Authors: Caroline Zulu.
Importance: Amidst the chronic shortage of HRH in Zambia, the health care system has been striving to “Provide cost effective health care services, as close to the family as possible”. Children being most vulnerable suffer chronic high child mortality rates still as high as 88 per 1,000 live births. Implementation of Child Survival Programs relay heavily by Community-Based Child Growth Monitoring and Promotion Programs (CCGMP) hence the need to determine challenges that they encounter.
Objective: To determine experiences and challenges of CCGMPs’ during training and implementation programs for child survival in Zambia.
Design: This qualitative study included two methods; Five (5) FGD were conducted and interviews with women. Data recorded on tape, transcribed, grouped and manually analysed thematically using the ‘framework method’.
Setting: Two districts Lusaka and Chirundu were purposively selected in order to provide a diverse picture of people with different life styles of urban and rural Zambia. Institutions providing PHC were used as entry points.
Participants: Fifty participants for each of the two qualitative methods applied gave a total of 100 participants. FGD included 50 CCGMPs leaders in groups of ten and 50 mothers randomly selected for in-depth exit interviews facilitated data collection.
Main Outcome: Evidence showed inadequate training which could have resulted in challenges faced by implementation programs which suffered unaddressed problems like; lack of supervision form professionally qualified staff, equipment, protective clothing, no remuneration amoung many others.
Results: CCGMPs’ expressed evidence that their training was inadequate that during training, they did not cover most of the mandatory topics from their recommended curriculum. Practical experiences were compromised as some were never allocated time or/and supervision to practice what they learnt theoretically in order to sharpen their skills and competencies. They bemoaned training was compromised, coupled by lack of regular and timely refresher course by training organizations.
Conclusion and Relevance: The numerous challenges being experienced by CCGMPs expressed in this study can guide policy makers of the Health care systems of countries who rely heavily on Community Health Workers (CHW) for the delivery of Primary Health care.
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