Development of strategies to enhance health-seeking behaviour of parents and caregivers with children under-five years with acute diarrhoea in THE Ohangwena region, Namibia
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Date
2022
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Publisher
University of Namibia
Abstract
The study aimed to develop strategies for healthcare professionals and healthcare extension workers (HEWs) to enhance appropriate health-seeking behaviours of parents/caregivers of children under five with diarrhoea in the Ohangwena Region in Namibia. In Namibia, the prevalence of diarrhoea nationally is 17%, responsible for 5% of all deaths in children under five, and is the second leading cause of death. Mortality due to diarrhoea is preventable when appropriate and prompt healthcare is sought on time. However, in Namibia, few studies have been conducted to assess the magnitude and factors associated with health-seeking behaviour. The researcher conducted a study with a convergent parallel mixed-method design between January and March 2019 in Engela District, Ohangwena Region, Namibia. The study comprised four phases. Phase 1: During this phase, the researcher conducted concept analysis. For quantitative data, the researcher used the multistage cluster sampling method. The researchers purposively included only households with children under five, and a total of 530 houses were selected. Structured questionnaires were used to collect quantitative data. The International Business Machines (IBM) Statistical Package for Social Science (SPSS) software version 25 was used to analyse quantitative data. For qualitative data, the researcher purposively selected three doctors, ten nurses, four priests and five traditional healers for key informant interviews. Additionally, the researcher conducted nine focus group discussions (FGD) with 57 HEWs and six FGD with 30 parents/caregivers, and all participants were purposively sampled. All interviews were audiotaped and transcribed verbatim, and Atlas ti was used to analyze qualitative data. The overall prevalence of diarrhoea among children under five was high—23.8%, with informal settlements having the highest prevalence of 48%. Equally, we found evidence showing that 77% of children suffering from diarrhoea had severe malnutrition. Some mothers or caregivers perceived diarrhoea as being associated with spiritual beliefs, traditional beliefs, and myths. Furthermore, most mothers/caregivers (64%) were categorized as having inadequate knowledge of the aetiology, prevention, and ii management of diarrhoea, 84% had poor practices, and 61% admitted to having practised perineal cutting as part of the management of acute diarrhoea. However, the existing guidelines do not reflect aspects aiming to improve parents’ and caregivers’ current practices and health-seeking behaviours. Phase 2: Involved conceptualizing the study's key findings on health-seeking behaviour and linking them to the Dickoff, James, and Wiedenbach’s (1968) practice-oriented theory for development of strategies. Phase 3: Was informed by the factors identified in Phases 1 & 2; Phase 3 outlines the procedures followed in developing the strategies. Furthermore, the strategies in the current study were developed using Howe’s Compass Aligned Performance System (c@ps), created in 2011. The strategies were constructed upon the conceptual framework by using the Delphi process. Phase 4: A team of experts verified the strategies after development. Furthermore, based on the study findings, recommendations were made.
Description
A dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy in Public Health
Keywords
Healthcare extansion workers, Ohangwena region, health-seeking