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Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries
Authors: Kruk ME, Gage AD, Mbaruku GM, and Leslie HH
Source: Health Services Research, 53(4): 2084-2098; DOI: 10.1111/1475-6773.12842
Topic(s): Child health
Childhood mortality
Health equity
Country: Africa
Latin American/Caribbean
More than one region
  Multiple Regions
Published: AUG 2018
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. © 2018 Bill & Melinda Gates Foundation. Health Services Research published by Wiley Periodicals, Inc. on behalf of Health Research and Educational Trust. KEYWORDS: Health care quality; child mortality