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HOME-BASED CARE FOR MALARIA CAMPAIGN

HOME-BASED CARE FOR MALARIA CAMPAIGN. THE GHANA EXPERIENCE MRS ABA BAFFOE-WILMOT. PRESENTATION OUTLINE. RATIONALE ENABLING FACTORS THE HOME-BASED CARE CAMPAIGN ACHIEVEMENTS CHALLENGES PROSPECTS CONCLUSIONS. RATIONALE.

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HOME-BASED CARE FOR MALARIA CAMPAIGN

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  1. HOME-BASED CARE FOR MALARIA CAMPAIGN • THE GHANA EXPERIENCE • MRS ABA BAFFOE-WILMOT

  2. PRESENTATION OUTLINE • RATIONALE • ENABLING FACTORS • THE HOME-BASED CARE CAMPAIGN • ACHIEVEMENTS • CHALLENGES • PROSPECTS • CONCLUSIONS

  3. RATIONALE • HOME MANAGEMENT OF MALARIA EXISTS IN THE COMMUNITIES – BUT INAPPROPRIATELY • STUDIES IN 3 DISTRICTS SHOWED THAT: • EARLY AND APPROPRIATE HOME MANAGEMENT OF MALARIA IS POSSIBLE THROUGH: • STRONG, EFFECTIVE AND SUSTAINED IEC TO IMPROVE HEALTH SEEKING BEHAVIOUR • USE OF APPROPRIATE PREPACKS

  4. RATIONALE-2 • 71% MOTHERS ARE ABLE TO RECALL HOW TO ADMINISTER DRUGS CORRECTLY BUT ONLY 14.6% GIVE CORRECT DRUG/DOSAGE/DURATION AT HOME (N = 489) • 63% MOTHERS KNOW THAT CHILD SHOULD BE SPONGED, GIVEN ANTIPRECTICS BUT ONLY 2.7% PRACTICE IT (n= 489)

  5. RATIONALE-3 • DRUG VENDORS/CHEMICAL SELLERS: • ONLY 52% KNOW CORRECT TREATMENT FOR MALARIA YET • CUSTOMERS ASK THEM OF THEIR OPINION ON DISEASE • ONLY 42% SELL FULL DOSES OF ANTI-MALARIA DRUG ALWAYS

  6. ENABLING FACTORS-1 • COMMUNITY HEALTH NURSES AND HEALTH OFFICERS UNDER THE COMMUNITY HEALTH PLANNING AND SERVICES CARRY OUT HOME VISITS/ SOME LIVE IN THE COMMUNITY SO EASILY ACCESSIBLE FOR ADVISE/REFFERAL

  7. ENABLING FACTORS-2 • INTEGRATED CHILD SURVIVAL INFORMATION CAMAPAIGN BY JHU/USAID (“HE-HA-HO” = HEALTHIER HAPPIER HOMES) • COMMERCIAL MARKETING AND DISTRIBUTION OF PREPACKAGED CHLOROQUINE TABLETS BY DRUG MANUFACTURER

  8. THE HOME-BASED CARE CAMPAIGN OBJECTIVE: • INCREASE PROPORTION OF CAREGIVERS WHO ARE ABLE TO RECOGNISE AND RESPOND APPROPRIATELY TO MALARIA • MOTIVATE PRIMARY CAREGIVERS TO GIVE CORRECT TREATMENT AT HOME AND REFER PROMPTLY AND TIMELY

  9. THE CHOSEN MEDIUM-RADIO AND TELEVISION • AVAILABILITY: OVER HALF OF THE POPULATION IN GHANA OWN A RADIO SET • WIDER COVERAGE, GEOGRAPHICAL AND LANGUAGE • EASILY ACCESSIBLE.REACHES LISTENERS AT THEIR HOMES • COST-EFFECTIVE: CHEAPER (RADIO

  10. CHOSEN MEDIUM-2 • PORTABLE.EASY TO CARRY ALONG TO MARKET, FARM, SHORE, OFFICE • HIGHLY CREDIBLE.MOST PEOPLE BELIEVE WHAT THEY HEAR FROM RADIO/TV AS TRUE AND FACTUAL

  11. THE CAMPAIGN • DIFFERENT LOCAL LANGUAGES • ON TV: PICTURES OF MOTHER WHOSE CHILD IS ILL WITH FEVER • MOTHER GOES TO DRUG STORE TO PURCHASE MALARIA DRUG (TABLETS)

  12. THE CAMPAIGN • SHE IS OBSERVED DISSOLVING THE TABLETS IN JUICES/PORRIDGE FOR CHILD • PUBLIC ADVISED TO CONSULT NEAREST DRUG STORE FOR CORRECT DOSE FOR CHILD • SAME MESSAGE AIRED ON RADIO

  13. ACHIEVEMENT • LEAFLETS AND PAMPHLETS/ POSTERS PRODUCED FOR MOTHERS AND CARETAKERS /CHEMICAL SELLERS • MORE MOTHERS PURCHASING CHLOROQUINE TABLETS FOR THEIR CHILDREN WHEN ILL

  14. CHALLENGES-1 • OPPOSITION FROM PHARMACIES THAT WE ARE DISCOURAGING USE OF SYRUPS (PHARMACISTS IN KUMASI WENT ON DEMOSTRATION) • MOTIVATION AND COMMITMENT OF ALL STAKEHOLDERS VERY IMPORTANT • ADDITIONAL RESOURCES NEEDED; I.E. TRANSPORT FOR SUPERVISION AND REFFERAL, FUNDS TO MOTI VATE AND HEALTH STAFF CLOSE-BY

  15. CHALLENGES-2 • REGULAR TRAINING AND UPDATES OF COMMUNITY-BASED AGENTS WHO ARE THE AUTOMATIC NEXT LEVEL OF CARE FROM THE HOME • MAKING AVAILABLE EDUCATIONAL MATERIALS TO INFORM/EDUCATE MOTHERS AND CHILD CARETAKERS

  16. CHALLENGES-3 • REGULAR VISITS TO HOMES BY HEALTH STAFF REQUIRED • MONITORING OF PATTERN OF DRUG USE, SIDE EFFECTS AND RESISTANCE VERY IMPORTANT • ENSURING COOPERATION FROM HEALTH STAFF:POLICY ISSUES

  17. CHALLENGES -4 • ENSURING QUALITY OF CARE AT HOME: CORRECT DRUG DOSING AND DURATION • IS PRE-PACKAGING FROM AN APPROVED SOURCE THE ANSWER • KNOWING WHEN TO GIVE UP AND SEEK HELP • INTENSIFIED/SUSTAINED HEALTH EDUCATION: COST IMPLICATIONS

  18. CHALLENGES-5 • ENSURING ACCESS TO HIGHER LEVEL OF CARE • MANPOWER: INCREASED WORKLOAD OF SUPERVISING • DATA CAPTURE: • MONITORING HOME-BASED CARE

  19. ISSUES TO CONSIDER • POLICY IMPLICATIONS: TABLETS /SYRUPS TO BE PHASED OUT? • ARE WE ENDORSING SELF-MEDICATION/DRUG ABUSE/ LEADING TO DRUG RESISTANCE DEVELOPMENT? • WILL HEALTH STAFF COOPERATE: EXTRA RESPONSIBILITY OF SUPERVISING.

  20. ISSUES CTD • CAN WE COPE WITH THE EXTRA RESOURCE IMPLICATIONS?: • DRUGS:SIMPLE, ATTRACTIVE PACKAGING • REMUNERATION OF STAFF TO SUPERVISE • TRAIN/EQUIPPING COMMUNITY-BASED PROVIDERS TO GIVE RIGHT DOSE/INFORMATION

  21. PROSPECTS • CHEMICAL SELLERS TRAINING MANUAL IS BEING DEVELOPED • RADIO DISTANCE LEARNING FOR COMMUNITY HEALTH NURSES IS BEING DEVELOPED • PERSON TO PERSON CONTACT TO EDUCATE AND EXPLAIN

  22. CONCLUSION • HOME MANAGEMENT OF MALARIA/FEVERS IS GOING ON • NEED TO EDUCATE THE MOTHERS CARETAKERS TO DO IT CORRECTLY • THE MOST POPULAR MEDIUM HAS BEEN USED • NEED TO GO DOWN: PERSON TO PERSON CONTACT TO HAVE THE MAXIMUM IMPACT

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