Survey on Mothers/Caretakers Awareness on Child Illnesses, Health Care seeking behavior and Utilization of Health Care services in Ajuong Thok refugee camp, South Sudan
Africa Humanitarian Action (AHA) South Sudan, August, 2016
Africa Humanitarian Action partnered with UNICEF in May 2016, to implement an Integrated Community Case Management (iCCM) project for a period of six months. The project was the first of its kind in a refugee setting in South Sudan.
iCCM is an integrated approach for assessing and classifying signs and symptoms of pneumonia, diarrhea, and malaria by Community Health Promoters/Community Based Distributors (CHP/CBDs) among Under Five(U5) children. Recognizing the critical role of CHP/CBDs; WHO, UNICEF, USAID and other partners developed the iCMM strategy to enable provision of home-based treatment; and/or, as and when necessary, to sort out referral cases and transfer to health facilities.
According to the UNHCR refugee’s registration, Ajoung Thok refugee camp in South Sudan hosted 40, 693 refugees by the end of June 2016, of which 7,463 (18%) were U5 children. The health service data at start of iCCM project for the month of April 2016 showed that, 42.1 % of the total cases recorded in the AHA Primary Health Care Facilities were children. The compiled cause specific morbidity data showed that pneumonia, malaria and diarrhea accounted respectively for 49, 18 and 11 percent of U5 children morbidity.
The iCCM project covered 8 zones of the refugee camp. It aimed to increase care seeking behavior of U5 children mothers/caretakers for pneumonia, malaria and diarrhea cases and to improve their utilization of available health care services. Activities during the project included; recruitment of technical personnel, training of AHA CHPs in iCCM, provision of necessary drugs and supplies by the CHP/CBDs for treatment of U5 children suffering from malaria/fever, diarrhea and pneumonia illnesses.
In August 2016, a survey was conducted in collaboration with UNICEF and UNHCR, after a joint planning meeting comprised of AHA and stakeholders decided to carry out a survey at the start of the iCCM project foreseeing also a possible impact assessment.
The objective of the survey was to establish U5 children’s mothers/caretakers child illnesses awareness, health care seeking behavior and utilization of available health care services in the Ajuong Thok refugee camp and to evaluate the two week period prevalence of diarrhea, fever and ARI of U5 children in Ajuong Thok refugee camp prior to the start of the iCCM project. It was also understood the survey result will serve to set benchmark for AHA’s health and nutrition programs, as well as for future iCCM intervention.
The survey was conducted in the eight zones of the Ajuong Thok refugee camp. A total of 423 mothers/caretakers (households) and five CHP/CBDs directly providing health care service in Ajuong Thok refugee camp were selected for the interview using multi-stage and random sampling. A pre-tested questionnaire was used to carry out the interviews and collect data. The questionnaires employed for the U5 children was adopted from the UNICEF multiple indicator cluster survey (MICS).
The questionnaire to the mothers/caretakers focused on collecting information on the interviewee’s awareness regarding common childhood illness (malaria, diarrhea, and ARI) and iCCM in the two weeks preceding the survey; and on their access to and utilization of available health care services.
Accordingly, findings from the survey showed:
• Mothers/Care takers of the U5 children demonstrated appreciable awareness of the symptoms and danger signs of malaria, diarrhea and ARIs.
• 3% of the respondents knew about the ongoing iCCM services and the majority of the U5 children mothers/caretakers utilize the services
• The prevalence of fever, ARI, diarrhea among U5 children two weeks before the survey was respectively 9.5 , 9.2 and 5.4 percent;
• CHP/CBDs play a significant role as main source of information in matters related to health promotion and disease prevention and 88% of them had received iCCM services through the CHP/CBDs and;
• It takes 30 minutes to an hour on foot for 86.1% of the respondents to reach the health facilities and seek treatment.
Source: AHA South Sudan