title: Integrating child health services into malaria control services of village malaria workers in remote Cambodia: service utilization and knowledge of malaria management of caregivers.
abstract: BACKGROUND
  Malaria and other communicable diseases remain major threats in developing countries. In Cambodia, village malaria workers (VMWs) have been providing malaria control services in remote villages to cope with the disease threats. In 2009, the VMW project integrated child health services into the original malaria control services. However, little has been studied about the utilization of VMWs' child health services. This study aimed to identify determinants of caregivers' VMW service utilization for childhood illness and caregivers' knowledge of malaria management.
  
  
  METHODS
  A cross-sectional study was conducted in 36 VMW villages of Kampot and Kampong Thom provinces in July-September 2012. An equal number of VMW villages with malaria control services only (M) and those with malaria control plus child health services (M+C) were selected from each province. Using structured questionnaires, 800 caregivers of children under five and 36 VMWs, one of the two VMWs who was providing VMW services in each study village were interviewed.
  
  
  RESULTS
  Among the caregivers, 23% in M villages and 52% in M+C villages utilized VMW services for childhood illnesses. Determinants of caregivers' utilization of VMWs in M villages included their VMWs' length of experience (AOR = 11.80, 95% confidence interval [CI] = 4.46-31.19) and VMWs' service quality (AOR = 2.04, CI = 1.01-4.11). In M+C villages, VMWs' length of experience (AOR = 2.44, CI = 1.52-3.94) and caregivers' wealth index (AOR = 0.35, CI = 0.18-0.68) were associated with VMW service utilization. Meanwhile, better service quality of VMWs (AOR = 3.21, CI = 1.34-7.66) and caregivers' literacy (AOR = 9.91, CI = 4.66-21.05) were positively associated with caregivers' knowledge of malaria management.
  
  
  CONCLUSIONS
  VMWs' service quality and length of experience are important determinants of caregivers' utilization of VMWs' child health services and their knowledge of malaria management. Caregivers are seeking VMWs' support for childhood illnesses even if they are providing only malaria control services. This underlines the importance of scaling-up VMWs' capacity by adding child health services of good quality, which will result in improving child health status in remote Cambodia.
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
authors: Aya
authors: A
authors: Hasegawa
authors: Junko
authors: J
authors: Yasuoka
authors: Po
authors: P
authors: Ly
authors: Chea
authors: C
authors: Nguon
authors: Masamine
authors: M
authors: Jimba
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002160:Cambodia; D017028:Caregivers; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D003150:Community Health Workers; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult
references: BMC Res Notes. 2012 Aug 03;5:405
references: 22863397
references: Trop Med Int Health. 2007 Jan;12(1):52-61
references: 17207148
references: Pathog Glob Health. 2012 Mar;106(1):32-9
references: 22595272
references: J Health Popul Nutr. 2008 Mar;26(1):22-35
references: 18637525
references: Lancet. 2007 Jun 23;369(9579):2121-31
references: 17586307
references: Health Policy Plan. 2000 Jun;15(2):223-9
references: 10837046
references: Health Policy Plan. 2005 Jul;20(4):199-212
references: 15965032
references: Malar J. 2012 May 24;11:121
references: 22521034
references: PLoS Med. 2010 Sep 21;7(9):e1000340
references: 20877714
references: Psychol Methods. 2002 Mar;7(1):19-40
references: 11928888
references: Health Policy Plan. 2009 Mar;24(2):101-7
references: 19147699
references: Lancet. 2005 Sep 17-23;366(9490):1026-35
references: 16168785
references: J Health Care Poor Underserved. 2009;20(4 Suppl):99-115
references: 20168036
references: BMC Int Health Hum Rights. 2009 Nov 10;9:28
references: 19903349
references: Lancet. 2011 Feb 26;377(9767):769-81
references: 21269674
references: J Health Popul Nutr. 2001 Jun;19(2):S111-48
references: 11503353
references: Am J Public Health. 2004 Mar;94(3):406-15
references: 14998804
references: Soc Sci Med. 2008 May;66(10):2096-107
references: 18342421
references: Bull World Health Organ. 2005 Apr;83(4):260-7
references: 15868016
references: Health Policy Plan. 2002 Dec;17(4):345-53
references: 12424206
references: PLoS One. 2011;6(12):e27997
references: 22194801
references: Lancet. 2009 Aug 1;374(9687):393-403
references: 19647607
references: Malar J. 2010 Apr 23;9:109
references: 20412600
references: Lancet. 2004 Oct 23-29;364(9444):1541-8
references: 15500901
references: Health Policy Plan. 2006 Nov;21(6):459-68
references: 17030551
references: Malar J. 2012 Jan 04;11:4
references: 22217322
references: Trop Med Int Health. 2000 Mar;5(3):179-84
references: 10747280
references: Soc Sci Med. 1989;29(5):599-608
references: 2799410