The role of community health workers in the inventory management of antimalarial medicines in Rwanda: a case study of Bugesera district

Abstract

Introduction: Malaria is public health concern worldwide, and more than 90% of malaria deaths worldwide occur in sub-Saharan Africa, affecting mainly children under five years of age. In Rwanda, the interventions to reduce malaria cases include; the availability of antimalarial pharmaceuticals, particularly Artemisinin-based combination therapies (ACTs) and rapid diagnostic test kits (RDTs), and the contribution of Community Health Workers (CHWs) to the distribution of antimalarial products. Aim: The current study aims to evaluate the role of community health workers in the inventory management of antimalarial drugs in Rwanda at the decentralized community level. Methods: Descriptive cross-sectional research design was used to collect data. A structured research questionnaire was used. Data exported to SPSS to be coded and analyzed. Frequencies were used to determine associations between the dependent and independent categorical variables. Results: CHWs were found to be closely involved in the inventory management of the antimalarial products and widely respected by the beneficiaries; Overall, 65.1% of the CHWs stated that the population had access quickly the antimalarial products from the Community Health Workers, and 31.2 % CHWs agreed that people get antimalaria products from both Health center and CHWs, 78% of the CHWs observed to have the appropriate storage conditions, although, the overall stock out recorded was 3.20 %, while 53.22% (n=295) CHWs in Bugesera District used more than 10 RTDsthe last month preceding this study. Furthermore, CHWs described a lack of appropriate or dependable transportation as a critical barrier to accessing antimalarial products. Where almost 70.8% of CHWs depended on traveling on foot for resupply. Overall, 65.4% CHWs stated they spent at least 2000 RWF of their pocket on community health duties. Conclusion and recommendation: This study highlights the role of CHWs in the inventory management of antimalarial products. Identifying and understanding these roles and addressing them accordingly, particularly within the context of performance based on the availability of antimalarial products, availability of adequate medical storage, rate of stock out; will serve to strengthen the current CHW system and provide essential guidance for the continuing evolution of the CHW system in Rwanda.