Community health workers – a resource for identification and referral of sick newborns in rural Uganda. Issue 7 (2nd April 2013)

• Record Type: Journal Article
• Authors: Kayemba Nalwadda, Christine; Guwatudde, David; Waiswa, Peter; Kiguli, Juliet; Namazzi, Gertrude; Namutumba, Sarah; Tomson, Göran; Peterson, Stefan
• Is Part Of: Tropical medicine & international health. Volume 18:Issue 7(2013:Jul.)
• Page Start: 898
• Page End: 906
• Publication Date: 2013-04-02
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12106
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12106-abs-0001"> <title>Abstract</title> <sec id="tmi12106-sec-0001" sec-type="section"> <title>Objective</title> <p>To determine community health workers' (CHWs) competence in identifying and referring sick newborns in Uganda.</p> </sec> <sec id="tmi12106-sec-0002" sec-type="section"> <title>Methods</title> <p>Case‐vignettes, observations of role‐plays and interviews were employed to collect data using checklists and semistructured questionnaires, from 57 trained CHWs participating in a community health facility–linked cluster randomised trial. Competence to identify and refer sick newborns was measured by knowledge of newborn danger signs, skills to identify sick newborns and effective communication to mothers. Proportions and median scores were computed for each attribute with a pre‐defined pass mark of 100% for knowledge and 90% for skill and communication.</p> </sec> <sec id="tmi12106-sec-0003" sec-type="section"> <title>Results</title> <p>For knowledge, 68% of the CHWs attained the pass mark. The median percentage score was 100 (IQR 94 100). 74% mentioned the required five newborn danger signs unprompted. 'Red umbilicus/cord with pus' was mentioned by all CHWs (100%), but none mentioned chest in‐drawing and grunting as newborn danger signs. 63% attained the pass mark for both skill and communication. The median percentage scores were 91 (IQR 82 100) for skills and 94 (IQR 89, 94) for effective communication. 98% correctly identified the four case‐vignettes as sick or not sick newborn. 'Preterm birth' was the least identified danger sign from the case‐vignettes, by 51% of the CHWs.</p> </sec> <sec id="tmi12106-sec-0004" sec-type="section"> <title>Conclusion</title> <p>CHWs trained for a short period but effectively supervised are competent in identifying and referring sick newborns in a poor resource setting.</p> </sec> </abstract>