Malaria is a major public health concern in many countries, including Ghana. Community Health Volunteers (CHVs) play a vital role in the delivery of Seasonal Malaria Chemoprevention (SMC) services in rural and hard-to-reach communities. The World Health Organization (WHO) recommends Seasonal Malaria Chemoprevention (SMC) as an effective intervention to reduce …
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Malaria is a major public health concern in many countries, including Ghana. Community Health Volunteers (CHVs) play a vital role in the delivery of Seasonal Malaria Chemoprevention (SMC) services in rural and hard-to-reach communities. The World Health Organization (WHO) recommends Seasonal Malaria Chemoprevention (SMC) as an effective intervention to reduce the burden of malaria in children aged 3 to 59 months. However, little is known about the quality of care provided by the community health volunteers. This study sought to assess the quality of SMC services provided by CHVs in the Nanumba South District. The study was a cross-sectional survey. The quantitative study method was employed. Systematic sampling method was used to select caregivers for the study. All community health volunteers were studied. Descriptive analysis was used to show frequencies and percentages of variables. The study adopted the Donabedians model. Chi-square was used to show association between variables on supervisory activities and quality of care. Binary logistics regression was also used to determine the influence of volunteers’ adherence on quality of care. A higher coverage (96.7%) of beneficiary children received the SMC drug. An insignificant percentage (6.3%) of caregivers had adequate level of knowledge on SMC. No significant association between SMC supervisory activities and quality of care provided by SMC volunteers was identified. The presence of a supervisor during CHV's work (χ2 = 0.086, p = 0.769) and the frequency of supervisor’s visits (χ2 = 0.215, p = 0.643) did not demonstrate significant associations with the quality of care. There was a significant influence of volunteers’ adherence to SMC protocol on quality of care. Caregivers who received health education from their CHVs had significantly higher odds of receiving high-quality care compared to those who did not receive such education (COR = 20.055, 95% CI: 0.871-0.998, p = 0.001*). CHVs who asked about the child's health status before administering the drug had significantly lower odds of caregivers receiving poor-quality care (COR = 0.01, 95% CI: 0.001-0.012, p = 0.001*). Moreover, caregivers whose volunteers observed the child for 30 minutes after drug administration had significantly higher odds of receiving high-quality care (COR = 3.9, 95% CI: 0.34-4.373, p = 0.02*). Though the coverage of the programme is high, caregivers’ level of knowledge and adherence to SMC protocol by CHVs need improvement as these can influence the quality of care provided. To improve the SMC effectiveness, health education and supervision are critical. Regular assessment of performance of CHVs, comprehensive training including technical skills and SMC protocols should be stepped up.
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