Abstract
Competency of peripheral health workers in the detection and management of common syndromic conditions is crucial as they are the first point of contact for the majority of the Indian population. We measured the competency of auxiliary nurse midwives (ANMs), and factors associated with inadequate competency, in the detection and management of common conditions-diarrhoea, acute respiratory tract infection, fever, malaria-through a cross-sectional study using condition specific validated clinical vignettes and structured questionnaires. Out of 272 selected ANMs, 68% (95% CI 62-74%) were adequately competent. Factors independently associated with inadequate competency were unavailability of essential drugs in preceding month [adjusted odds ratio (AOR)=1.95; 95% CI 1.1-3.5] and ever trained in integrated management of childhood illness (AOR=2.4; 95% CI 1.4-4.1). More than two third of the peripheral health workers were adequately competent to detect and manage common conditions. Ensuring uninterrupted drug availability and improved quality in service trainings might facilitate competency levels.
Highlights
Peripheral health workers are the final common pathway for implementation of all health programmes in the primary health care delivery system
We examined multi-collinearity among the variables and used multiple logistic regression to calculate the adjusted odds ratio (OR) (AOR) with 95% confidence interval (CI) for each of the variables found significant in the univariate analysis, adjusted for potential confounders
Most had more than 11 years (median = 22 years; inter-quartile range (IQR) = 10– 28 years) of service experience
Summary
We measured the competency of auxiliary nurse midwives (ANMs), and factors associated with inadequate competency, in the detection and management of common conditions diarrhoea, acute respiratory tract infection, fever, malaria through a cross-sectional study using condition specific validated clinical vignettes and structured questionnaires
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