Evaluation of In door Residual houseHold spraying:Challenges faced by Ndola Urban District
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The study aimed at determining challenges associated with implementation of IRHS in Ndola urban district, Zambia. A cross sectional study was conducted at Ndola city council and public health offices along Broadway. All the 122 service providers were purposively selected into the study. This included 8 program officers and 114 spray operators. Data was collected using two separate semi-structured interview schedules and a checklist for program officers. The study sought to answer research questions on; policy challenges, operational challenges, institutional challenges and how these challenges can be addressed. The study was analyzed using SPSS version 11.5, Epi-info version 6 and content analysis, then Univariate and bivariate analysis. Chi-square was used to determine the association of the qualitative variables and the outcome (IRS challenges). The qualitative variables include adherence to policy guidelines, availability of IRS logistics and acceptability of IR§.Policy challenges; the study revealed varied levels of compliance across different components of policy guidelines on DDT. The highest level of corripliance n=7 was with storage and disposal guidelines, while n=4 did not comply with use and environmental safeguards. Program officers said that Spray operators used to spill DDT on the ground. Operational challenges; the most significant factors fownd to be associated with implementation of IRS were availsJDility of logistics, level of training, and acceptability of IRS. A significant association was found between availability of respirators and experienced problem, majority 81.3% of the respondents who said respirators were available experienced no problems while spraying compared to those who said they were not available. 71.4% experienced itching or rash, srreezing and difficulties in breathing, p value 0.005. Training was associated with operational problems. 66% of Spray operators who had good training acquired more skill and had less problems in implementing IRS than 12 who had poor training and acquired less skills, p value 0.017. Acceptability of IRS in the community was between average and low because of refusals mainly due to bad smell, itching effect and dirtying walls, 75.2%, while 24.7%, said lack of Information, not effective and does not kill insects p value 0.036. Majority 73.7% of the respondents said acceptability of IRS in the community was average. The study found that out of 8 program officers interviewed, n=7 said that residents in the townships refused IRS. About 28.1% of the Spray operators revealed that Repainting of walls was very much an operational problem. Concerning service delivery, 44.7% of the respondents said that spraying was not done at the same time every year, and majority 68.4% said reasons for variation were due to late arrival of funds and logistics. 57% of the Spray operators experienced itching with regard to use of IRS chemicals. About 64% of the spray operators revealed that household members were less likely to be found in their homes for IRS in the rain season. Institutional challenges; 43.9% of the respondents said that shower and wash bay facilities were inadequate. Also more than half n=5 of the program officers said that storage facilities were inadequate and said it affected their operations much n=4. Verification using a checklist revealed Serious inadequacies evident in poor transport, disposal bay, preparation bay, wash bay, and change rooms , while shower clog were not sufficient, leading to some of the policy, operational and institutional problems experienced by service providers. Poor institutional structure, poor lEC oh IRS, non availability and insufficient logistics greatly impinged on daily operations of service providers in IRS and highly contributed to non adherence to some of the policy guidelines on DDT. Therefore refurbishment of storage facilities, regular supply of IRS commodities, community involvement, adequate community sensitization and proper planning and timing are cardinal to success of IRS not only in Ndola urban district but in all IRS clistricts.
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