Download - 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