Use of Community Health Workers for Management of Malaria and Pneumonia in Urban and Rural Areas in Eastern Uganda

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Abstract

Use of community health workers (CHWs) has been implemented the same way in urban and rural areas despite differences in availability of health providers and sociodemographic characteristics. A household survey was conducted in rural and urban areas in eastern Uganda, and all children who were febrile in the previous two weeks were assessed for their symptoms, treatment received at home, and when and where they first went for treatment. Rural children were more likely to use CHWs than urban children. Urban children received outside treatment more promptly, and used herbs at home less. Symptoms and proportion of children being taken out for treatment were similar. Children from the poorest households used CHWs less and private providers more than the middle quintiles. Drug shops and private clinics should be included in the community case management to cater for the poorest in rural areas and persons in urban areas.

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Most cited references 23

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Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

Deon Filmer, Lant H. Pritchett (2001)

Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.

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Explaining trends in inequities: evidence from Brazilian child health studies.

C Victora, J Vaughan, F. Barros … (2000)

There is considerable international concern that child-health inequities seem to be getting worse between and within richer and poorer countries. The "inverse equity hypothesis" is proposed to explain how such health inequities may get worse, remain the same, or improve over time. We postulate that as new public-health interventions and programmes initially reach those of higher socioeconomic status and only later affect the poor, there are early increases in inequity ratios for coverage, morbidity, and mortality indicators. Inequities only improve later when the rich have achieved new minimum achievable levels for morbidity and mortality and the poor gain greater access to the interventions. The hypothesis was examined using three epidemiological data sets for time trends in child-health inequities within Brazil. Time trends for inequity ratios for morbidity and mortality, which were consistent with the hypothesis, showed both improvements and deterioration over time, despite the indicators showing absolute improvements in health status between rich and poor.

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Inequities among the very poor: health care for children in rural southern Tanzania.

Joanna Armstrong Schellenberg, Cesar Victora, Adiel K Mushi … (2003)

Few studies have been done to assess socioeconomic inequities in health in African countries. We sought evidence of inequities in health care by sex and socioeconomic status for young children living in a poor rural area of southern Tanzania. In a baseline household survey in Tanzania early in the implementation phase of integrated management of childhood illness (IMCI), we included cluster samples of 2006 children younger than 5 years in four rural districts. Questions focused on the extent to which carers' knowledge of illness, care-seeking outside the home, and care in health facilities were consistent with IMCI guidelines and messages. We used principal components analysis to develop a relative index of household socioeconomic status, with weighted scores of information on income sources, education of the household head, and household assets. 1026 (52%) of 1968 children reported having been ill in the 2 weeks before the survey. Carers of 415 (41%) of 1014 of these children had sought care first from an appropriate provider. 71 (26%) carers from families in the wealthiest quintile knew > or =2 danger signs compared with 48 (20%) of those from the poorest (p=0.03 for linear trend across quintiles) and wealthier families were more likely to bring their sick children to a health facility (p=0.02). Their children were more likely than poorer children to have received antimalarials, and antibiotics for pneumonia (p=0.0001 and 0.0048, respectively). Care-seeking behaviour is worse in poorer than in relatively rich families, even within a rural society that might easily be assumed to be uniformly poor.

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Author and article information

Journal

Journal ID (nlm-ta): Am J Trop Med Hyg

Journal ID (iso-abbrev): Am. J. Trop. Med. Hyg

Journal ID (publisher-id): tpmd

Title: The American Journal of Tropical Medicine and Hygiene

Publisher: The American Society of Tropical Medicine and Hygiene

ISSN (Print): 0002-9637

ISSN (Electronic): 1476-1645

Publication date (Print): 07 November 2012

Publication date PMC-release: 07 November 2012

Volume: 87

Issue: 5 Suppl

Pages: 30-35

Affiliations

Department of Health Policy, Planning and Management, and Department of Community Health and Behavioural Sciences Makerere University School of Public Health, Kampala, Uganda; Iganga–Mayuge Demographic Surveillance Site, Iganga, Uganda; African Field Epidemiology Network, Kampala, Uganda; Division of International Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Department of Pharmacy, Makerere University School of Health Sciences, Kampala, Uganda; Clinical Epidemiology Unit, Department of Medicine, Makerere University, Kampala, Uganda; Department of Paediatrics, Makerere University School of Medicine, Kampala, Uganda

Author notes

*Address correspondence to Elizeus Rutebemberwa, Department of Health Policy, Planning and Management, Makerere University School of Public Health, PO Box 7072, Kampala, Uganda. E-mail: ellie@ 123456musph.ac.ug

Article

DOI: 10.4269/ajtmh.2012.11-0732

PMC ID: 3748519

PubMed ID: 23136275

SO-VID: af107e9a-d740-40d7-b189-1bcd05fb5dcc

License:

This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 25 November 2011

Date accepted : 12 April 2012

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