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[Low level educated community health workers training: a strategy to improve children access to acute respiratory treatment in Senegal].
Arch Pediatr. 2007 Mar; 14(3):244-8.AP

Abstract

BACKGROUND

Acute respiratory infections (ARI) are the leading cause of death in childhood. Most of children's deaths happen at home without health level first cares. However in Senegal only health workers are allowed to prescribe antibiotics. A competency-based training was developed to improve and assess the management of acute respiratory infections in young children aged 2 to 59 months by low level educated community health workers (CHWs) in 4 districts of Senegal. The first findings showed the CHWs capable of acquiring the skills needed to effectively manage ARI cases in accordance with the World Health Organization's ARI case management strategy. The aim of this study was to assess the quality of their management after a 1 year follow-up.

METHODS

We provided to CHWs 3 days course in ARI management. After the 3-day course, a 4-month follow-up was performed. We organized a 1-day refresher course every month and in every district. In order to assess the quality of management of CHWs we analyzed the management process and compared the CHWs classification to the classification of the first level health facilities.

RESULTS

Twenty-three percent (3727/15,965) of IRA cases of district were managed by CHWs. Ninety percent (2738/3042) among them were well classified, well managed and well followed-up. But 28% of severe pneumonia cases were misclassified as pneumonia. About treatment, 22.5% of 'cough or cold' got wrong treatment with cotrimoxazole and 10.3% of severe pneumonia got cotrimoxazole without referral. Less than half of severe pneumonia benefited of the first follow-up and only 18% of the second.

CONCLUSIONS

The results highlight that a CHWs low-level educated in French, trained and followed-up could apply the WHO algorithm of IRA management. They could help to give proximal care related to children ARI, to the community. But it seems useful of emphasizing the recognition of danger signs and the follow-up of severe cases.

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Publisher Full Text

Authors+Show Affiliations

Sylla A
Chaire de pédiatrie de l'université Cheikh -Anta-Diop de Dakar, Dakar, Sénégal. syllaassane@hotmail.com
Guèye EH
No affiliation info available
N'diaye O
No affiliation info available
Sarr CS
No affiliation info available
Ndiaye D
No affiliation info available
Diouf S
No affiliation info available
Fall L
No affiliation info available
Moreira C
No affiliation info available
Sall MG
No affiliation info available

MeSH

Acute DiseaseChild, PreschoolCommunity Health WorkersFeasibility StudiesHealth Services AccessibilityHumansInfantProspective StudiesRespiratory Tract InfectionsSenegal

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

17175144

Citation

Sylla, A, et al. "[Low Level Educated Community Health Workers Training: a Strategy to Improve Children Access to Acute Respiratory Treatment in Senegal]." Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, vol. 14, no. 3, 2007, pp. 244-8.
Sylla A, Guèye EH, N'diaye O, et al. [Low level educated community health workers training: a strategy to improve children access to acute respiratory treatment in Senegal]. Arch Pediatr. 2007;14(3):244-8.
Sylla, A., Guèye, E. H., N'diaye, O., Sarr, C. S., Ndiaye, D., Diouf, S., Fall, L., Moreira, C., & Sall, M. G. (2007). [Low level educated community health workers training: a strategy to improve children access to acute respiratory treatment in Senegal]. Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie, 14(3), 244-8.
Sylla A, et al. [Low Level Educated Community Health Workers Training: a Strategy to Improve Children Access to Acute Respiratory Treatment in Senegal]. Arch Pediatr. 2007;14(3):244-8. PubMed PMID: 17175144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Low level educated community health workers training: a strategy to improve children access to acute respiratory treatment in Senegal]. AU - Sylla,A, AU - Guèye,E-H-B, AU - N'diaye,O, AU - Sarr,C-S, AU - Ndiaye,D, AU - Diouf,S, AU - Fall,L, AU - Moreira,C, AU - Sall,M-G, Y1 - 2006/12/18/ PY - 2005/07/13/received PY - 2006/11/16/accepted PY - 2006/12/19/pubmed PY - 2007/7/10/medline PY - 2006/12/19/entrez SP - 244 EP - 8 JF - Archives de pediatrie : organe officiel de la Societe francaise de pediatrie JO - Arch Pediatr VL - 14 IS - 3 N2 - BACKGROUND: Acute respiratory infections (ARI) are the leading cause of death in childhood. Most of children's deaths happen at home without health level first cares. However in Senegal only health workers are allowed to prescribe antibiotics. A competency-based training was developed to improve and assess the management of acute respiratory infections in young children aged 2 to 59 months by low level educated community health workers (CHWs) in 4 districts of Senegal. The first findings showed the CHWs capable of acquiring the skills needed to effectively manage ARI cases in accordance with the World Health Organization's ARI case management strategy. The aim of this study was to assess the quality of their management after a 1 year follow-up. METHODS: We provided to CHWs 3 days course in ARI management. After the 3-day course, a 4-month follow-up was performed. We organized a 1-day refresher course every month and in every district. In order to assess the quality of management of CHWs we analyzed the management process and compared the CHWs classification to the classification of the first level health facilities. RESULTS: Twenty-three percent (3727/15,965) of IRA cases of district were managed by CHWs. Ninety percent (2738/3042) among them were well classified, well managed and well followed-up. But 28% of severe pneumonia cases were misclassified as pneumonia. About treatment, 22.5% of 'cough or cold' got wrong treatment with cotrimoxazole and 10.3% of severe pneumonia got cotrimoxazole without referral. Less than half of severe pneumonia benefited of the first follow-up and only 18% of the second. CONCLUSIONS: The results highlight that a CHWs low-level educated in French, trained and followed-up could apply the WHO algorithm of IRA management. They could help to give proximal care related to children ARI, to the community. But it seems useful of emphasizing the recognition of danger signs and the follow-up of severe cases. SN - 0929-693X UR - https://www.unboundmedicine.com/medline/citation/17175144/[Low_level_educated_community_health_workers_training:_a_strategy_to_improve_children_access_to_acute_respiratory_treatment_in_Senegal]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-693X(06)00594-X DB - PRIME DP - Unbound Medicine ER -