Outcomes and associated factors of integrated community case management of childhood illnesses in Dawro zone, Southwest Ethiopia

Abstract

Background: After its scale up in March 2011 integrated community case management (ICCM) was provided in about 86% national geographic coverage; 88% health extension workers (HEWs) were trained; and care seeking for under-five children at health posts was increased. However, no study was found on under-five children health outcomes and associated factors following management of common childhood illnesses by HEWs using ICCM protocol in Ethiopia including the study area. Objective: To assess outcomes and associated factors of integrated community case management of childhood illnesses service in Dawro zone, southwest Ethiopia, 2017 Methods: Community based retrospective cross-sectional study design was employed in this study. The study was conducted from March 15 to April 12, 2017 in Dawro zone, southwest Ethiopia. Caregivers of 791 randomly selected under-five children treated by using ICCM protocol from July 08, 2016 to January 09, 2017 in sampled kebeles were participated in this study. Multinomial logistic regression analysis was used to fit a model and identify variables associated with outcomes of ICCM. Summary of the result was presented descriptively by frequency tables and graphs; and analytically by p-value, adjusted odds ratio, and confidence interval. Result: Seven hundred ninety one child-caregiver pairs of under-five children were participated in this study yielding about 98 percent response rate. Among the 791 under-five year children managed by health extension workers for common childhood illnesses, 89.1%, 7.3%, and 3.5% were cured, their illnesses worsen, and died respectively. Caregiver’s educational status, household wealth, age of the child, travel time from home to health post, age of the caregivers, caregiver’s knowledge of childhood danger signs, and harmful traditional practices were significant predictors of outcomes of children managed by HEWs through ICCM strategy. Conclusion: This study revealed that most of the under-five children cured following the management of common childhood illnesses by health extension workers. Attention should be given to infants, children far from health posts, educating caregivers about childhood danger signs, eliminating harmful traditional practices on under-five children to gain better child health outcomes.