Performance of Community Based Agents Care For Malaria in Under Fives Jirapa And LAMBUSSIE Districts Of The Upper West Region,Ghana

ABSTRACT 

Introduction:Home-based Management of Malaria (HMM) is a strategy to increase access to malaria treatment in Africa. In 2006, the strategy was launched in the Upper West Region (UWR) of Ghana. Community Based Agents (CBAs) were trained and equipped to provide home-based treatment to children aged 6-59 months with malaria. HMM was expected to reduce the number of children seen in health facilities with malaria. However, there has been a consistent increase in the burden of malaria since 2009 despite the role CBAs are expected to play in reducing the burden of malaria. This study was conducted to assess the knowledge and performance of CBAs on HMM, eight years after it‟s implementation and to assess the perception of community members and health workers about the services provided by CBAs in the region. Methods: A cross-sectional study was conducted in two purposive selected districts in the UWR.We interviewed 384 CBAs and 154 mothers/caregivers using a structured questionnaire.We conducted Key Informant Interviews (KII) with 13 community leaders and 15 health workers and held 2 Focus Group Discussions (FGDs) with mothers/caregivers. CBAs and health facility records were also reviewed and we observed the management practices of 37 CBAs offering services at the time of interviews. Variables obtained were age, sex, and indicators on knowledge and management practices. Data entry, cleaning and analysis was done using SPSS software version 18.0. Descriptive data analysis was done and categorical variables expressed as frequencies and relative frequencies. For bi-variate analysis, cross tabulation was undertaken to establish associations and results presented in tables. Significance level of 5% (0.05) was used. Qualitative data from KII and FGDs were translated and transcribed into English, coded and thereafter analysed and separated into the emerging themes. Results:The mean age of CBAs was 42.71(+/- 9.62) with 369(96%) being females.