Access to integrated community case management of childhood illnesses services in rural Ethiopia: a qualitative study of the perspectives and experiences of caregivers
被引:32
作者:
Shaw, Bryan
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Johns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Shaw, Bryan
[1
]
Amouzou, Agbessi
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h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Amouzou, Agbessi
[1
]
Miller, Nathan P.
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h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Miller, Nathan P.
[1
]
Tafesse, Mengistu
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h-index: 0
机构:
ABH Serv PLC, Addis Ababa, EthiopiaJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Tafesse, Mengistu
[2
]
Bryce, Jennifer
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h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Bryce, Jennifer
[1
]
Surkan, Pamela J.
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h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, 615 N Wolfe St,10, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Surkan, Pamela J.
[3
]
机构:
[1] Johns Hopkins Bloomberg Sch Publ Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
[2] ABH Serv PLC, Addis Ababa, Ethiopia
[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, 615 N Wolfe St,10, Baltimore, MD 21205 USA
Background: In 2010, Ethiopia began scaling up the integrated community case management (iCCM) of childhood illness strategy throughout the country allowing health extension workers (HEWs) to treat children in rural health posts. After 2 years of iCCM scale up, utilization of HEWs remains low. Little is known about factors related to the use of health services in this setting. This research aimed to elicit perceptions and experiences of caregivers to better understand reasons for low utilization of iCCM services. Methods: A rapid ethnographic assessment was conducted in eight rural health post catchment areas in two zones: Jimma and West Hararghe. In total, 16 focus group discussions and 78 in-depth interviews were completed with mothers, fathers, HEWs and community health volunteers. Results: In spite of the HEW being a core component of iCCM, we found that the lack of availability of HEWs at the health post was one of the most common barriers to the utilization of iCCM services mentioned by caregivers. Financial and geographic challenges continue to influence caregiver decisions despite extension of free child health services in communities. Acceptability of HEWs was often low due to a perceived lack of sensitivity of HEWs and concerns about medicines given at the health post. Social networks acted both to facilitate and hinder use of HEWs. Many mothers stated a preference for using the health post, but some were unable to do so due to objections or alternative care-seeking preferences of gatekeepers, often mothers-in-law and husbands. Conclusion: Caregivers in Ethiopia face many challenges in using HEWs at the health post, potentially resulting in low demand for iCCM services. Efforts to minimize barriers to care seeking and to improve demand should be incorporated into the iCCM strategy in order to achieve reductions in child mortality and promote equity in access and child health outcomes.
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
UNICEF, New York, NY USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Amouzou, Agbessi
Hazel, Elizabeth
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Hazel, Elizabeth
Shaw, Bryan
论文数: 0引用数: 0
h-index: 0
机构:
Populat Serv Int, Washington, DC USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Shaw, Bryan
Miller, Nathan P.
论文数: 0引用数: 0
h-index: 0
机构:
UNICEF, New York, NY USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Miller, Nathan P.
Tafesse, Mengistu
论文数: 0引用数: 0
h-index: 0
机构:
Alliance Better Hlth Serv Private Ltd Co, Addis Ababa, EthiopiaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Tafesse, Mengistu
Mekonnen, Yared
论文数: 0引用数: 0
h-index: 0
机构:
Mela Res Private Ltd Co, Addis Ababa, EthiopiaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Mekonnen, Yared
Moulton, Lawrence H.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Moulton, Lawrence H.
Bryce, Jennifer
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Bryce, Jennifer
Black, Robert E.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daniels, Karen
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机构:
Sanders, David
Daviaud, Emmanuelle
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daviaud, Emmanuelle
Doherty, Tanya
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Univ Western Cape, Sch Publ Hlth, ZA-7535 Bellville, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Nsibande, Duduzile
Loveday, Marian
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Loveday, Marian
Daniels, Karen
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daniels, Karen
论文数: 引用数:
h-index:
机构:
Sanders, David
Doherty, Tanya
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Univ Western Cape, Sch Publ Hlth, Bellville, South Africa
Univ Witwatersrand, Sch Publ Hlth, Johannesburg, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Doherty, Tanya
Zembe, Wanga
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Field, Patricia E.
Franklin, Richard C.
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Franklin, Richard C.
Barker, Ruth
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Healthcare Sci, Cairns, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Barker, Ruth
Ring, Ian
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Div Trop Hlth & Med, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Ring, Ian
Leggat, Peter
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Flinders Univ S Australia, Fac Hlth Sci, Adelaide, SA, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Leggat, Peter
Canuto, Karla
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Hlth Equ, Adelaide, SA, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
机构:
Partners Hope, Lilongwe, Malawi
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USAPartners Hope, Lilongwe, Malawi
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA
Univ Calif San Francisco, Global Hlth Inst, San Francisco, CA 94143 USAPartners Hope, Lilongwe, Malawi
机构:
Partners Hope, Lilongwe, Malawi
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USAPartners Hope, Lilongwe, Malawi
Gupta, Sundeep
论文数: 引用数:
h-index:
机构:
Richter, Linda
Coates, Thomas J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA
Univ Calif San Francisco, Global Hlth Inst, San Francisco, CA 94143 USAPartners Hope, Lilongwe, Malawi
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
UNICEF, New York, NY USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Amouzou, Agbessi
Hazel, Elizabeth
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Hazel, Elizabeth
Shaw, Bryan
论文数: 0引用数: 0
h-index: 0
机构:
Populat Serv Int, Washington, DC USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Shaw, Bryan
Miller, Nathan P.
论文数: 0引用数: 0
h-index: 0
机构:
UNICEF, New York, NY USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Miller, Nathan P.
Tafesse, Mengistu
论文数: 0引用数: 0
h-index: 0
机构:
Alliance Better Hlth Serv Private Ltd Co, Addis Ababa, EthiopiaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Tafesse, Mengistu
Mekonnen, Yared
论文数: 0引用数: 0
h-index: 0
机构:
Mela Res Private Ltd Co, Addis Ababa, EthiopiaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Mekonnen, Yared
Moulton, Lawrence H.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Moulton, Lawrence H.
Bryce, Jennifer
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
Bryce, Jennifer
Black, Robert E.
论文数: 0引用数: 0
h-index: 0
机构:
Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Inst Int Programs, 615 N Wolfe St, Baltimore, MD 21205 USA
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daniels, Karen
论文数: 引用数:
h-index:
机构:
Sanders, David
Daviaud, Emmanuelle
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daviaud, Emmanuelle
Doherty, Tanya
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Univ Western Cape, Sch Publ Hlth, ZA-7535 Bellville, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Nsibande, Duduzile
Loveday, Marian
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Loveday, Marian
Daniels, Karen
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Daniels, Karen
论文数: 引用数:
h-index:
机构:
Sanders, David
Doherty, Tanya
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Univ Western Cape, Sch Publ Hlth, Bellville, South Africa
Univ Witwatersrand, Sch Publ Hlth, Johannesburg, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
Doherty, Tanya
Zembe, Wanga
论文数: 0引用数: 0
h-index: 0
机构:
South African Med Res Council, Hlth Syst Res Unit, Cape Town, South AfricaSouth African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Field, Patricia E.
Franklin, Richard C.
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Franklin, Richard C.
Barker, Ruth
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Healthcare Sci, Cairns, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Barker, Ruth
Ring, Ian
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Div Trop Hlth & Med, Townsville, Qld, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Ring, Ian
Leggat, Peter
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Flinders Univ S Australia, Fac Hlth Sci, Adelaide, SA, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
Leggat, Peter
Canuto, Karla
论文数: 0引用数: 0
h-index: 0
机构:
James Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Hlth Equ, Adelaide, SA, AustraliaJames Cook Univ, Coll Publ Hlth Med & Vet Sci, Townsville, Qld, Australia
机构:
Partners Hope, Lilongwe, Malawi
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USAPartners Hope, Lilongwe, Malawi
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA
Univ Calif San Francisco, Global Hlth Inst, San Francisco, CA 94143 USAPartners Hope, Lilongwe, Malawi
机构:
Partners Hope, Lilongwe, Malawi
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USAPartners Hope, Lilongwe, Malawi
Gupta, Sundeep
论文数: 引用数:
h-index:
机构:
Richter, Linda
Coates, Thomas J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA
Univ Calif San Francisco, Global Hlth Inst, San Francisco, CA 94143 USAPartners Hope, Lilongwe, Malawi