Knowledge of primary healthcare providers in the prevention of drowning .case of community health workers and staff of health centers bordering lake kivu in the district of karongi.

Abstract

The Rwanda utilities regulatory agency (RURA) has put in place regulations about safe trips on lake using canoes, ships, boats to protect passengers and crew members against drowning. Users of these means of transportation need to show their interest in knowing and applying these rules. Among users and passengers are opinion leaders including community health workers (CHW) and health centers workers (HCW). These persons play a key as role models in the society. As far as health matters are concerned. CHW and HCW are key people to know and apply safety measures in order to show a good example and sensitize the neighboring population.

This study aimed at assessing the knowledge of CHW and HCW in sectors bordering Lake Kivu in Karongi District about safety measures against drowning in order to improve them.

The study specific objectives were the following: 1. to determine the proportion of health workers at the health center and community with knowledge of the standards in respect of the safety of lake transport, 2. to determine the proportion of boats recently used by these workers who meet the optimal conditions for the transport of persons on the lake, 3. To estimate the proportion of trips that posed risks of drowning. Both quantitative and qualitative approaches were used through a questionnaire and a focus group discussion among 575 primary healthcare workers.

Results show that less than 10 % of respondents have knowledge about safety laws and regulations of the transport on the lake. Some of trips on the lake were dangerous with death among passengers (almost 10%of cases) Passengers used the boat without knowing whether or not it was licensed for transport on the lake (more than 50 % of cases), Boats were sometimes overcrowded (more than 60% of cases) and in almost all cases, the weight of was not systematically taken. In 2/3 of cases, boat crew did not have systematically a mobile phone for an emergency call for assistance, while in 64% of cases boats were not always covered and in 56% of cases, lifejackets were not systematically put. There was a significant difference between Community health workers and health center workers in the following situations: Being at risk of drowning, death among trips companions, having a cell phone for emergency calls for assistance, coverage of the boat and knowing whether or not the boat was licensed to carry passengers.

There is an urgent need to carry out training sessions and sensitization campaigns focusing on the importance of abiding by safety regulations and laws. Primary health care providers need to be empowered in order to be able to train their communities’ members in this area.

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Prevention of drowning need to be put as a priority in the public health package of information, education and communication (IEC) sessions for CHWs. A study to assess the magnitude of morbidity and mortality related to drowning in Lake Kivu is also needed.