Improving Home-Based Use of Coartem for Malaria Management in Children Under Five Years of Age

Author(s): H. A. Oluyedun1
Affiliation(s): 1Sociology, University of Ibadan, Nigeria
Keywords: Home-based, health volunteers, adherence, malaria management
Background:

Malaria is the largest cause of health service attendance, hospital admissions and child deaths in Nigeria. Resistances of plasmodium falciparum to chloroquine and sulphadoxine plus pyrimetamine have led to adoption of policy to use Coartem as the first-line drug of treatment. This is an intervention programme at Orile-Odo in Oluyole L.G of Nigeria. It targets the mothers of under-five children with uncomplicated malaria, using 200 households, 20 health volunteers and four supervisors. A cohort (non-experimental epidemiologic intervention) study will be used a multistage sampling technique. The 20 volunteers and four supervisors are to act as community advocates in sharing the knowledge they have acquired and support mother and caregivers in the community in managing simple malaria.

Summary/Objectives:

The objectives of the intervention are - to find out the home based practice, to train the health volunteers on the correct usage of Coartem as the first line of treatment in other to improve adherence, to increase the awareness of the mothers and community about Coartem. To ensure accessibility of Coartem in the community health centres and in the drug sellers shops in the community and to ensure early recognition of symptoms and proper administration of Coartem.

Results:

The result showed that: (1) prior to the study the patronage of the Health facility in the community is poor, it is as low as 20% due to lack of knowledge and preference for herbal treatment, after the intervention the hospital cannot meet the demand for Coartem because nearly every mothers in the community wanted to enrolled in the programme; (2) The accessibilty to Coartem improved in the community because the record of the drug dealers in the community all improved on the average of 200%; (3) Early recognition and prompt treatment improved by 100% as revealed by the health volunteers and the drug seller; (4) The adherence to dosage regimen was seen in 90% of the mothers; (5) The health Volunteers and the drug sellers in the community after the training were better informed, and the assessment showed that they passed correct information to the mothers.

Lessons learned:

The programme is an innovative approach to malaria control involving community members. The monitoring ensured validity of the evaluation and made it feasible for replication in other areas in order to inform national scale up. The outcomes of the intervention showed improved and correct use of antimalarial (Coartem) in home management, early recognition and prompt action taken in the malaria management, and compliance to antimalarial drug regimen.

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