Factors associated with uptake of anaemia related prevention and control interventions for children aged 6-59 months in Gulu district.

Abstract

Introduction: More than 70% of children in Gulu district are anaemic. Despite government interventions to control anaemia, uptake of the anaemia related prevention and control interventions remains low. Objective: To determine the uptake of anaemia related prevention and control interventions and associated factors for children 6-59 months in Gulu district. Methods: Through a cross-sectional study, a random sample of 552 caregivers of children aged 6-59 months was selected and interviewed using a semi-structured questionnaire. Eleven indepth interviews and 10 key informant interviews held with caregivers and health workers respectively using KII and IDI guides. The main outcome, uptake was measured as the number of interventions taken up out of the six intervention for (children under two years) and five interventions (children above two years). Interventions were; Breastfeeding (children under two) Vitamin A, deworming, use of LLINs, consumption of iron rich foods and good hygiene and sanitation practice. Level of uptake was defined as low (0-2 interventions), moderate (3-4 interventions) and high uptake (5-6 interventions). Independent variables included individual, system, and community factors. Analysis of individual factors was done by multinomial regression using STATA 14.0 while system, and community factors were analysed qualitatively through thematic analysis. Results: The number of children studied comprised males (52%) and females (48%). The mean age of children was 29 months while that of caregivers was 29 years. Uptake of Vitamin A was at 56.7%, deworming at 58.8%, breastfeeding was 85.5%, LLIN was 93.5%, consumption of iron rich foods at 37% and hygiene and sanitation low at 19%. For levels of uptake 37.5% had low (0-2 interventions), 50.2% had moderate (3-4 interventions) and 12.3% had high uptake (5 interventions and above). Age of a child was associated with both high and low uptakes while only perceived risk and knowledge of anaemia was associated with high uptake. Income and employment status were associated with only low uptake. Community child health campaigns, timing of immunisation, and supply stock outs were key system factors identified while spousal and family support, workload and myths were key community factors identified. Conclusion: Uptake of anaemia related preventive interventions for children 6-59 months is still low among caregivers in Gulu district with youngest child category disproportionately affected. More awareness and behaviour change campaigns should focus on younger children and encourage spousal support for women who are burdened by heavy workload. Child Days Campaigns should be planned with consideration for cultivation seasons of the community.