Accessibility to Integrated Community Case Management Services For Childhood Pneumonia among Caregivers in Kisii County, Kenya

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dc.contributor.advisorIsaac Mwanzoen_US
dc.contributor.authorMwambi, Dennis Oroo
dc.date.accessioned2024-06-04T08:34:38Z
dc.date.available2024-06-04T08:34:38Z
dc.date.issued2023-11
dc.descriptionA Research Thesis Submitted In Fulfillment of the Award of the Degree of Master of Public Health (Monitoring And Evaluation) In The School Of Health Sciences Of Kenyatta University November, 2023en_US
dc.description.abstractPneumonia contributes to the increased childhood deaths worldwide. Prompt diagnosis and treatment with antibiotics has resulted in the reduction of pneumonia deaths. In 2014, Kisii County had a pneumonia prevalence of 10% among children under the age of five years, which surpassed the 9% national average. Even though most caregivers (71%) in Kisii sought advice from health facilities or provider, this did not translate to treatment of the pneumonia cases, as only 41% of the cases were eventually provided with antibiotics. Although Kisii County implemented iCCM for childhood illnesses, including pneumonia, there are information gaps regarding accessibility, knowledge and factors that could influence access to iCCM for childhood pneumonia. Therefore, the main goal of this study was to ascertain whether caregivers in Kisii County had access to iCCM services related to childhood pneumonia. A descriptive cross-sectional research approach was used for this study. The research participants included 332 randomly sampled caregivers of children below 5 years in Bomachoge Borabu and Bomachoge Chache sub-counties and 10 key informants from both the county and subcounty levels. Data were collected using both structured and key informant interviews (KIIs). The variables of interest were analysed using frequency-based descriptive analysis, which was utilised to study quantitative data. Qualitative data were organised and analysed thematically. Findings revealed that only 111 (34%) of the respondents had access to iCCM for childhood pneumonia. Notably, the likelihood of access to iCCM for childhood pneumonia reduced with caregiver age, with caregivers under 20 years being 1.5 times more likely to access iCCM. Separated or single caregivers were six times as likely to access iCCM, while those ascribing to the Catholic faith increased the likelihood of access by 1.7 times. Respondents engaged in business as their main source of income increased the likelihood by 2.97 times, while employed caregivers had a 1.4 times higher likelihood to access iCCM for childhood pneumonia. This study showed a high knowledge of childhood pneumonia among the caregivers. Most respondents, 232 (70.3%), mentioned at least one pneumonia symptom and nearly all respondents, 326 (98.8%), identified at least one severe pneumonia symptom. Additionally, 26 (7.9%) mentioned at least one of the three main causes of pneumonia and 287 (87%) mentioned at least one approach to prevent pneumonia. Knowledge of pneumonia symptoms (p 0.315, df 2), severe pneumonia symptoms (p 0.125, df 3), cause of pneumonia (p 0.885, df 3) and pneumonia prevention approaches (p 0.575, df 2) were not significant predictors of access to iCCM for childhood pneumonia. Many respondents, 160 (48.5%), sought help a CHV as their first point of contact when their children started showing signs of pneumonia, with very few, 48 (15%), visiting government health facilities, 3 (1%) visiting private clinics and 3 (1%) went to chemists, while a small fraction, 4 (1.2%), visited traditional herbalists. Only 98 (29.7%) of sick children are taken through the MoH protocol for pneumonia diagnosis and treatment at the community level, posing a potential risk of mismanagement of children with pneumonia. The likelihood of access to iCCM for childhood pneumonia increased by 3.03 times for caregivers who perceived pneumonia as a serious disease, while it increased by 0.1 times for respondents who did not think pandemics affected access to iCCM. The study recommends continuous access to timely diagnosis and treatment for pneumonia among children under 5 years, investment in pneumonia awareness creation programmes targeting caregivers of children under 5 years, provision of routine support supervision to the CHVs and as such ensure compliance with the MoH protocol on pneumonia case identification and management, mechanisms for households to continue accessing health services.en_US
dc.description.sponsorshipKenyatta Universityen_US
dc.identifier.urihttps://ir-library.ku.ac.ke/handle/123456789/28192
dc.language.isoenen_US
dc.publisherKenyatta Universityen_US
dc.subjectAccessibilityen_US
dc.subjectIntegrated Communityen_US
dc.subjectCase Management Servicesen_US
dc.subjectChildhood Pneumoniaen_US
dc.subjectCaregiversen_US
dc.subjectKisii Countyen_US
dc.subjectKenyaen_US
dc.titleAccessibility to Integrated Community Case Management Services For Childhood Pneumonia among Caregivers in Kisii County, Kenyaen_US
dc.typeThesisen_US
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