Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study
Background Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera. Objective Describe facility capacity and provider knowledge for case management of diarrhoea and choler...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2317774 |
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| author | Mattias Schedwin Aurélie Bisumba Furaha Kelly Elimian Carina King Espoir Bwenge Malembaka Marc K Yambayamba Thorkild Tylleskär Tobias Alfvén Simone E Carter Placide Welo Okitayemba Mala Ali Mapatano Helena Hildenwall |
| author_facet | Mattias Schedwin Aurélie Bisumba Furaha Kelly Elimian Carina King Espoir Bwenge Malembaka Marc K Yambayamba Thorkild Tylleskär Tobias Alfvén Simone E Carter Placide Welo Okitayemba Mala Ali Mapatano Helena Hildenwall |
| author_sort | Mattias Schedwin |
| collection | DOAJ |
| description | Background Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera. Objective Describe facility capacity and provider knowledge for case management of diarrhoea and cholera surveillance in cholera hotspots in the Democratic Republic of Congo (DRC) among health facilities, drug shops, and traditional health practitioners. Methods We conducted a sequential exploratory mixed-method study, using focus group discussions, facility audits, and provider knowledge questionnaires during September and October 2022 in North Kivu and Tanganyika provinces, Eastern DRC. Content analysis was used for qualitative data. Quantitative data were summarised by facility level and healthcare provider type. Audit and knowledge scores (range 0–100) were generated. Multivariable linear regression estimated association between scores and explanatory factors. Qualitative and quantitative data were triangulated during interpretation. Results Overall, 244 facilities and 308 providers were included. The mean audit score for health facilities was 51/100 (SD: 17). Private facilities had an −11.6 (95% CI, −16.7 to −6.6) lower adjusted mean score compared to public. Mean knowledge score was 59/100 (95% CI, 57 to 60) for health facility personnel, 46/100 (95% CI, 43 to 48) for drug shop vendors and 37/100 (95% CI, 34 to 39) for traditional health practitioners. Providers had particularly low knowledge concerning when to check for low blood sugar, use of nasogastric tubes, and dosing schedules. Knowledge about case definitions for cholera was similar between groups (range 41–58%) except for traditional health practitioners for the definition during an outbreak 15/73 (21%). Conclusions Increasing awareness of cholera case definitions in this context could help improve cholera surveillance and control. Increased support and supervision, especially for private providers, could help ensure facilities are equipped to provide safe care. More nuanced aspects of case management should be emphasised in provider training. |
| format | Article |
| id | doaj-art-cca94d2ded724188b2e0eb7c39ec7f88 |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-cca94d2ded724188b2e0eb7c39ec7f882025-02-05T12:46:13ZengTaylor & Francis GroupGlobal Health Action1654-98802024-12-0117110.1080/16549716.2024.23177742317774Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods studyMattias Schedwin0Aurélie Bisumba Furaha1Kelly Elimian2Carina King3Espoir Bwenge Malembaka4Marc K Yambayamba5Thorkild Tylleskär6Tobias Alfvén7Simone E Carter8Placide Welo Okitayemba9Mala Ali Mapatano10Helena Hildenwall11Karolinska InstitutetHôpital Provincial Général de Référence de BukavuKarolinska InstitutetKarolinska InstitutetJohns Hopkins UniversityKinshasa School of Public HealthUniversity of BergenKarolinska InstitutetPublic Health Emergencies, UNICEFProgramme National d’Elimination du Choléra et de lutte contre les autres Maladies Diarrhéiques, Ministry of HealthKinshasa School of Public HealthKarolinska InstitutetBackground Wider healthcare-strengthening interventions are recommended in cholera hotspots and could benefit other types of diarrhoeal diseases which contribute to greater mortality than cholera. Objective Describe facility capacity and provider knowledge for case management of diarrhoea and cholera surveillance in cholera hotspots in the Democratic Republic of Congo (DRC) among health facilities, drug shops, and traditional health practitioners. Methods We conducted a sequential exploratory mixed-method study, using focus group discussions, facility audits, and provider knowledge questionnaires during September and October 2022 in North Kivu and Tanganyika provinces, Eastern DRC. Content analysis was used for qualitative data. Quantitative data were summarised by facility level and healthcare provider type. Audit and knowledge scores (range 0–100) were generated. Multivariable linear regression estimated association between scores and explanatory factors. Qualitative and quantitative data were triangulated during interpretation. Results Overall, 244 facilities and 308 providers were included. The mean audit score for health facilities was 51/100 (SD: 17). Private facilities had an −11.6 (95% CI, −16.7 to −6.6) lower adjusted mean score compared to public. Mean knowledge score was 59/100 (95% CI, 57 to 60) for health facility personnel, 46/100 (95% CI, 43 to 48) for drug shop vendors and 37/100 (95% CI, 34 to 39) for traditional health practitioners. Providers had particularly low knowledge concerning when to check for low blood sugar, use of nasogastric tubes, and dosing schedules. Knowledge about case definitions for cholera was similar between groups (range 41–58%) except for traditional health practitioners for the definition during an outbreak 15/73 (21%). Conclusions Increasing awareness of cholera case definitions in this context could help improve cholera surveillance and control. Increased support and supervision, especially for private providers, could help ensure facilities are equipped to provide safe care. More nuanced aspects of case management should be emphasised in provider training.http://dx.doi.org/10.1080/16549716.2024.2317774choleraconflicthealthcare workersinterventionsdemocratic republic of the congo |
| spellingShingle | Mattias Schedwin Aurélie Bisumba Furaha Kelly Elimian Carina King Espoir Bwenge Malembaka Marc K Yambayamba Thorkild Tylleskär Tobias Alfvén Simone E Carter Placide Welo Okitayemba Mala Ali Mapatano Helena Hildenwall Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study Global Health Action cholera conflict healthcare workers interventions democratic republic of the congo |
| title | Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study |
| title_full | Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study |
| title_fullStr | Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study |
| title_full_unstemmed | Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study |
| title_short | Facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the Democratic Republic of Congo – a mixed-methods study |
| title_sort | facility capacity and provider knowledge for cholera surveillance and diarrhoea case management in cholera hotspots in the democratic republic of congo a mixed methods study |
| topic | cholera conflict healthcare workers interventions democratic republic of the congo |
| url | http://dx.doi.org/10.1080/16549716.2024.2317774 |
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