Use of community health workers for management of malaria and pneumonia in urban and rural areas in eastern Uganda.

Use of community health workers (CHWs) has been implemented the same way in urban and rural areas despite differences in availability of health providers and sociodemographic characteristics. A household survey was conducted in rural and urban areas in eastern Uganda, and all children who were febrile in the previous two weeks were assessed for their symptoms, treatment received at home, and when and where they first went for treatment. Rural children were more likely to use CHWs than urban children. Urban children received outside treatment more promptly, and used herbs at home less. Symptoms and proportion of children being taken out for treatment were similar. Children from the poorest households used CHWs less and private providers more than the middle quintiles. Drug shops and private clinics should be included in the community case management to cater for the poorest in rural areas and persons in urban areas.