TY - JOUR
T1 - Health promotion through existing community structures
T2 - A case of churches’ roles in promoting rotavirus vaccination in rural Zambia
AU - Wesevich, Austin
AU - Chipungu, Jenala
AU - Mwale, Mercy
AU - Bosomprah, Samuel
AU - Chilengi, Roma
N1 - Publisher Copyright:
© The Author(s) 2016.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Introduction: Rural populations, particularly in Africa, suffer worse health outcomes from poor health services access. Community health workers (CHWs) effectively improve health outcomes, but the best means for CHWs reaching rural populations is unknown. Since Zambia is predominantly Christian, this study explored the use of CHWs through churches as an existing community structure for promoting preventive health behaviors, specifically rotavirus vaccine uptake. Methods: A noncontrolled cross-sectional study of 32 churches receiving a packaged intervention of diarrhea prevention and treatment messaging was conducted with repeated time points of data collection over 13 months (2013-2014) in the Kafue District of Zambia. Two churches were selected for each of the 17 catchment areas, and CHWs were identified and trained in the intervention of promoting 4 key messages related to diarrhea prevention and treatment: hand washing with soap, exclusive breast-feeding, rotavirus vaccination, and treating diarrhea with oral rehydration solution and zinc. The intervention was conducted within existing church’s women’s groups, and data was collected on attendance and the distribution of Rota Cards for tracking rotavirus immunizations. Results: Nineteen (59%) churches completed the study, and CHWs delivered health messages at a total of 890 women’s group meetings. The overall reach of the intervention was to 37.0% of church-attending women, and the efficacy was 67.7% (317 of 468 Rota Cards collected at health centers). Discussion: Implementing community health programs is often expensive and unsustainable, but the reach and efficacy levels achieved through existing structures like churches are encouraging in resource-constrained countries. Churches can be effective channels for delivering health prevention strategies to often difficult-to-reach rural populations. Further research is needed to investigate the impact of the intervention on health outcomes.
AB - Introduction: Rural populations, particularly in Africa, suffer worse health outcomes from poor health services access. Community health workers (CHWs) effectively improve health outcomes, but the best means for CHWs reaching rural populations is unknown. Since Zambia is predominantly Christian, this study explored the use of CHWs through churches as an existing community structure for promoting preventive health behaviors, specifically rotavirus vaccine uptake. Methods: A noncontrolled cross-sectional study of 32 churches receiving a packaged intervention of diarrhea prevention and treatment messaging was conducted with repeated time points of data collection over 13 months (2013-2014) in the Kafue District of Zambia. Two churches were selected for each of the 17 catchment areas, and CHWs were identified and trained in the intervention of promoting 4 key messages related to diarrhea prevention and treatment: hand washing with soap, exclusive breast-feeding, rotavirus vaccination, and treating diarrhea with oral rehydration solution and zinc. The intervention was conducted within existing church’s women’s groups, and data was collected on attendance and the distribution of Rota Cards for tracking rotavirus immunizations. Results: Nineteen (59%) churches completed the study, and CHWs delivered health messages at a total of 890 women’s group meetings. The overall reach of the intervention was to 37.0% of church-attending women, and the efficacy was 67.7% (317 of 468 Rota Cards collected at health centers). Discussion: Implementing community health programs is often expensive and unsustainable, but the reach and efficacy levels achieved through existing structures like churches are encouraging in resource-constrained countries. Churches can be effective channels for delivering health prevention strategies to often difficult-to-reach rural populations. Further research is needed to investigate the impact of the intervention on health outcomes.
KW - Church
KW - Community health
KW - Diarrhea
KW - Global health
KW - Rotavirus
KW - Rural health
KW - Vaccination
KW - Zambia
UR - http://www.scopus.com/inward/record.url?scp=85006190474&partnerID=8YFLogxK
U2 - 10.1177/2150131915622379
DO - 10.1177/2150131915622379
M3 - Article
C2 - 26792908
AN - SCOPUS:85006190474
SN - 2150-1319
VL - 7
SP - 81
EP - 87
JO - Journal of Primary Care and Community Health
JF - Journal of Primary Care and Community Health
IS - 2
ER -