ArticleHealth policy and planning2016
Access to integrated community case management of childhood illnesses services in rural Ethiopia: a qualitative study of the perspectives and experiences of caregivers.
Article in Health policy and planning, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Understanding influences of care-seeking behaviours for diarrhoeal illnesses: a qualitative meta-synthesis.BMJ open · 2026Pooled it
- Utilization of integrated community-based case management of childhood illness and associated factors in Ethiopia: a systematic review and meta-analysis.Italian journal of pediatrics · 2024Pooled it
- Community health workers and health equity in low- and middle-income countries: systematic review and recommendations for policy and practice.International journal for equity in health · 2022Pooled it
- Effects of the integrated Community Case Management of Childhood Illness Strategy on Child Mortality in Ethiopia: A Cluster Randomized Trial.The American journal of tropical medicine and hygiene · 2016Trial
- Enablers and barriers of community health programs for improved equity and universal coverage of primary health care services: A scoping review.BMC primary care · 2024Article
- Barriers to equitable healthcare services for under-five children in Ethiopia: a qualitative exploratory study.BMC health services research · 2024Article
- Evaluation of integrated community case management of the common childhood illness program in Gondar city, northwest Ethiopia: a case study evaluation design.BMC pediatrics · 2024Article
- Article
- Analyzing Primary Healthcare Governance in Indonesia: Perspectives of Community Health Workers.Cureus · 2024Article
- Article
- Identifying delays in healthcare seeking and provision: The Three Delays-in-Healthcare and mortality among infants and children aged 1-59 months.PLOS global public health · 2024Article
- Quality of sick child management by health extension workers: role of a complex improvement intervention.BMC health services research · 2023Article
- Poor Adherence to the Integrated Community Case Management of Newborn and Child Illness Protocol in Rural Ethiopia.The American journal of tropical medicine and hygiene · 2022Article
- Socio-cultural barriers to the delivery and utilisation of child healthcare services in rural Ghana: a qualitative study.BMC health services research · 2022Article
- Community health workers at the dawn of a new era: 5. Roles and tasks.Health research policy and systems · 2021Review
- Barriers to the uptake of community-based curative child health services in Ethiopia.BMC public health · 2021Article
- Barriers to the utilization of community-based child and newborn health services in Ethiopia: a scoping review.Health policy and planning · 2021Article
- Prevention and treatment of suspected pneumonia in Ethiopian children less than five years from household to primary care.Acta paediatrica (Oslo, Norway : 1992) · 2021Article
- Applying a gender lens to understand pathways through care for acutely ill young children in Kenyan urban informal settlements.International journal for equity in health · 2021Article
- Health extension service utilization barriers in East Gojjam Zone, Northwest Ethiopia: qualitative study.The Pan African medical journal · 2021Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn 2010, Ethiopia began scaling up the integrated community case management (iCCM) of childhood illness strategy throughout the country allowing health extension workers (HEWs) to treat children in rural health posts. After 2 years of iCCM scale up, utilization of HEWs remains low. Little is known about factors related to the use of health services in this setting. This research aimed to elicit perceptions and experiences of caregivers to better understand reasons for low utilization of iCCM services.
methodsA rapid ethnographic assessment was conducted in eight rural health post catchment areas in two zones: Jimma and West Hararghe. In total, 16 focus group discussions and 78 in-depth interviews were completed with mothers, fathers, HEWs and community health volunteers.
resultsIn spite of the HEW being a core component of iCCM, we found that the lack of availability of HEWs at the health post was one of the most common barriers to the utilization of iCCM services mentioned by caregivers. Financial and geographic challenges continue to influence caregiver decisions despite extension of free child health services in communities. Acceptability of HEWs was often low due to a perceived lack of sensitivity of HEWs and concerns about medicines given at the health post. Social networks acted both to facilitate and hinder use of HEWs. Many mothers stated a preference for using the health post, but some were unable to do so due to objections or alternative care-seeking preferences of gatekeepers, often mothers-in-law and husbands.
conclusionCaregivers in Ethiopia face many challenges in using HEWs at the health post, potentially resulting in low demand for iCCM services. Efforts to minimize barriers to care seeking and to improve demand should be incorporated into the iCCM strategy in order to achieve reductions in child mortality and promote equity in access and child health outcomes.
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