Community-based training of medical students is associated with malaria prevention and treatment seeking behaviour for children under 5 years in Uganda: a study of MESAU-MEPI COBERS in Uganda

Abstract Background Four university medical training institutions in Uganda have trained students at off-site health facilities under community-based education and Research Service (COBERS) programme for over 5 years. One of the major components of COBERS placement is for the students to provide health education in the communities about malaria as a major public health disease in Uganda. This study seeks to assess if targeted community-based medical education programme is associated with better prevention and treatment seeking behaviours in the management of malaria, a leading cause of morbidity and mortality of children under five in Uganda. Methods A cross-sectional survey was done to compare communities around health facilities where medical students were placed at COBERS sites with communities around similar health facilities where medical students were not placed (non-COBERS sites). We randomly selected two villages near each health facility and consecutively selected 10 households per village for interviews using nearest-neighbour method. We used a structured questionnaire to interview household heads on malaria prevention and treatment seeking behaviour for children under 5 years. We performed univariate analysis to determine site and demographic characteristics and performed a multivariate logistic regression to assess association between dependant and independent variables. Results Five hundred twenty-three (66.8%) of the children under 5 years in COBERS communities slept under Insecticide Treated Nets (ITNs) the night before survey compared with 1451 (57.8%) in non-COBERS communities (AOR = 0.66, p = 0.017). 100 (60.0%) of children under 5 years in COBERS communities sought care for fever within 24 h of onset compared with 268 (47.0%) in non-COBERS communities (AOR = 0.71, P = 0.009). Conclusion The presence of COBERS in communities is associated with improved malaria prevention and treatment-seeking behaviour for parents of children under 5 years. Further study needs to be done to determine the long-term impact of COBERS training program on malaria control and prevention in Uganda, along with other effects of COBERS

Additional file 1: of Community-based training of medical students is associated with malaria prevention and treatment seeking behaviour for children under 5Â years in Uganda: a study of MESAU-MEPI COBERS in Uganda

Household Questionnaire used for the baseline collection of data during survey. (PDF 136 kb

Prevalence of borrowing and sharing prescription medicines and associated socio-demographic factors: findings from COBERS health centres in northern Uganda

Abstract Background The use of prescription medications without the involvement of medical professionals is a growing public health concern. Therefore this study was conducted to determine the prevalence of borrowing and sharing prescription medicines and associated socio-demographic factors among community members who had sought health care from COBERS health centres. Methods We conducted analytical cross – sectional study among former patients who sought treatment during the two months period prior to data collection in nine COBERS health centres. We used cluster proportional-to-size sampling method to get the numbers of research participants to be selected for interview from each COBERS site and logistic regression model was used to assess the associations. Results The prevalence of borrowing prescription medication was found to be 35.9% (95% CI 33.5–38.2%) and sharing prescription medication was 32.7% (95% CI 30.4–34.9%). The Socio-demographic factors associated with borrowing prescription medicines were: age group ≤19 years (AOR = 2.64, 95%CI 1.47–4.74, p-value = 0.001); age group 20–29 years (AOR = 2.78, 95%CI 1.71–4.50, p-value≤0.001); age group 30–39 years (AOR = 1.90, 95%CI 1.18–3.06, p-value = 0.009); age group 40–49 (AOR = 1.83, 95%CI 1.15–2.92, p-value = 0.011); being a female (AOR = 2.01, 1.58–2.55, p-value< 0.001); being a Pentecostal by faith (AOR = 1.69, 95%CI 1.02–2.81, p-value = 0.042) and being Employed Salary Earner (AOR = 0.44, 95%CI 0.25–0.78, p-value = 0.005). The socio-demographic factors associated with sharing prescription medicines were: age group ≥19 years (AOR = 4.17, 95%CI 2.24–7.76, p-value< 0.001); age group 20–29 years (AOR = 3.91, 95%CI 2.46–6.29, p-value< 0.001); age group 30–39 years (AOR = 2.94, 95%CI 2.05–4.21, p-value< 0.001); age group 40–49 years (AOR = 2.22, 95%CI 1.29–3.82, p-value = 0.004); being female (AOR = 2.50, 95%CI 1.70–3.47, p-value< 0.001); being Pentecostal by faith (AOR = 2.15, 95%CI 1.15–4.03, p-value = 0.017); and being engaged in business (AOR = 1.80, 95%CI 1.16–2.80, p-value = 0.009). Conclusion A high proportion of study participants had borrowed or shared prescription medicines during the two months prior to our study. It is recommended that stakeholders sensitise the community members on the danger of borrowing and sharing prescription medicines to avert the practice