Effectiveness of revised IMCI strategy in malaria management among caregivers in Amansie West District, Ghana

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June, 2016
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Introduction: The revised IMCI strategy combines community, nutritional and diagnostic measures to effectively manage malaria and other illnesses among children under five years of age. The objective of the study was to assess the awareness level of caregivers on presumptive approaches in malaria management, perception and acceptability of malaria management strategies under revised IMCI and the challenges caregivers encounter in adopting the malaria management strategies under the revised IMCI. Methodology: This was a cross sectional study for which 379 respondents were conveniently sampled. A multi-stage sampling procedure was used to sample 120 household heads, whereas 240 community members and 19 community health workers were purposively sampled for focus group discussions. Questionnaire and focus group discussion guides were used to gather data from the respondents. Descriptive statistics were used to analyse quantitative data. Content analysis was used to analyse responses from the focus group discussion. Results: The study found that caregivers were highly aware of the use of treated nets and good community sanitation to reduce the incidence of malaria whereas 60% were aware that balance diet helps to improve the immune system of children against malaria. 58.3% of the respondents strongly agreed that poor understanding on the recommended vitamin-rich foods for children is a challenge they encounter in managing malaria among their children, whereas 41.7% disagreed. Poor participation by the household heads, who are dominantly males, influenced the acceptability of the nutritional and some preventive aspects of the revised IMCI strategy. 52.5% of the respondents indicated that they seek first treatment for their children on malaria from health facilities, 31.7% use chemical shops, while 15.8% resort to herbal treatment. Room congestion, no proper beds, and frequent power outages prevented some caregivers from sleeping under treated nets with their children. The NHIS encouraged attendance of health facilities; however the occasional suspension of the system discouraged caregivers in accessing healthcare for their children. All caregivers admitted that health personnel conduct malaria test on children before giving them drugs. The implication is that Rapid Diagnostic Testing is effectively being implemented in the district. Conclusion and recommendation: The study recommends that health education programmes should encourage more male attendance to improve the acceptability of improved practices to enhance malaria management. Community leaders should organise communal labour to effectively address community sanitation issues. Community health nurses should intensify public education on the suggested vitamin-rich foods for children and the need for seeking proper healthcare early.
A thesis submitted to The Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences in partial fulfillment of the requirements for the degree of Master of Public Health in Population and Reproductive Health,