Maternal and Child Health Clinical Trial
Official title:
Healthy Child Uganda: Can Village Health Volunteers Trained in Integrated Community Case Management of Childhood Illness Improve Access to Care for Africa's Most Vulnerable Children?
In Sub-Saharan Africa (SSA), many children die from diarrhoea, acute respiratory illness
(ARI) and malaria, despite well- recognized, inexpensive and highly effective treatments,
since health access and human resources are limited. Healthy Child Uganda (HCU) is a
Ugandan-Canadian partnership that since 2003, has developed, implemented and evaluated a
Village Health Volunteer (VHV) program in 175 rural villages. Volunteers, selected by peers,
provide health education and refer sick children. Volunteer retention (94%) and significant
decreases in child deaths are remarkable. Now, HCU wonders whether VHV scope can extend to
provide treatment for sick children using Oral Rehydration Salts (ORS)/Zinc, antibiotics,
and antimalarials. Use of lay providers in this capacity, called integrated community case
management (iCCM), has been proposed as a potential inexpensive solution to SSA's human
health resource crisis.
PRIMARY QUESTION: In rural southwest Uganda, can iCCM provided by lay volunteers, improve
the proportion of children with diarrhoea receiving ORS/Zn, ARI receiving antibiotics, and
fever/malaria receiving antimalarials? Secondary study questions consider VHV capacity to
prescribe appropriate drug, dose, duration; iCCM acceptance by family, and VHV; VHV
retention/motivation; program cost. Selected VHV will be iCCM trained then receive
treatments for distribution. Qualitative and quantitative methods including household
surveys, and focus groups will consider pre/post intervention differences and differences in
control and intervention populations. A research short course and micro research grants (~
$3000 to multidisciplinary groups pursuing relevant questions) will promote health system
evaluation capacity. Lessons learned are critical as SSA countries move forward in planning
for increased iCCM programming.
n/a
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Health Services Research
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