Evaluation of scabies management approach at primary health care in Deder district: Ethiopia

Abstract

Scabies is an ectoparasitic, highly contagious skin disease caused by an infestation of the skin by the human itch mite, and the major cause of morbidity and disease burden in developing countries. In 2017, the WHO recognised scabies as a neglected tropical disease. The aim of this study was to evaluate the current management approach to scabies at primary health care in the Deder district in order to develop a strategy that enhances the management of scabies. The study objectives were designed to explore the current knowledge and experiences of health care users on the management of scabies provided at primary health care facilities. Furthermore, the study sought to evaluate the current management of scabies, describing in the process the enablers and barriers thereto. This study also explores and describes the needs with regard to improving the management of scabies within health care providers' views and experiences. Ultimately, the study designs and proffers a strategy that would contribute toward enhancing the management of scabies in primary health care. A multiphase qualitative research design was used to address the research objectives. Data were collected using focus group discussion, and in-depth face-to-face interviews with 58 healthcare users and 18 healthcare providers respectively. Thematic analysis was performed on the verbatim transcriptions using Tesch’s approach. Overall, thirteen themes emerged from the analysis of the data from phase one and phase two of the study. The findings of the study identified that the knowledge of health care users on scabies,their management, prevention and control was limited, and healthcare users experienced different challenges regarding scabies and the management thereof. This study also verified that there are different difficulties in diagnosing and managing scabies and identified different challenges that need serious redress in improving the management of scabies in primary health care. These challenges contribute to low quality of health service with undesirable health outcomes. Accordingly, after a review of diverse but related literature and the Ministry of Health policies, the researcher used the findings of the study to develop a strategy that enhances the management of scabies at the primary health care level. Programme managers working at different levels in the Ethiopian health system also validated the strategy developed here, and the researcher strongly recommends full utilization of the strategy to enhance the management of scabies at the primary health care level.