Services provided by FCHVs
Among the five child health services, more than the half (51.6%) of the FCHVs had treated at least one case of diarrhoea with ORS in the last three months, which was the highest among all the services provided. One out of ten FCHVs had counseled or referred to the malnourished child which was the lowest among all the services. More than two out of five FCHVs had treated at least one case of diarrhoea with Zinc and the same proportions had examined at least one case of a cough or cold. The proportion of FCHVs that had treated the pneumonia cases with antibiotic Cotrimoxazole was 24.3%. Overall, around two-thirds (62.6%) of FCHVs had provided at least one child health service within the last three months prior to the survey (Table 1).
Relationship between socio-demographic profile of FCHVs and delivery of child health services
In the bivariate analysis, child health service delivery by FCHVs was associated with their literacy status, ethnic group, residence and province. Age of the FCHVs was not associated with child health service delivery (Table 2).
Relationship of child health service delivery with other background characteristics
Table 3 shows that child health service delivery was associated with the use of mobile phone, time to reach the nearest public health facility, training received, dress allowance received, incentive received, availability of all key commodities (Zinc, ORS, Cotrimoxazole), support in ANC service, support in PHC-ORC clinic, conduction of mother’s group meeting, use of FCHV fund and involvement in local committees On the other hand, child health service delivery was not associated with the support in immunization clinic and involvement with FCHV’s right based organization.
Factors associated with child health service delivery
The results of multiple regression analyses are presented in Table 4. FCHVs from Muslim and other tarai caste were less likely to provide child health services compared to the hill caste FCHVs (AOR= 0.52, 95% CI: 0.32, 0.84). Likewise, FCHVs from Province 5 were 1.83 times (AOR=1.83, 95% CI: 1.43, 2.32) and those from province 7 were twice more likely to provide child health services (AOR=2.45, 95% CI: 1.89, 3.17) than the FCHVs from province 1.
Compared to the FCHVs who did not have ORS on stock, those with the stock were more likely to provide child health services (AOR= 1.44, 95% CI: 1.22, 1.70). Similarly, FCHVs who had Zinc tablet on stock were more likely to provide child health services than those who did not have Zinc on stock (AOR=1.48, 95% CI: 1.27, 1.72). Likewise, FCHVs who had at least one complete dose of Cotrimoxazole on the stock had higher odds to provide child health services than those who did not have Cotrimoxazole on the stock (AOR=1.27, 95% CI: 1.09, 1.48).
FCHVs who supported to pregnant women in ANC related activities within the last three months were two times more likely to provide child health services than those who did not support in the same activity (AOR=2.22, 95% CI: 1.72, 2.87). Likewise, FCHVs who supported PHC-ORC in the last three months were more likely to provide child health services compared to those who did not support in the similar activities (AOR=1.34, 95% CI: 1.15, 1.55). Similarly, FCHVs who conducted mothers’ group meeting within the last three months had higher odds of providing child health services than those who did not conduct the mothers’ group meeting in the last three months (AOR=1.66, 95% CI: 1.21, 2.2).
FCHVs who utilized money within last one year from the FCHV fund were more likely to provide child health services compared to those who did not use the money from the fund (AOR=1.31, 95% CI: 1.14, 1.51). Similarly, FCHVs who used mobile phone had higher odds to provide child health services as compared to those who did not use the mobile phone (AOR=1.64, 95% CI: 1.35, 1.98). Likewise, FCHVs who were involved in different local committees were more likely to provide the child health services than those who were not involved in such committees (AOR=1.29, 95% CI: 1.11, 1.49).
In the adjusted analysis, literacy, residence, time to reach the nearest health facility, training received, dress allowance received, incentive received other than dress allowance were not significantly associated with the child health service delivery by FCHVs (Table not shown).