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Caregivers’ and Health Extension Workers’ Perceptions and Experiences of Outreach Management of Childhood Illnesses in Ethiopia: A Qualitative Study

Author

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  • Atkure Defar

    (Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
    Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia)

  • Kassahun Alemu

    (Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia)

  • Zemene Tigabu

    (Department of Paediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia)

  • Lars Åke Persson

    (Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
    Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK)

  • Yemisrach B. Okwaraji

    (Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
    Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK)

Abstract

Introduction: Ethiopian Health Extension Workers provide facility-based and outreach services, including home visits to manage sick children, aiming to increase equity in service coverage. Little is known about the scope of the outreach services and caregivers’ and health workers’ perceptions of these services. We aimed at exploring mothers’ and health extension workers’ perceptions and experiences of the outreach services provided for the management of childhood illnesses. Methods: Four focus groups and eight key informant interviews were conducted. A total of 45 community members participated. Interviews were recorded, transcribed verbatim, and translated into English. We applied thematic content analysis, identified challenges in providing outreach services, and suggestions for improvement. We balanced the data collection by selecting half of the participants for interview and focus group discussions from remote areas and the other half from areas closer to the health posts. Results: Mothers reported that health extension workers visited their homes for preventive services but not for managing childhood illnesses. They showed lack of trust in the health workers’ ability to treat children at home. The health extension workers reported that they provide sick children treatment during outreach services but also stated that in most cases, mothers visit the health posts when their child is sick. On the other hand, mothers considered distance from home to health post not to be a problem if the quality of services improved. Workload, long distances, and lack of incentives were perceived as demotivating factors for outreach services. The health workers called for support, incentives, and capacity development activities. Conclusions: Mothers and health extension workers had partly divergent perceptions of whether outreach curative services for children were available. Mothers wanted improvements in the quality of services while health workers requested capacity development and more support for providing effective community-based child health services.

Suggested Citation

  • Atkure Defar & Kassahun Alemu & Zemene Tigabu & Lars Åke Persson & Yemisrach B. Okwaraji, 2021. "Caregivers’ and Health Extension Workers’ Perceptions and Experiences of Outreach Management of Childhood Illnesses in Ethiopia: A Qualitative Study," IJERPH, MDPI, vol. 18(7), pages 1-11, April.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3816-:d:530807
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    References listed on IDEAS

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    1. Benjamin Saunders & Julius Sim & Tom Kingstone & Shula Baker & Jackie Waterfield & Bernadette Bartlam & Heather Burroughs & Clare Jinks, 2018. "Saturation in qualitative research: exploring its conceptualization and operationalization," Quality & Quantity: International Journal of Methodology, Springer, vol. 52(4), pages 1893-1907, July.
    2. Yemisrach B. Okwaraji & Zelee Hill & Atkure Defar & Della Berhanu & Desta Wolassa & Lars Åke Persson & Geremew Gonfa & Joanna A. Schellenberg, 2020. "Implementation of the ‘Optimising the Health Extension Program’ Intervention in Ethiopia: A Process Evaluation Using Mixed Methods," IJERPH, MDPI, vol. 17(16), pages 1-20, August.
    3. Madhu Gupta & Federica Angeli & Hans Bosma & Monica Rana & Shankar Prinja & Rajesh Kumar & Onno C P van Schayck, 2016. "Effectiveness of Multiple-Strategy Community Intervention in Reducing Geographical, Socioeconomic and Gender Based Inequalities in Maternal and Child Health Outcomes in Haryana, India," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-13, March.
    4. Laura Treacy & Håkon A Bolkan & Mette Sagbakken, 2018. "Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-17, February.
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