Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda
Objective To assess the uptake of services provided by community health workers who were trained as community health entrepreneurs (CHEs) for febrile illness and diarrhoea.Design A cross-sectional survey among households combined with mapping of all providers of basic medicine and primary health ser...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/2/e074393.full |
| _version_ | 1827254888401207296 |
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| author | Raymond Tweheyo Monique van Lettow Elizeus Rutebemberwa Trynke Hoekstra Maarten Olivier Kok Marinka van der Hoeven Pien Boonstra |
| author_facet | Raymond Tweheyo Monique van Lettow Elizeus Rutebemberwa Trynke Hoekstra Maarten Olivier Kok Marinka van der Hoeven Pien Boonstra |
| author_sort | Raymond Tweheyo |
| collection | DOAJ |
| description | Objective To assess the uptake of services provided by community health workers who were trained as community health entrepreneurs (CHEs) for febrile illness and diarrhoea.Design A cross-sectional survey among households combined with mapping of all providers of basic medicine and primary health services in the study area.Participants 1265 randomly selected households in 15 rural villages with active CHEs.Setting Bunyangabu district, Uganda.Outcome measures We describe the occurrence and care sought for fever and diarrhoea in the last 3 months by age group in the households. Care provider options included: CHE, health centre or clinic (public or private), pharmacy, drug shop and other. Geographic Information Ssystem (GIS)-based geographical measures were used to map all care providers around the active CHEs.Results Fever and diarrhoea in the last 3 months occurred most frequently in children under 5; 68% and 41.9%, respectively. For those who sought care, CHE services were used for fever among children under 5, children 5–17 and adults over 18 years of age in 34.7%, 29.9% and 25.1%, respectively. For diarrhoea among children under 5, children 5–17 and adults over 18 years of age, CHE services were used in 22.1%, 19.5% and 7.0%, respectively. For those who did not seek care from a CHE (only), drug shops were most frequently used services for both fever and diarrhoea, followed by health centres or private clinics. Many households used a combination of services, which was possible given the high density and diversity of providers found in the study area.Conclusions CHEs play a considerable role in providing care in rural areas where they are active. The high density of informal drug shops and private clinics highlights the need for clarity on the de facto roles played by different providers in both the public and private sector to improve primary healthcare. |
| first_indexed | 2024-04-25T01:48:46Z |
| format | Article |
| id | doaj.art-81c4bcb47869467788e17ad9212742f7 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2025-03-22T01:14:16Z |
| publishDate | 2024-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-81c4bcb47869467788e17ad9212742f72024-05-10T19:20:09ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-074393Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, UgandaRaymond Tweheyo0Monique van Lettow1Elizeus Rutebemberwa2Trynke Hoekstra3Maarten Olivier Kok4Marinka van der Hoeven5Pien Boonstra6School of Public Health, Makerere University, Kampala, UgandaDepartment of Implementation and Operational Research, Madiro, Toronto, Ontario, CanadaSchool of Public Health, Makerere University, Kampala, UgandaFaculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsFaculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsFaculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsFaculty of Science, Department of Health Sciences and Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The NetherlandsObjective To assess the uptake of services provided by community health workers who were trained as community health entrepreneurs (CHEs) for febrile illness and diarrhoea.Design A cross-sectional survey among households combined with mapping of all providers of basic medicine and primary health services in the study area.Participants 1265 randomly selected households in 15 rural villages with active CHEs.Setting Bunyangabu district, Uganda.Outcome measures We describe the occurrence and care sought for fever and diarrhoea in the last 3 months by age group in the households. Care provider options included: CHE, health centre or clinic (public or private), pharmacy, drug shop and other. Geographic Information Ssystem (GIS)-based geographical measures were used to map all care providers around the active CHEs.Results Fever and diarrhoea in the last 3 months occurred most frequently in children under 5; 68% and 41.9%, respectively. For those who sought care, CHE services were used for fever among children under 5, children 5–17 and adults over 18 years of age in 34.7%, 29.9% and 25.1%, respectively. For diarrhoea among children under 5, children 5–17 and adults over 18 years of age, CHE services were used in 22.1%, 19.5% and 7.0%, respectively. For those who did not seek care from a CHE (only), drug shops were most frequently used services for both fever and diarrhoea, followed by health centres or private clinics. Many households used a combination of services, which was possible given the high density and diversity of providers found in the study area.Conclusions CHEs play a considerable role in providing care in rural areas where they are active. The high density of informal drug shops and private clinics highlights the need for clarity on the de facto roles played by different providers in both the public and private sector to improve primary healthcare.https://bmjopen.bmj.com/content/14/2/e074393.full |
| spellingShingle | Raymond Tweheyo Monique van Lettow Elizeus Rutebemberwa Trynke Hoekstra Maarten Olivier Kok Marinka van der Hoeven Pien Boonstra Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda BMJ Open |
| title | Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda |
| title_full | Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda |
| title_fullStr | Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda |
| title_full_unstemmed | Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda |
| title_short | Uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea: a cross-sectional survey in rural communities in Bunyangabu district, Uganda |
| title_sort | uptake of community health care provision by community health entrepreneurs for febrile illness and diarrhoea a cross sectional survey in rural communities in bunyangabu district uganda |
| url | https://bmjopen.bmj.com/content/14/2/e074393.full |
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