Proximity to a community health worker is associated with utilization of malaria treatment services in the community among under-five children: a cross-sectional study in rural Uganda.
BACKGROUND
In rural areas of sub-Saharan Africa, health facilities are difficult to access for prompt treatment of malaria. Community health workers (CHWs) have been trained and equipped to treat malaria. Utilization of their service has not been adequately evaluated. The aim of this study was to determine the level of utilization of CHWs, and whether distance and other factors influence the utilization.


METHODS
The authors conducted a cross-sectional study among households with a child below 5 y of age and interviewed caregivers in Sheema district, rural western Uganda. Logistic regression was used to calculate adjusted ORs (aOR) for factors associated with use of CHW services.


RESULTS
Among 547 households, 64% (338/528) reported using CHWs as the first point of consultation for their febrile children. Factors associated with the use of CHWs services were lower asset index (aOR=1.9, p=0.02), mother being the decision maker for site of first consultation (aOR=1.9, p=0.01), distance to nearest CHW of <3 km (aOR=2.1, p=0.03) compared to >3 km, and trust for CHWs services (aOR=7.8, p<0.001).


CONCLUSION
Proximal location to a CHW is associated with use of CHW services. Programs should ensure that CHW are well located to enable easy access.
['Mazzi|Micheal|M|', 'Bajunirwe|Francis|F|', 'Aheebwe|Emmanuel|E|', 'Nuwamanya|Simpson|S|', 'Bagenda|Fred N|FN|']
D000293:Adolescent D000328:Adult D017028:Caregivers D002675:Child, Preschool D003150:Community Health Workers D003430:Cross-Sectional Studies D005260:Female D006297:Health Services Accessibility D006801:Humans D007223:Infant D008288:Malaria D008297:Male D008875:Middle Aged D019035:Rural Health Services D014454:Uganda D055815:Young Adult
malaria community health workers (CHW) household Caregivers prompt malaria treatment