ASSESSMENT OF THE CONTRIBUTION OF COMMUNITY HEALTH WORKERS IN THE PREVENTION AND CONTROL OF MALARIA IN SANTA HEALTH DISTRICT-NORTH WEST REGION

SUMMARY

Background: Malaria is a fatal life-threatening parasitic infection and a leading cause of morbidity and mortality especially in Sub-Saharan African countries. Community health workers (CMWs) play a crucial role in malaria prevention and control. However, there are no significant studies to show the contributions of community health workers in the prevention and control of malaria.  This study, therefore, seeks to assess the contributions of community health workers in the prevention and control of malaria by examining their responsibilities in malaria prevention and control, evaluating the quality of services they provide and investigating the factors that influence the activities of community health workers.

Study design: A community-based cross-sectional study involving 39 community health workers will be carried in Santa Health District from December 2022 to June 2023. A simple random sampling technique will be applied to select thirty-nine (39) participants out of a total of sixty-five community health workers in the Health District for the study. Data will be collected manually through the administration of a structured questionnaire, input in MS Excel version 2016 and imported in to SPSS version 26 for analysis.

Expected outcomes: The number of malaria patients managed by community health workers is expected to be high. Community health workers are expected to provide high-quality services to the population. Community health workers are equally expected to list the factors influencing the services the rendered in the community.

Keywords: Malaria; community health workers; malaria prevention and control; assessment.

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The etiology of malaria was first described more than a century ago and it has become one of the world’s best-known infectious diseases.  In 2019, approximately 230 million cases and 620,000 deaths were reported globally, nearly all in sub-Saharan African countries [1]. A key question is why malaria control and elimination have proven so difficult in this sub-region, while the disease has been either eliminated or greatly diminished elsewhere [2].

The prevalence of malaria in Cameroon is still a major public health problem both in urban and rural settings. An estimated 1.6 million and 18,738 confirmed cases were reported in health facilities and communities respectively, with about 8000 estimated deaths in 2016 [3].

The World Health Organization (WHO) recognizes that the world is facing a chronic shortage of healthcare professionals, and its negative impact is felt more acutely in low and middle income countries, including Sub-Saharan African countries [4].

In response to this crisis, one of the solutions recommended by WHO was to utilize community health workers (CHWs), volunteers selected from the community and trained to provide primary health care (PHC), to reach remote areas [5,6]. CHWs were first identified as key components of PHC and achieving the “Health for All” principle during the Alma-Ata conference, organized by the WHO in 1978 [7]. Key points from this meeting were the statement that health is a basic human right, inequality in health is unacceptable and that PHC is essential and should bring healthcare to the community level. Since the conference, CHWs’ programmes have been implemented in many countries and there is evidence suggesting that CHWs contribute to the reduction of morbidity and mortality caused by different diseases [8]. Trained CHWs also provide a cost-effective means of offering quality healthcare services in hard to reach, rural communities [9, 10].

 Malaria remains a major public health problem and there is a chronic shortage of qualified health personnel in Cameroon, and one of the strategies recommended by the WHO and adopted by the National Malaria Control Programme (NMCP) is the use of CHWs in the prevention and control of malaria [11].  However, malaria remains a major cause of morbidity and mortality in Cameroon in general and Santa health district in particular. As such, the aim of this study is to assess the contributions of CHWs in the prevention and control of malaria. This will be done by examining the responsibilities of CHWs in malaria intervention, evaluating the quality of their services and investigating the factors that influence CHWs in providing malaria prevention and control services in Santa Health District- North West Region.

1.2 STATEMENT OF THE PROBLEM

Community health workers are recognized as an integral part of the Primary Health Care System essential for bringing health care services closer to the people. They play a vital role in malaria prevention and control activities, yet the burden of the disease remains high. Patients usually arrived the health facilities late and most often when complications have started. Pregnant women commenced antenatal care late and do benefit fully from the package of services provided during antenatal care. Mosquito nets are not properly used or are misused in households in the community. Hygiene and sanitation remain a major problem in the community. The number of patients properly referred to the health facilities by CHWs remains low.

With these gaps, malaria remains a major public health problem signifying that CHWs do not contribute optimally to the prevention and control activities.

It is for the above-mentioned reasons that the investigator deemed it necessary to assess the contribution of CHWs in the prevention and control of malaria in Santa Health District –North West Region.

1.3 RESEARCH QUESTIONS

1. What is the percentage of malaria cases managed by CHWs in Santa Health District in 2021?

2. What is the quality of services rendered by CHWs in Santa Health District?

3. What are the factors influencing the activities of CHWs in the prevention and control of malaria in Santa Health District?

1.4. RESEARCH HYPOTHESES

1. CHWs managed a large number of malaria cases in Santa Health District.

2. The services rendered by CHWs are of good quality in Santa Health District.

3. There are many factors influencing the contributions of CHWs in malaria prevention and control in Santa Health District.

1.5 RESEARCH OBJECTIVES

1.5.1 General Objective of the Study           

1. To assess the contributions of Community health workers in the prevention and control of malaria in Santa Health District- North West Region

1.5.2 Specific Objectives of the Study

1. To determine the percentage of malaria cases managed by CHWs in 2020
2. To evaluate the quality of services rendered by CHWs in Santa Health District
3. To identify the factors influencing the activities of CHWs in Santa Health District.

PUBLIC HEALTH TOPICS WITH MATERIALS