Factors Determining Correct Case Management of Acute Respiratory Infections in Children by Primary Health care in Ibadan

Abstract

Background: Inappropriate case management of Acute Respiratory Infections (ARIs) is one of the factors responsible for the high ARI mortality in developing countries. Identification of factors which influence ARI case management by health workers is key for interventions to improve Quality of case management. Objective: To identify factors which determine correct case management of Acute Respiratory Infections (ARIs) in children by primary health care workers in Ibadan. Design: A descriptive cross sectional study was carried out from June to December 1999 in Ibadan South East LGA and Lagelu LGA. Study materials included observation checklists, validation checklist, and health worker interview questionnaires. Results: Twenty-five health workers and 20 health workers were observed managing 390 children and 386 children in Ibadan South East and Lagelu LGA respectively. More than half of Pneumonia cases were correctly treated in the two LGAs (62.3% and 66.1% respectively). Sex and category of health workers was significantly associated with correct treatment of mild ARI with female workers and Nursing staff doing better (Odds ratio 4.57, 95% CI 2.15, 9.95 and 4.61, 95% CI 2.57, 8.31 respectively). Health workers who had been trained performed better in the management of Pneumonia though it was not statistically significant. Conclusions: There is a need for targeted research to identify the relative contribution of the myriad of factors influencing health worker performance in specific localities in order to improve the quality of care in child health programmes. Keywords: Factors, Case Management, ARI, Health workers.NQJHM Vol. 16 (1) 2005: pp. 14-19