Experiences of households using municipal ward-based primary health care outreach teams in Kwa-Zulu Natal, South Africa: a cross-sectional survey [post]

2019 unpublished
BACKGROUND: Globally, the success of community-based health care teams varies between programmes, and their designs tend to be unique based on local needs and context. Whilst the body of knowledge on community-based health care teams is growing in sub-Saharan Africa, there is still a lack of evaluation studies designed from the perspective of service users. OBJECTIVE: To assess household experiences of health care services delivered by outreach teams, and identify potential areas for service
more » ... rovement by further examining sub-optimal household experiences. METHODS: We used a cross-sectional household survey in three municipality wards with functional ward-based outreach teams in the iLembe District, out of 74 wards, carried out from October to December 2016. Systematic random sampling was used, and 383 households were surveyed. The mean point of 70% in the strongly agreed category was used to classify household experiences as either optimal (70% and above) or sub-optimal (below 70%). Further univariate and multivariate analyses were conducted for sub-optimal experiences. RESULTS: Nearly all households (99.2%) reported being visited most frequently by community health workers, relative to other outreach team members. Optimal experiences reported by households included services being free-of-charge (91.3%), convenient operating hours (77.9%), and outreach team members treating people with respect and courtesy (72.4 %). Sub-optimal experiences were identified as; outreach teams bringing with them sufficient equipment and medication (46.5%), associated with perceived skill level of team member (aOR 0.28, p: 0.001); teams perceived as being professional in carrying out their duties (56.3%), associated with age (aOR 3.22, p: 0.022) and marital status (aOR 1.80, p: 0.027); and teams providing a satisfactory service to respondents (61.8%), associated with quality of information provided (aOR 0.10, p: 0.002). CONCLUSION: Household experiences are influenced by team composition, and limited to skill sets of CHWs frequently visiting households. Whilst policy-related aspects of the outreach team programme were considered optimal, there was a gap in the service-related experience, which should not only be improved by upskilling CHWs, but also ensuring the full implementation of the
doi:10.21203/rs.2.19217/v1 fatcat:uu4ebdjj3ra3bkrrhwnsu5waiq