Is Home Visiting an Effective Strategy for Improving Family Health a Case Study in the Sekyere West District

Abstract

This was a descriptive study carried out in the Sekyere West District of the Ashanti Region of Ghana. The purpose of the study was to review the practice of home visiting in the district. A hundred households selected from five of the six sub-districts were interviewed. Further, five FGD sessions each comprising six to eight community leaders were also carried out in the study communities. All the sixteen Public/Community Nurses working in the district were interviewed. In addition, participatory observation of home visiting sessions, by Public/Community Health Nurses were carried out, in each of the five study communities. Data were collected by means of a structured questionnaire, interview guide and checklist. Study findings indicate that although nurses had knowledge of home visiting and had positive opinion of the practice, they could not perform their home visiting tasks/functions up to standard; i.e.57% rate of non-performance; 11% of them performed poorly and only 32% performed up to the standard expected of them. Home visiting practice in the district among nurses, was found to be very low (i.e.7%). Chi square tests indicate no significant relationship between home visiting by nurses and reduction in child morbidity, sanitation and hygiene practices of households, which might be accounted for by the poor quality of home visiting. On the other hand, community members desire home visiting and the findings indicate that there is a need for home visiting. In houses visited, 82% had children 0~5years, 33% nursing mothers, 26% aged and 18% pregnant mothers. Also identified were several health hazards, such as uncovered refuse containers, open fires, misplaced sharp objects, open defaecation and other unhygienic practices, which a proper home visiting regime can address. A gap, thus exists between what is expected and what is pertains, and efforts such as orientation of nurses, support and good supervision, should help bridge this gap.