| dc.description.abstract | Background: Pneumonia is the 2nd leading cause of death in children under 5 years of age in
Uganda. Pneumonia deaths could be prevented if Village Health Teams (VHTs) knew how to
manage pneumonia correctly. The objective of the study was to determine factors associated with
management of pneumonia among under-five year children by VHTs in Abim district.
Methods: This was a cross sectional mixed methods study that investigated management of
pneumonia by VHTs. Data was collected from 374 VHTs using a training video, questionnaires
and case vignettes. The proportion of VHTs that correctly manage pneumonia was determined.
Modified Poisson regression was used to investigate factors associated with management of
pneumonia in children by VHTs. Four (4) key informants’ interviews with health workers (VHT
focal persons) of health centres II, III and five focus group discussions with community members
were conducted.
Results: The study found that 15.51% of VHTs correctly manage children with pneumonia in
the district as per the Sick Child Job Aid. In addition, the study reported that 73.8% of the VHTs
could count within +/- 5 count of an expert. The study found that educational level [Adj. PR
2.06; 95% CI: (1.18-3.61) p-value 0.011], having a VHT register [Adj. PR 0.54; 95% CI (0.30-
0.98) p-value 0.041] and drug stock outs [Adj. PR 4.24; 95% CI (1.37-13.13) p-value 0.012]
were significantly associated with management of pneumonia. The qualitative component
identified refresher training, equipment and supplies and support supervision as main health
facility factors influencing management of pneumonia among children by VHTs. Similarly
community perception that VHTs cannot manage a child with pneumonia, drug stock outs, and
trust were the community factors influencing VHT management of pneumonia.
Conclusion: A low proportion of VHTs in the district manage children with pneumonia as per
the Sick Child Job Aid. Strategies to improve provision of VHT registers and drugs, support
supervision, refresher trainings and recruitment of educated individuals into the VHT structure
are necessary to improve management of pneumonia. Communities should also be sensitised on
roles and responsibilities of VHTs in management of pneumonia | en_US |
