District Report LQAS Survey Wa Municipal

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By: Dachaga Osw

Wa Municipal

LQAS Household Survey

Preliminary F indings

23 November, 2012


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LOT QUALITY ASSURANCE SAMPLING


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PRELIMINARY FINDINGS


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Key Findings 1

75.8% of Mothers practiced exclusive breastfeeding in the past 24hrs

survey

63.2% & 69.% of mothers attended at 4 ANC visits in the their last pr

recall and by card Respectively.

61.1% of mothers received at least 2 doses of IPT during last pregna

57.9% of Chn. 0-5mths received PNC & 23.2% of mothers report the

PNC by skilled provider within 48hrs of childbirth

22.1% of mothers practiced appropriate umbilical cord care (nothing

after birth


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Key Findings 2

25.3% of Chn. 0-59mths with suspected ARI received appr

antibiotic from an appropriate health provider

56.8% of Chn 0-59 mths with diarrhea were taken to an ap

health provider

27.4% of Chn 0-59 mths with diarrhea received ORS, 1.1% receivedreceived both ORS & Zinc from an appropriate health provider.

15.8% Chn 0-59 mths with fever were taken to an appropriate health

24hrs of onset of symptoms and only 5.3% of them received approp

antimalarial drugs


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Key Findings 3 44.2% of chin 1223 mths received at least one high dose of vitamin A supplemen

(card confirmed)

91.6% households with chn 0-59 mths own at least one LLIN

67.0% & 68.5% of Mothers & chn 0-59mths respectively slept under an LLIN the n

survey

88.4% and 78.9% of Households with chn 0-59s received at least one & Two bed from the Hang up Campaign.

42.1% & 49.5% of Mothers of chn 0-59mths were visited by CBAs & CHOs Respe

three months

Prevalence of presumed pneumonia among children 0-59 months stands at 9.5%


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Prevalen


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Pneumonia, diarrhea and malaria prevalence


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Knowled


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Care giver knowledge of danger signs

in children U5

44.2%

24.2%

15.8%

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

Mothers who know atleast two danger signs of

diarrhoea

Mothers who know atleast two danger signs of

fever

Motherswho knowleast two danger sig

cough


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Accessibi


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Pneumonia Case Management

66.3%

25.3%

50.5%

77.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

suspected ARItaken to an

appropriate healthprovider

suspected ARI inthe last two wks

receiving anappropriate

antibiotic from anappropriate health

provider

Mothers of Chn 0-59 mths with

suspected ARI validNHIS card

Chn 0-59 mthsuspected

Valid NHIS


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Diarrheoa Case Management

56.8%

27.4%

1.1% 0.0%

54.7%

65.3

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Chn 0-59mths with

taken to anappropriate

healthprovider

ReceivingORS from anappropriate

healthprovider

ReceivingZINC from

anappropriate

healthprovider

ReceivingORS ANDZINC from

anappropriate

health

provider

Mothers ofChn 0-59mths with

diarrhea withvalid NHIS

card

Chn 0mths

diarrhevalid N

ca

District Priority


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Malaria Case Management

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

Taken to anappropriate health

provider within 24hrsof onset of symptoms

Receiving anappropriate

antimalarial from anappropriate health

provider within 24hrs

of onset of symptoms

Mothers of Chn withfever having valid

NHIS card

Chn withfeverhaving valid

NHIS card

15.8%

5.3%

67.4% 67.4%

Children 0-59 Months with Fever in the Last Two weeks Preceding the Survey


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Intermittent Preventive Treatment(IPT)

69.5% 69.5%

61.1%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

55.0%

60.0%

65.0%

70.0%

Attended their first ANC visit

at < 4 mths pregnant

All doses of IPT as directly

observed therapy

At least IPT2 during

pregnancy


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Tetanus Toxoid, Iron & Folic Acid

100.0%

44.2%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Iron and folic acid during their last

pregnancy

At least TT2 during their la

pregnancy


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Skilled Delivery & Postnatal Care

87.4% 87.4%

57.9%

23.2% 22.

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Birth by skilledbirth attendant

Birth in a healthfacility

PNC by skilledprovider within

2 days ofchildbirth

PNC by skilledprovider within

2 days ofchildbirth(Mother's

Report)

Practappro

umbiliccare (noantisepti

bir


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ANC, Delivery & PNC

69.5%

87.4%

57.9%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Four ANC visitsduring their last

pregnancy (card)

Birth in a healthfacility

PNC by skillprovider with

days of childb


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Childhood Immunization

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

BCG BCG-MeaslesDrop out Rate

measles Fully vaccinatedbefore their first

birthday

At least one highdose vitamin A

supplement in thelast 6 mths (card

confirmed)

91.6%

12.6%

78.9%74.7%

44.2%

BCG, MEASLES & VITAMIN A


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Childhood Immunization

0.0%

10.0%

20.0%

30.0%

40.0%50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Penta1/Polio1 Penta1 -Penta3

Drop out rate

Penta3/Polio 3

93.7%

2.1%

91.6%

Pentavalent & Oral Polio Vaccines


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Meningitis Campaign

Receivedvaccine durin

the lastcampaign,

85.3%

Did not receivevaccine during

the lastcampaign,

14.7%


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Hang up Campaign Coverage

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%90.0%

100.0%

HouseholdsRegistered

before the HangUp Campaign

Householdsreceiving atleast one

bednet from theHang Up

Campaign

Householdsreceiving at

least twobednets fromthe Hang UpCampaign

All nets hangedby volunteers

during Hang upCampaign

Mothers whoremember at

least two of themain messages

transmittedduring the Hang

Up Campaign

92.6%88.4%

78.9%66.3%

36.8%


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Health Insurance Status

Mothwho havalid hinsura

card, 5

ChildrenUnder 5yrswith valid

healthinsurance

card, 62.1%


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CBA/CHO Services

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

Mothers who were visitedby a CBA in the past three

months

Mothers who were visitedby a CHO/CHN in the past

three months

42.1%

49.5%


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Pract


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Antenatal Care Visits

69.5% 69.5%63.2%

5.0%

15.0%

25.0%

35.0%

45.0%

55.0%

65.0%

Attended their firstANC visit at < 4 mths

pregnant

Four ANC visits duringtheir last pregnancy

(card)

Four ANC visits dtheir last pregna

(recall)


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Exclusive Breastfeeding

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Health facilityDelivery

Breastfeedingwithin one hour of

birth

Exclusively breastfed in the past 24

hours

87.4%

70.5%75.8%


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Malaria Prevention

75.8% 74.7% 76.8%

91.6%

67.0% 68.5

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

Mothers whoknow the cause

of malaria(mosquito bite or

P Falciparum)

Motherswhoknow that

sleeping under amosquito net

prevents malaria

Mothers who'shousehold wassprayed with

IRS in the last12 mths

Chn 0-59 mthsthat own at least

one LLIN

Mothers whoslept under aLLIN the nightpreceding the

survey

Childreslept unLLIN theprecedi

surv

Knowledge

Practice

Access


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Reasons behind Coverage

Poor Documentation of Services provided by Health staff on record c

mothers & Children affected coverage on indicators that needed evid

record cards

Health education at the community level have not had the serious att

deserves which is accounting for the poor performance with regards

and practices for most key indicators.

Little supervision & motivation of CBAs/CHOs

The turning of CHPS zones into treatment centers & clinics by Comm

makes it difficult for CHOs to carry out home Visits


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Reasons behind Coverage

Availability of Pharmacies and chemical shops accounts for high rate

medications

Hard to reach and rural Sub districts (Charingu) with poor health see

Business culture in urban areas (Wa Central an Kambali) affected th

mothers as far as key interventions are concern.

Not all fevers are due to malaria and that could account for low usag

since RDTs are now being used.

Shortage of essential program drugs ( SP, ORS & Zinc) in some Fac

year.

Priority Indicators that need immediate


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Priority Indicators that need immediate

attention Proportion of mothers of infants 0-5 months who received at least the

tetanus toxoid

Proportion of mothers of infants 0-5 months who practiced appropriacord care

Proportion of children 1223 months who have received at least one

vitamin A supplement in the last 6 months

Mothers children 0-59 months who were visited by a CBAs & CHOs.

Mothers knowledge of danger signs of diarrhea, fever & cough

Health seeking behaviour of mothers whose children have fever, dia

Children 0-59 months with diarrhea in the last two weeks receiving O

both from an appropriate health provider

Children 0-59 months with fever or cough in the last two weeks recei

antimalarial or antibiotic respectively from an appropriate health prov


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Priority SAs & Indicators
http://localhost/var/www/apps/conversion/tmp/scratch_9/Priority%20SAs.pdfhttp://localhost/var/www/apps/conversion/tmp/scratch_9/Priority%20SAs.pdf


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Priority SAs that need Immediate Attention

Charingu

Wa central & Kambali

Ch ll


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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 d

Some respondents expected gifts after interview

Poor documentation on the part of Health care providers was eviden

were used during the survey

Nature of settlements made sampling of houses difficult

No motivation for some volunteers who assisted in the demarcation

houses

Lack of commitment of some respondents

Timing of the survey was not favorable because of the harvest seaso

Inaccessibility of some houses due to wild dogs especially in Wa Tow

C l i


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Conclusions

The Survey was a learning experience and skills lea

put to use in future surveys to be able to gather qua

baseline data for decision making in the municipalit

The findings of the survey will also be put to use in

improve maternal and child health towards to achiev

the MDGs 4 & 5.

R d ti


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Recommendation The Municipality will have to re-strategize and allocate more resources to priority S

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 supp

at community level

Embark on massive education on Mothers health seeking behaviors especially for

diarrhea, fever and pneumonia

Intensify the use of ORS & Zinc by Health care providers for the treatment of Diarr

Engage Mother Support groups to promote appropriate care of newborn care inclu

A k l d t


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Acknowledgement

Ghana Health Service

RHA-U.W/R NHRC

UNICEF

LSTM

Community leaders

All beneficiaries/Respondents


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THANK YOU

District Report LQAS Survey Wa Municipal

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