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. 2015 Jul 2;10(7):e0130305.
doi: 10.1371/journal.pone.0130305. eCollection 2015.

The Impact of a Community Awareness Strategy on Caregiver Treatment Seeking Behaviour and Use of Artemether-Lumefantrine for Febrile Children in Rural Kenya

Beatrice Wasunna  1 , Emelda A Okiro  2 , Jayne Webster  3 , Jim Todd  4 , Robert W Snow  2 , Caroline Jones  5
Affiliations

The Impact of a Community Awareness Strategy on Caregiver Treatment Seeking Behaviour and Use of Artemether-Lumefantrine for Febrile Children in Rural Kenya

Beatrice Wasunna et al. PLoS One. .

Abstract

Background: Access to prompt and effective treatment is the cornerstone for malaria control. Population Services International in collaboration with the Ministry of Health launched a malaria behaviour change communication intervention in Nyanza province, Kenya. The initiative aimed to improve: symptom recognition and prompt access to government health facilities for febrile children; effective treatment with the recommended first-line drug artemether-lumefantrine (AL) in public health facilities and adherence to the AL regimen.

Methods: Pre- and post-intervention cross-sectional household surveys were used to evaluate the impact of the intervention on prompt and correct use of AL for febrile children below five years of age. The primary outcome was the proportion of children below five years of age with fever in the last 14 days accessing AL within 48 hours of fever onset.

Results: There was an increase from 62.8% pre-intervention to 79.4% post-intervention (95% CI: 11.1, 22.1) in caregivers who reported seeking formal treatment promptly (on the same day, or next day) for their febrile children. However, there was a decrease in the use of government health facilities in the post-intervention period. There was a small increase in the proportion of children accessing AL within 48 hours of fever onset [18.4% vs 23.5% (0.1-10.0)].

Conclusion: The findings of this evaluation demonstrate that interventions that target only one sector may have a limited impact on improvements in prompt and effective treatment where multiple sources of treatments are sought for febrile illness. Additionally, the context in which an intervention is implemented is likely to influence the process and outcomes.

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Conflict of interest statement

Competing Interests: Pfizer Mobilize against Malaria Initiative (MAM) provided funding for this study but was not involved in study design, data collection, and interpretation of the results or decisions to submit the final manuscript. RWS has participated in the Novartis National Malaria Control Programme Best Practice Workshops in Africa and has received consultative fees for participation. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. The distribution of randomly selected pre- (Green) and Post-intervention (Pink) enumeration area clusters for the household surveys.
Blue clusters indicate where ten clusters were randomly selected in both pre- and post-intervention selection
See this image and copyright information in PMC

References

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    1. United Nations Children Fund (2013) Invest in the future: Defeat malaria; World Malaria Day 2013 Focus on Africa. New York, United Nations Children Fund.
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    1. Pharmacy and Poisons Board (PPB) and Division of Malaria Control (2007) Antimalarial Medicines in Kenya—availability, quality and registration status: A baseline study undertaken prior to widespread distribution of Artemether-Lumefantine (AL) in Kenya. Ministry of Health, Republic of Kenya, November 2007.

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