McHugh, M.Availability of child-friendly medicines and child caretaker knowledge on administering them among children below 5 years at lower public health facilities under Kampala Capital City

Abstract

Introduction In 2011, an estimated 7.6 million children under the age of 5 years died globally (Lozano et al.,2011). In Uganda, 32% of childhood mortality is due to malaria (MoH, 2010) and another 17–26% attributed to pneumonia (Black et al., 2003), conditions which are treatable with existing medicines. This study aimed at assessing the availability of child-friendly medicines for treating uncomplicated malaria and pneumonia among children below 5 years attending lower public health facilities under Kampala Capital City Authority (KCCA) and caretaker knowledge on administering theses medicines in order to improve childhood morbidity and mortality.

Methodology A cross sectional study was conducted at 8 KCCA clinics. The study population comprised of caretakers of children below 5 years of age who had received medical treatment for Uncomplicated malaria and/or pneumonia and health workers who had been involved in prescribing and dispensing medicines to the sick children. Availability of children medicines on the survey day and 12 months preceding the study was determined using an observation checklist. Face-to-face exit interviews with caretakers were conducted to collect information on health worker prescribing and dispensing practices, caretaker knowledge on dispensed medicines, and factors associated with caretaker knowledge on administering medicines to children. Data on availability was analyzed and summarized using Microsoft Office Excel 2007. Data on health worker prescribing and dispensing practices, caretaker knowledge and factors associated with their knowledge on administering medicines to sick children was analyzed using STATA version 10.0. Caretakers who recalled all the four instructions (indication of medicine, dosage, frequency of dosing and treatment duration) were regarded knowledgeable. Bivariate and multivariate analyses were performed to determine factors associated with caretaker knowledge on administering medicines.

Results Availability of child-friendly medicines for treating uncomplicated malaria and pneumonia was unpredictable. None of the health facilities stocked any child-friendly formulation of artemether lumefantrine (A/L) during the study period. Dispersible amoxicillin 125mg tablet and dispersible cotrimoxazole 120mg tablet for treating pneumonia were available during 42% and 81% of the study period respectively. Overall, health workers performed good prescribing and dispensing practices. On the other hand, caretaker knowledge on the dispensed medicines was low. Caretakers had limited recall of duration of the treatment, however, they had good recall of the reason for receiving the medicine, correct dosage and frequency. The factors that were associated with caretaker knowledge on the dispensed medicines were caretaker age, level of education and level of health facility attended.

Conclusion and recommendations Availability of child-friendly medicines for treating uncomplicated malaria and pneumonia under KCCA clinics is still erratic. Overall, caretaker knowledge on administering medicines to children was very low. Efforts to improve the availability of children medicines and caretaker knowledge should be implemented so as to contribute toward the reduction of under five mortality.