Wa Municipal

LQAS Household Survey Preliminary Findings
23 November, 2012
By: Dachaga Oswald

LOT QUALITY ASSURANCE SAMPLING

PRELIMINARY FINDINGS

• 57. 0-5mths received PNC & 23.1% of mothers practiced appropriate umbilical cord care (nothing or antiseptic) after birth .2% of mothers report the children had PNC by skilled provider within 48hrs of childbirth • 22.2% & 69. • 61.Key Findings 1 • 75.8% of Mothers practiced exclusive breastfeeding in the past 24hrs preceding the survey • 63.% of mothers attended at 4 ANC visits in the their last pregnancy by recall and by card Respectively.9% of Chn.1% of mothers received at least 2 doses of IPT during last pregnancy.

8% of Chn 0-59 mths with diarrhea were taken to an appropriate health provider • 27. 1.4% of Chn 0-59 mths with diarrhea received ORS.Key Findings 2 • 25. • 15. 0-59mths with suspected ARI received appropriate antibiotic from an appropriate health provider • 56.8% Chn 0-59 mths with fever were taken to an appropriate health provider within 24hrs of onset of symptoms and only 5.1% received Zinc and 0.3% of them received appropriate antimalarial drugs .0% received both ORS & Zinc from an appropriate health provider.3% of Chn.

2% of chin 12–23 mths received at least one high dose of vitamin A supplement in the last 6 mths (card confirmed) • 91.6% households with chn 0-59 mths own at least one LLIN • 67.0% & 68. • 42.5% of Mothers & chn 0-59mths respectively slept under an LLIN the night preceding the survey • 88.1% & 49.9% of Households with chn 0-59s received at least one & Two bed nets respectively from the Hang up Campaign.4% and 78.5% .Key Findings 3 • 44.5% of Mothers of chn 0-59mths were visited by CBAs & CHOs Respectively in the past three months • Prevalence of presumed pneumonia among children 0-59 months stands at 9.

Prevalence .

diarrhea and malaria prevalence .Pneumonia.

Knowledge .

2% .0% 45.0% 15.0% Mothers who know at Mothers who know at Motherswho know at least two danger signs of least two danger signs of least two danger signs of diarrhoea fever cough 24.Care giver knowledge of danger signs in children U5 50.0% 0.2% 15.0% 10.0% 5.0% 25.0% 40.8% 44.0% 20.0% 35.0% 30.

Accessibility .

0% 50.5% 25.0% 77.0% 60.0% 10.0% 0.3% suspected ARI taken to an appropriate health provider suspected ARI in Mothers of Chn 0.3% 50.Chn 0-59 mths with the last two wks 59 mths with suspected ARI receiving an suspected ARI valid Valid NHIS card appropriate NHIS card antibiotic from an appropriate health provider .0% 80.0% 20.0% 30.0% 40.0% 70.9% 66.Pneumonia Case Management 90.

3% 56.Diarrheoa Case Management 70.0% 10.1% 0.0% 40.0% District Priority 27.0% 50.8% 54.0% 0.0% 20.0% 1.0% Chn 0-59 Receiving Receiving Receiving Mothers of Chn 0-59 mths with ORS from an ZINC from ORS AND Chn 0-59 mths with taken to an appropriate an ZINC from mths with diarrhea with appropriate health appropriate an diarrhea with valid NHIS health provider health appropriate valid NHIS card provider provider health card provider .4% 30.7% 60.0% 65.

0% 67.Malaria Case Management Children 0-59 Months with Fever in the Last Two weeks Preceding the Survey 67.0% 40.0% 10.0% 60.8% 5.4% 70.0% 30.0% 50.4% 15.0% 20.0% 0.3% Taken to an Receiving an Mothers of Chn with appropriate health appropriate fever having valid provider within 24hrs antimalarial from an NHIS card of onset of symptoms appropriate health provider within 24hrs of onset of symptoms Chn with feverhaving valid NHIS card .

0% 40.0% 5.0% 69.0% Attended their first ANC visit at < 4 mths pregnant All doses of IPT as directly observed therapy At least IPT2 during last pregnancy .0% 55.0% 15.5% 69.0% 20.0% 35.Intermittent Preventive Treatment(IPT) 70.0% 60.0% 10.1% 45.0% 50.0% 30.0% 65.0% 25.5% 61.

0% 60.0% 80.0% 100.0% 0.0% 44.2% 40. Iron & Folic Acid 120.Tetanus Toxoid.0% Iron and folic acid during their last pregnancy At least TT2 during their last pregnancy .0% 100.0% 20.

2% 22.0% 20.0% 87.0% 80.0% 0.0% 40.0% 10.4% 57.0% 90.0% 70.1% Birth by skilled Birth in a health PNC by skilled PNC by skilled Practice of birth attendant facility provider within provider within appropriate 2 days of 2 days of umbilical cord childbirth childbirth care (nothing or (Mother's antiseptic) after Report) birth .0% 50.9% 23.0% 60.Skilled Delivery & Postnatal Care 100.0% 30.4% 87.

Delivery & PNC 100.0% 10.0% 60.4% 69.5% 57.0% Four ANC visits during their last pregnancy (card) Birth in a health facility PNC by skilled provider within 2 days of childbirth .0% 87.0% 80.0% 40.ANC.0% 20.9% 30.0% 90.0% 0.0% 50.0% 70.

2% 12.Childhood Immunization BCG.0% 10.9% 74.0% 91.0% 50.0% 0.6% 78.0% 20.0% 90.0% 70. MEASLES & VITAMIN A 100.0% 60.0% 80.0% 40.7% 44.0% 30.6% BCG BCG-Measles Drop out Rate measles Fully vaccinated before their first birthday At least one high dose vitamin A supplement in the last 6 mths (card confirmed) .

6% 90.0% 80.0% 30.1% Penta1/Polio1 Penta1 -Penta3 Drop out rate Penta3/Polio 3 .0% 2.0% 91.0% 20.0% 50.0% 10.0% 60.0% 0.Childhood Immunization Pentavalent & Oral Polio Vaccines 93.0% 70.0% 40.7% 100.

85. 14.Meningitis Campaign Did not receive vaccine during the last campaign.7% Received vaccine during the last campaign.3% .

9% 80.4% 78.0% 20.0% 92.0% 50.0% 70.0% 10.0% 90.0% 30.0% Households Households Registered receiving at before the Hang least one Up Campaign bednet from the Hang Up Campaign Households receiving at least two bednets from the Hang Up Campaign All nets hanged Mothers who by volunteers remember at during Hang up least two of the Campaign main messages transmitted during the Hang Up Campaign .0% 0.0% 66.6% 88.Hang up Campaign Coverage 100.8% 40.3% 60.0% 36.

62. 53.7% .Health Insurance Status Children Under 5yrs with valid health insurance card.1% Mothers who have a valid health insurance card.

0% Mothers who were visited Mothers who were visited by a CBA in the past three by a CHO/CHN in the past months three months .0% 5.5% 42.CBA/CHO Services 49.0% 45.1% 50.0% 35.0% 20.0% 40.0% 30.0% 10.0% 15.0% 25.

Practice .

0% 69.5% 65.5% 63.Antenatal Care Visits 69.0% 35.0% 55.0% 25.0% Attended their first Four ANC visits during Four ANC visits during ANC visit at < 4 mths their last pregnancy their last pregnancy pregnant (card) (recall) .0% 45.2% 5.0% 15.

Exclusive Breastfeeding 87.0% 60.0% 20.0% Health facility Delivery Breastfeeding Exclusively breast within one hour of fed in the past 24 birth hours .8% 80.0% 40.0% 10.0% 50.0% 30.0% 70.5% 75.4% 90.0% 70.0% 0.

0% 30.0% Practice 91.0% 90.0% 0.0% 60.Malaria Prevention Access Knowledge 100.6% 80.8% 74.0% 40.7% 76.5% Mothers who Motherswho Mothers who's Chn 0-59 mths Mothers who know the cause know that household was that own at least slept under a of malaria sleeping under a sprayed with one LLIN LLIN the night (mosquito bite or mosquito net IRS in the last preceding the P Falciparum) prevents malaria 12 mths survey Children who slept under a LLIN the night preceding the survey .0% 50.0% 68.0% 70.8% 67.0% 20.0% 75.0% 10.

Reasons behind Coverage • Poor Documentation of Services provided by Health staff on record cards of mothers & Children affected coverage on indicators that needed evidence on the record cards • Health education at the community level have not had the serious attention that it deserves which is accounting for the poor performance with regards to knowledge and practices for most key indicators. • Little supervision & motivation of CBAs/CHOs • The turning of CHPS zones into treatment centers & clinics by Community members makes it difficult for CHOs to carry out home Visits .

• Not all fevers are due to malaria and that could account for low usage of antimalarial since RDTs are now being used. • Business culture in urban areas (Wa Central an Kambali) affected the practice of mothers as far as key interventions are concern.Reasons behind Coverage • Availability of Pharmacies and chemical shops accounts for high rates of self medications • Hard to reach and rural Sub districts (Charingu) with poor health seeking behavior. • Shortage of essential program drugs ( SP. . ORS & Zinc) in some Facilities during the year.

fever & cough • Health seeking behaviour of mothers whose children have fever. • Mothers knowledge of danger signs of diarrhea.Priority Indicators that need immediate attention • Proportion of mothers of infants 0-5 months who received at least the 2nd dose of tetanus toxoid • Proportion of mothers of infants 0-5 months who practiced appropriate umbilical cord care • Proportion of children 12–23 months who have received at least one high dose vitamin A supplement in the last 6 months • Mothers children 0-59 months who were visited by a CBAs & CHOs. diarrhea or cough • Children 0-59 months with diarrhea in the last two weeks receiving ORS or Zinc or both from an appropriate health provider • Children 0-59 months with fever or cough in the last two weeks receiving antimalarial or antibiotic respectively from an appropriate health provider .

Priority SAs & Indicators .

Priority SAs that need Immediate Attention • Charingu • Wa central & Kambali .

Challenges • Difficult population as most mothers are in commercial business • • • • • • • • • • Mothers complained of volume of questionnaires Breakdown of motor bikes Interference by household heads and other members of the house during interviews Some respondents expected gifts after interview Poor documentation on the part of Health care providers was evident in cards that were used during the survey Nature of settlements made sampling of houses difficult No motivation for some volunteers who assisted in the demarcation and sampling of houses Lack of commitment of some respondents Timing of the survey was not favorable because of the harvest season Inaccessibility of some houses due to wild dogs especially in Wa Township .

.Conclusions • The Survey was a learning experience and skills learnt will be put to use in future surveys to be able to gather quality baseline data for decision making in the municipality • The findings of the survey will also be put to use in order to improve maternal and child health towards to achievement of the MDGs 4 & 5.

fever and pneumonia • Intensify the use of ORS & Zinc by Health care providers for the treatment of Diarrhea • Engage Mother Support groups to promote appropriate care of newborn care including cord care .Recommendation • The Municipality will have to re-strategize and allocate more resources to priority SAs to help them improve on indicators while sustaining the gains in other SAs as well. • Intensify IE&C to raise awareness and encourage practice through the use of support/social groups at community level • Embark on massive education on Mothers health seeking behaviors especially for children with diarrhea.

W/R NHRC UNICEF LSTM Community leaders All beneficiaries/Respondents .Acknowledgement • • • • • • • Ghana Health Service RHA-U.

THANK YOU .

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