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Quality of sick child care delivered by Health Surveillance Assistants in Malawi

Gilroy, Kate E. ; Callaghan-Koru, Jennifer A. ; Cardemil, Cristina V. ; Nsona, Humphreys ; Amouzou, Agbessi ; Mtimuni, Angella ; Daelmans, Bernadette ; Mgalula, Leslie ; Bryce, Jennifer

In: Health Policy and Planning, 2013, vol. 28, no. 6, p. 573-585

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    Titel
    • Quality of sick child care delivered by Health Surveillance Assistants in Malawi
    Autor
    • Gilroy, Kate E.. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Callaghan-Koru, Jennifer A.. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Cardemil, Cristina V.. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Nsona, Humphreys. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Amouzou, Agbessi. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Mtimuni, Angella. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Daelmans, Bernadette. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Mgalula, Leslie. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    • Bryce, Jennifer. Institute for International Programs, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA, Department of Pediatrics, Children's National Medical Center, Washington, DC, USA, Integrated Management of Childhood Illness (IMCI) Unit, Ministry of Health, Lilongwe, Malawi, Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland, World Health Organization, Malawi and The Community Case Management (CCM)-Malawi Quality of Care Working group includes: Samira Aboubaker, Agbessi Amouzou, Enoch Bonongwe, Jennifer Bryce, Jennifer Callaghan, Cristina Cardemil, Bernadette Daelmans, Kate Gilroy, Asha George, Timothy Kachule, Susan Kambale, Regis Katsande, Leslie Mgalula, Angella Mtimuni, Edwin Nkhono, Humphreys Nsona, Thoko, Sambakunsi, Newton Temani, and Texas Zamasiya
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • Health Policy and Planning, 2013, vol. 28, no. 6, p. 573-585. Oxford University Press
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:302968
    Summary
    Objective To assess the quality of care provided by Health Surveillance Assistants (HSAs)—a cadre of community-based health workers—as part of a national scale-up of community case management of childhood illness (CCM) in Malawi. Methods Trained research teams visited a random sample of HSAs (n = 131) trained in CCM and provided with initial essential drug stocks in six districts, and observed the provision of sick child care. Trained clinicians conducted ‘gold-standard' reassessments of the child. Members of the survey team also interviewed caregivers and HSAs and inspected drug stocks and patient registers. Findings HSAs provided correct treatment with antimalarials to 79% of the 241 children presenting with uncomplicated fever, with oral rehydration salts to 69% of the 93 children presenting with uncomplicated diarrhoea and with antibiotics to 52% of 58 children presenting with suspected pneumonia (cough with fast breathing). About one in five children (18%) presented with danger signs. HSAs correctly assessed 37% of children for four danger signs by conducting a physical exam, and correctly referred 55% of children with danger signs. Conclusion Malawi's CCM programme is a promising strategy for increasing coverage of sick child treatment, although there is much room for improvement, especially in the correct assessment and treatment of suspected pneumonia and the identification and referral of sick children with danger signs. However, HSAs provided sick child care at levels of quality similar to those provided in first-level health facilities in Malawi, and quality should improve if the Ministry of Health and partners act on the results of this assessment