Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers
Seasonal Malaria Chemoprevention (SMC) is currently recommended for children under five in areas where malaria transmission is highly seasonal. We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme. Thirteen in-depth int...
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| Veröffentlicht in: | PloS one 2016-11, Vol.11 (11), p.e0166951-e0166951 |
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| creator | Antwi, Gifty D Bates, Laura A King, Rebecca Mahama, Princess R Tagbor, Harry Cairns, Matt Newell, James N |
| description | Seasonal Malaria Chemoprevention (SMC) is currently recommended for children under five in areas where malaria transmission is highly seasonal. We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme.
Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake.
There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for malaria during the baseline survey at the start of the SMC programme may have positively influenced uptake. Facilitators of uptake included caregivers' trust in and respect for administrators of SMC (including CHWs), access to medication and supportive (family) networks. Barriers to uptake related to poor communication of timings of community gatherings, travel distances, absence during SMC home deliveries, and limited demand for SMC due to lack of previous experience. Future delivery of SMC by trained CHWs would be acceptable to caregivers.
A combination of caregivers' physical access to SMC medication, the drug regimen, trust in the medical profession and perceived norms around malaria prevention all likely influenced caregivers' level of uptake. SMC programmes need to consider: 1) developing supportive, accessible and flexible modes of drug administration including home delivery and village community kiosks; 2) improving demand for preventive medication including the harnessing of learnt trust; and 3) developing community-based networks for users to support optimal uptake of SMC. |
| doi_str_mv | 10.1371/journal.pone.0166951 |
| format | Article |
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Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake.
There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for malaria during the baseline survey at the start of the SMC programme may have positively influenced uptake. Facilitators of uptake included caregivers' trust in and respect for administrators of SMC (including CHWs), access to medication and supportive (family) networks. Barriers to uptake related to poor communication of timings of community gatherings, travel distances, absence during SMC home deliveries, and limited demand for SMC due to lack of previous experience. Future delivery of SMC by trained CHWs would be acceptable to caregivers.
A combination of caregivers' physical access to SMC medication, the drug regimen, trust in the medical profession and perceived norms around malaria prevention all likely influenced caregivers' level of uptake. SMC programmes need to consider: 1) developing supportive, accessible and flexible modes of drug administration including home delivery and village community kiosks; 2) improving demand for preventive medication including the harnessing of learnt trust; and 3) developing community-based networks for users to support optimal uptake of SMC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0166951</identifier><identifier>PMID: 27898699</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Antimalarials - therapeutic use ; Attitude of Health Personnel ; Biology and Life Sciences ; Care and treatment ; Caregivers ; Case Management ; Chemoprevention ; Chemoprevention - methods ; Chemotherapy ; Child, Preschool ; Children ; Communities ; Community health aides ; Community Health Workers ; Decision making ; Diagnostic systems ; Diagnostic Tests, Routine - methods ; Disease transmission ; Drug delivery systems ; Drug dosages ; Drugs ; Female ; Focus Groups ; Ghana - epidemiology ; Health aspects ; Health sciences ; Humans ; Immunization ; Infant ; Infant, Newborn ; Insecticides ; Kiosks ; Malaria ; Malaria - epidemiology ; Malaria - prevention & control ; Malaria - transmission ; Male ; Medical personnel ; Medicine and Health Sciences ; Mortality ; Norms ; Patient Acceptance of Health Care ; People and Places ; Practice ; Prevalence ; Prevention ; Public health ; Qualitative research ; Seasons ; Tropical diseases ; Vector-borne diseases ; Wellness programs ; Workers</subject><ispartof>PloS one, 2016-11, Vol.11 (11), p.e0166951-e0166951</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Antwi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Antwi et al 2016 Antwi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c725t-1936602b48a20abf6287324267f8644d7e0b835b22d05f298f8097a42af453e13</citedby><cites>FETCH-LOGICAL-c725t-1936602b48a20abf6287324267f8644d7e0b835b22d05f298f8097a42af453e13</cites><orcidid>0000-0001-6172-9071</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127521/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127521/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27898699$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gutman, Julie</contributor><creatorcontrib>Antwi, Gifty D</creatorcontrib><creatorcontrib>Bates, Laura A</creatorcontrib><creatorcontrib>King, Rebecca</creatorcontrib><creatorcontrib>Mahama, Princess R</creatorcontrib><creatorcontrib>Tagbor, Harry</creatorcontrib><creatorcontrib>Cairns, Matt</creatorcontrib><creatorcontrib>Newell, James N</creatorcontrib><title>Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Seasonal Malaria Chemoprevention (SMC) is currently recommended for children under five in areas where malaria transmission is highly seasonal. We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme.
Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake.
There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for malaria during the baseline survey at the start of the SMC programme may have positively influenced uptake. Facilitators of uptake included caregivers' trust in and respect for administrators of SMC (including CHWs), access to medication and supportive (family) networks. Barriers to uptake related to poor communication of timings of community gatherings, travel distances, absence during SMC home deliveries, and limited demand for SMC due to lack of previous experience. Future delivery of SMC by trained CHWs would be acceptable to caregivers.
A combination of caregivers' physical access to SMC medication, the drug regimen, trust in the medical profession and perceived norms around malaria prevention all likely influenced caregivers' level of uptake. SMC programmes need to consider: 1) developing supportive, accessible and flexible modes of drug administration including home delivery and village community kiosks; 2) improving demand for preventive medication including the harnessing of learnt trust; and 3) developing community-based networks for users to support optimal uptake of SMC.</description><subject>Antimalarials - therapeutic use</subject><subject>Attitude of Health Personnel</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Caregivers</subject><subject>Case Management</subject><subject>Chemoprevention</subject><subject>Chemoprevention - methods</subject><subject>Chemotherapy</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Communities</subject><subject>Community health aides</subject><subject>Community Health Workers</subject><subject>Decision making</subject><subject>Diagnostic systems</subject><subject>Diagnostic Tests, Routine - methods</subject><subject>Disease transmission</subject><subject>Drug delivery systems</subject><subject>Drug dosages</subject><subject>Drugs</subject><subject>Female</subject><subject>Focus Groups</subject><subject>Ghana - epidemiology</subject><subject>Health aspects</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Immunization</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Insecticides</subject><subject>Kiosks</subject><subject>Malaria</subject><subject>Malaria - epidemiology</subject><subject>Malaria - prevention & control</subject><subject>Malaria - transmission</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Norms</subject><subject>Patient Acceptance of Health Care</subject><subject>People and Places</subject><subject>Practice</subject><subject>Prevalence</subject><subject>Prevention</subject><subject>Public health</subject><subject>Qualitative research</subject><subject>Seasons</subject><subject>Tropical diseases</subject><subject>Vector-borne diseases</subject><subject>Wellness programs</subject><subject>Workers</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk81u1DAQxyMEoqXwBggsISE47BJ_xUkPSGXVL6moQCkcrUky2XWbxIvtVO0L8Zx427Tqoh6qHJLM_OY_4_FMkrym6ZRyRT-d2cH10E6XtsdpSrOskPRJskkLziYZS_nTe98byQvvz9JU8jzLnicbTOVFnhXFZvJ3DyrTmgDBOk-gr8kXcM5g_AmWnC4DnCOxTfSQ3cuAfY01OUHwNqYmX6EFZ4DMFtjZpcML7IOxPfnm7NxB1yExPdlfQA_bZId8H-A6kblAchKG-mqlOwOH82gZk89s1w29CVfkAKENC_LbuvPofJk8a6D1-Gp8byWne7s_ZweTo-P9w9nO0aRSTIZJPHCWpawUObAUyiZjueJMsEw1eSZErTAtcy5LxupUNqzImzwtFAgGjZAcKd9K3t7oLlvr9dhir2kuhCykonkkDm-I2sKZXjrTgbvSFoy-Nlg31-CCqVrUOS8p4xxKLLkoyybmyWJioFgJgcCi1ucx21B2WFexfQ7aNdF1T28Wem4vtKRMSbYq98Mo4OyfAX3QnfEVti30aIdV3TJVShWKPwIVkkmaxRZuJe_-Qx9uxEjNIZ7V9I2NJVYrUb0jFGM0Z4WM1PQBKj41dqaKo9uYaF8L-LgWEJmAl2EOg_f68OTH49njX-vs-3vs4nq6vG2H1cD6dVDcgJWz3jts7u6Dpnq1ebfd0KvN0-PmxbA39-_yLuh21fg_z4wpcA</recordid><startdate>20161129</startdate><enddate>20161129</enddate><creator>Antwi, Gifty D</creator><creator>Bates, Laura A</creator><creator>King, Rebecca</creator><creator>Mahama, Princess R</creator><creator>Tagbor, Harry</creator><creator>Cairns, Matt</creator><creator>Newell, James N</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>F1W</scope><scope>H95</scope><scope>H97</scope><scope>L.G</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6172-9071</orcidid></search><sort><creationdate>20161129</creationdate><title>Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers</title><author>Antwi, Gifty D ; Bates, Laura A ; King, Rebecca ; Mahama, Princess R ; Tagbor, Harry ; Cairns, Matt ; Newell, James N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c725t-1936602b48a20abf6287324267f8644d7e0b835b22d05f298f8097a42af453e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Antimalarials - 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We explored children's caregivers' and community health workers' (CHWs) responses to an extended 5-month SMC programme.
Thirteen in-depth interviews and eight focus group discussions explored optimal and suboptimal 'uptake' of SMC to examine facilitators and barriers to caregivers' uptake.
There did not appear to be major differences between caregivers of children with optimal and sub-optimal SMC uptake in terms of their knowledge of malaria, their perceptions of the effect of SMC on a child's health, nor their understanding of chemoprevention. Caregivers experienced difficulty in prioritising SMC for well children, perceiving medication being for treatment rather than prevention. Prior to the study, caregivers had become accustomed to rapid diagnostic testing (RDT) for malaria, and therefore blood testing for malaria during the baseline survey at the start of the SMC programme may have positively influenced uptake. Facilitators of uptake included caregivers' trust in and respect for administrators of SMC (including CHWs), access to medication and supportive (family) networks. Barriers to uptake related to poor communication of timings of community gatherings, travel distances, absence during SMC home deliveries, and limited demand for SMC due to lack of previous experience. Future delivery of SMC by trained CHWs would be acceptable to caregivers.
A combination of caregivers' physical access to SMC medication, the drug regimen, trust in the medical profession and perceived norms around malaria prevention all likely influenced caregivers' level of uptake. SMC programmes need to consider: 1) developing supportive, accessible and flexible modes of drug administration including home delivery and village community kiosks; 2) improving demand for preventive medication including the harnessing of learnt trust; and 3) developing community-based networks for users to support optimal uptake of SMC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27898699</pmid><doi>10.1371/journal.pone.0166951</doi><tpages>e0166951</tpages><orcidid>https://orcid.org/0000-0001-6172-9071</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_1844595718 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Antimalarials - therapeutic use Attitude of Health Personnel Biology and Life Sciences Care and treatment Caregivers Case Management Chemoprevention Chemoprevention - methods Chemotherapy Child, Preschool Children Communities Community health aides Community Health Workers Decision making Diagnostic systems Diagnostic Tests, Routine - methods Disease transmission Drug delivery systems Drug dosages Drugs Female Focus Groups Ghana - epidemiology Health aspects Health sciences Humans Immunization Infant Infant, Newborn Insecticides Kiosks Malaria Malaria - epidemiology Malaria - prevention & control Malaria - transmission Male Medical personnel Medicine and Health Sciences Mortality Norms Patient Acceptance of Health Care People and Places Practice Prevalence Prevention Public health Qualitative research Seasons Tropical diseases Vector-borne diseases Wellness programs Workers |
| title | Facilitators and Barriers to Uptake of an Extended Seasonal Malaria Chemoprevention Programme in Ghana: A Qualitative Study of Caregivers and Community Health Workers |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T09%3A36%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Facilitators%20and%20Barriers%20to%20Uptake%20of%20an%20Extended%20Seasonal%20Malaria%20Chemoprevention%20Programme%20in%20Ghana:%20A%20Qualitative%20Study%20of%20Caregivers%20and%20Community%20Health%20Workers&rft.jtitle=PloS%20one&rft.au=Antwi,%20Gifty%20D&rft.date=2016-11-29&rft.volume=11&rft.issue=11&rft.spage=e0166951&rft.epage=e0166951&rft.pages=e0166951-e0166951&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0166951&rft_dat=%3Cgale_plos_%3EA472218295%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1844595718&rft_id=info:pmid/27898699&rft_galeid=A472218295&rft_doaj_id=oai_doaj_org_article_83b1233abeb34bbfa4262d0a1ec44ea2&rfr_iscdi=true |