Can community health workers and caretakers recognise pneumonia in children? Experiences from Western Uganda

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dc.creatorKällander, Karin
dc.creatorTomson, Göran
dc.creatorNsabagasanic, Xavier
dc.creatorNsungwa-Sabiiti, Jesca
dc.creatorPariyo, George
dc.creatorPeterson, Stefan
dc.date2012-11-19T09:52:22Z
dc.date2012-11-19T09:52:22Z
dc.date2006
dc.date.accessioned2018-09-04T12:32:53Z
dc.date.available2018-09-04T12:32:53Z
dc.descriptionAcute respiratory infections (ARI) are leading killers of children. Case management using community health workers (CHW) has halved ARI mortality in children in Asia. WHO/UNICEF recommend integrating pneumonia into Home Management of Malaria strategies. However, in sub-Saharan Africa, CHW’s performance to recognize pneumonia is rarely demonstrated. We evaluated the ability of CHWs to assess rapid breathing in under 5 year olds and explored caretaker interpretation of pneumonia symptoms. Ninety-six CHWs were evaluated for their skills to count and classify breathing rate in inpatient children. Respiratory illness concepts and actions were obtained from focus group discussions with mothers, video probing and key informant interviews. Of the CHW assessments, 71% were within ±5 breaths/min from the gold standard. The sensitivity of CHW classification was 75% and the specificity was 83%. Many local terms existed for ARIs, such as ‘quick breathing’ and ‘groaning breathing’. There was consistency in the interpretation of severity, cause and treatment, most being related to fever and treated with anti-malarials. Given the ability of CHWs to classify pneumonia, their skills should be tested in real life. To minimize failure to treat and over treatment, context specific Communication strategies that improve care-seeking and increase illness prevalence among patients assessed by CHWs are needed. A toolkit including a set of methods for this purpose is proposed.
dc.identifierKällander, K., Tomson, G., Nsabagasani, X., Nsungwa-Sabiiti, J., Peterson, S., Pariyo, G.W. (2006). Can community health workers and caretakers recognise pneumonia in children? Experiences from western Uganda. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100: 956-963.
dc.identifier0035-9203
dc.identifierhttp://hdl.handle.net/10570/871
dc.identifier.urihttp://hdl.handle.net/10570/871
dc.languageen
dc.publisherElsevier
dc.subjectMalaria
dc.subjectUganda
dc.subjectPneumonia
dc.subjectAcute respiratory infections
dc.subjectCommunity health workers
dc.subjectSub-Saharan Africa
dc.titleCan community health workers and caretakers recognise pneumonia in children? Experiences from Western Uganda
dc.typeJournal article, peer reviewed
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