Utilization and Satisfaction with Community Health Worker Services amongst Caregivers of Children under Five in Mwea West, Kirinyaga County

Abstract

CHWs provide a possible solution for delivery of promotive and preventive interventions which have the potential to improve child health. Studying the satisfaction of individual users is important for improving and strengthening health systems. A cross-sectional study was conducted in Mutithi and Thiba in Kirinyaga County to determine uptake and satisfaction with CHW services amongst caregivers of children under 5. Data was collected using a semi-structured questionnaire and through 3 FGDs. Respondents interacted with CHWs mainly for preventive and promotive services. These include information on child health (n=230), appointment reminders (n=11), one-on-one counselling (n=46), information on community resources (n=47). 101 (23%) respondents had not received any services from CHWs in the 3 months preceding the study. Satisfaction was assessed using a 5-item Likert scale that included satisfaction with range of services, competence, information given by CHWs, interpersonal skills, follow-up and overall satisfaction. 55% of the respondents reported satisfaction with CHW services. Overall satisfaction was found to be related to such factors as receiving drugs from the CHWs (Chi square=89.752, p=0.001), home visits (Chi square=193.064, p=0.001), agreement with the choice of CHW (Chi square=218.3, p=0.001), involvement in the choice of CHW (Chi square=63.606, p=0.001) community unit (Chi Square=25.536, p=0.001) and awareness of the existence and roles of the CHWs (Chi square=73.577, p=0.001). Greater community involvement of community members during selection of CHWs, carrying out home visits and targeted education on CHW roles may increase satisfaction with CHS and strengthen CHS especially because CHWs still have a role to play in interventions that could prevent deaths amongst children under 5.