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Health Serv Res. 2018 Aug;53(4):2084-2098. doi: 10.1111/1475-6773.12842. Epub 2018 Mar 7.

Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries.

Author information

1
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.
2
Ifakara Health Institute, Dar es Salaam, Tanzania.

Abstract

OBJECTIVE:

Describe content of clinical care for sick children in low-resource settings.

DATA SOURCES:

Nationally representative health facility surveys in Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda from 2007 to 2015.

STUDY DESIGN:

Clinical visits by sick children under 5 years were observed and caregivers interviewed. We describe duration and content of the care in the visit and estimate associations between increased content and caregiver knowledge and satisfaction.

PRINCIPAL FINDINGS:

The median duration of 15,444 observations was 8 minutes; providers performed 8.4 of a maximum 24 clinical actions per visit. Content of care was minimally greater for severely ill children. Each additional clinical action was associated with 2 percent higher caregiver knowledge.

CONCLUSIONS:

Consultations for children in nine lower-income countries are brief and limited. A greater number of clinical actions was associated with caregiver knowledge and satisfaction.

KEYWORDS:

Health care quality; child mortality

PMID:
29516468
PMCID:
PMC6052007
DOI:
10.1111/1475-6773.12842

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