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Effect of deploying community health assistants on appropriate treatment for diarrhoea, malaria and pneumonia: quasi‐experimental study in two districts of Zambia
Author(s) -
Biemba Godfrey,
YeboahAntwi Kojo,
Vosburg Kathryn Bradford,
Prust Margaret L.,
Keller Brett,
Worku Yekoyesew,
Zulu Happy,
White Emily,
Hamer Davidson H.
Publication year - 2016
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12730
Subject(s) - malaria , medicine , christian ministry , pneumonia , economic shortage , workforce , under five , environmental health , demography , government (linguistics) , immunology , philosophy , linguistics , theology , sociology , economics , economic growth
Objective A critical shortage of human resources for health in Zambia remains a great challenge. In response, the Zambian Ministry of Health developed a national community health assistant ( CHA ) programme, aiming to create a well‐trained and motivated community‐based health workforce. This study assessed whether CHA s increased treatment rates for diarrhoea, confirmed malaria or pneumonia in the first programme year. Methods This study used a quasi‐experimental difference‐in‐difference design, comparing changes in the catchment areas of health posts with CHA s to those without. Baseline and end line household surveys were conducted to measure the proportion of children under 5 years treated for diarrhoea, malaria or pneumonia in the 2 weeks before the survey and immunisation rates and malaria rapid diagnostic test rates. Results We surveyed 2330 women with children under five from the intervention area and 2314 from comparison areas at baseline and end line. Treatment for diarrhoea, malaria or pneumonia increased by 18.0% ( P < 0.01) and 23.5% ( P < 0.01) in the intervention and comparison groups, respectively, but DID analysis was not significant ( P = 0.27). The proportion of fully immunised children grew by 7.5% in the intervention, but shrank by 7.5% in the comparison group ( DID : 0.14; 95% CI 0.12–0.16, P < 0.01). Conclusion Although we observed no significant difference between the intervention and comparison groups in the DID estimates for the primary outcome, there were significant increases after one year in treatment for all three diseases in the intervention group from baseline to end line and in the proportion of fully immunised children.