标题：Outcomes and Associated Factors Of Integrated Community Case Management of Childhood Illnesses in Rural Districts of Dawro Zone, South West Ethiopia
摘要：Integrated community case management (ICCM), after its scale-up in March 2011in Ethiopia, has reached about 86% national geographic coverage, more than 38,000 health extension workers (HEWs) were trained and care seeking behavior at health posts was increased. However, there was no study on health outcomes of under-five children and associated factors following treatment of common childhood illnesses by HEWs in Ethiopia. Objective: To assess outcomes and associated factors of integrated community case management of childhood illnesses’ services in Dawro zone in order to provide evidence for informed decision-making. Methods: A community based retrospective cross-sectional study was conducted on randomly selected mothers and/or care givers of sick under-five years aged children from March 15 to April 12, 2017 in districts of Dawro zone, southwest Ethiopia. The Sample size was determined by single population proportion formula with assumption of p = 50%, 95% confidence interval, 5% marginal error, design effect of 2 due to multistage sampling that gave 768 and 5% non-response rate making the total calculated size of 806. The sample size was proportionally allocated to each woreda/district and town administration based on number of their children treaded in the study period. Multivariate logistic regression analysis was used identify variables associated with outcomes. Findings were presented descriptively by frequency tables and graphs. Ethical clearance was obtained from Health Institute of Jimma University. Result: Seven hundred ninety one child-caregiver pairs of under-five children were participated in this study. Among these 705, 58, and 28 were cured, illnesses worsen, and died respectively. Caregiver’s educational status, household wealth, age of the child, travel time from home to health post, age of the caregivers, caregiver’s knowledge of childhood danger signs, and harmful traditional practices were associated with outcomes of the treated children. Conclusion: This study revealed that most of the under-five children improved following the management by health extension workers. Distance of residence from health post, knowledge of Caregiver and harmful traditional practices had negatively influenced the outcome. Thus, it was recommended that capacity should be built to teach caregivers about danger signs of childhood illnesses and eliminating harmful traditional practices.
