An Evaluation of the Determinants of Effectiveness of Bilharzia Awareness Campaigns in Kisumu West Subcounty, Kenya

Abstract

Schistosomiasis (Bilharzia), is a one of the major tropical diseases affecting many people in developing countries, and is considered the second most important human parasitic disease after malaria in terms of morbidity and mortality. The availability of effective and safe drugs for treatment has led to its use in the global implementation of IllC:ls~ drug administration (MDA), at the recommendation of World HealthOrganization. Despite lllanystl.idiesadvocating)hesuccess ofMDAprogramsfor control, successes are often short-lived because of a variety of mitigating factors that include knowledge sharing with.affected communities and effective communication. A study was conducted in Kisumu West Sub-County, Kenya, with the broad objective of evaluating the effectiveness of pre-study health information communication on Bilharzia control, to-fhe- stuciycOn:lll1unity-:---Specifically-the-studysought to 'determine post study community perception on bilharzia and to identify and describe factors for acceptance of information provided during the health information campaigns in the study site. This was both a qualitative and quantitative study, adopting the health belief model which operates at the intrapersonallevel and attempts to predict health related behaviour. The study population comprised 134 key informant respondents drawn from teachers of primary school teachers, parents' school representatives, head of households, village elders, public health officers and local administration officers. A total of 25 interviews were conducted with16 primary school teachers, 8 parents' representatives, 87 heads of households, 13 village elders, 1 public health officer, and 9 local administration officers. Teachers, local administration and parents' representatives were purposively sampled and randomly selected from the schools and community. The questionnaire was pre-tested to ensure the validity and reliability of the results. Post study appreciation of MDA and the level of knowledge on bilharzia was low for a community that had just undergone MDA for five years, and who had undergone pre-study training. 56% of respondents found the educators very competent; a small section (4%) ofthe respondents were unsure of competence of health educators. Only 27.7% of respondents saw MDA as necessary, while 30% of the respondents reported no knowledge of schistosomiasis. Strategies, like radio call-in sessions and involving health officers, church leaders, and village elders in the community offered collateral benefits, such as perceived security for the CHWs during the exercise. However, some of the respondents still believe that religion and traditional doctors could cure bilharzia. Print and electronic media was reported as the main source of information (42.2%). 30% and 21% of the respondents who participated in the schistosomiasis campaign found it to be satisfactory and very satisfactory respectively. The involvement of church leaders and other key community decision makers in the campaign was found to be key. The study concluded that the effectiveness of awareness campaigns on bilharzia in Kisumu West Sub-County is commendable. The study recommends use of age specific materials on future bilharzia awareness campaigns.