinna Onwujekwe
Nkem Dike
Juliana Ojukwu
Benjamin Uzochukwu
Nkoli Ezumah
Elvis Shu
Paul Okonkwo
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2006
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-5-117

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