Abstract
AimThe Ethiopian primary care of sick children is provided within the integrated Community Case Management of childhood illnesses by Health Extension Workers (HEW). There is limited knowledge whether this cadre correctly assess and classify common diseases. The aim was to study their ability to correctly classify common childhood illnesses.MethodsA survey was conducted from December 2016 to February 2017 in four regions of Ethiopia. Observations of the HEWs‘ assessment and classification of sick children were followed by child re-examination by a trained health officer.ResultsThe classification by the HEWs of 620 sick children as compared to the reexaminer had a sensitivity of 89% and specificity of 94% for diarrhoea, sensitivity 52% and specificity 91% for febrile disorders, and a sensitivity of 59% and specificity of 94% for acute respiratory tract infection. Malnutrition and ear infection had a sensitivity of 39 and 61%, and a specificity of 99 and 99%, respectively.ConclusionMost cases of diarrhoea were correctly classified, while other illnesses were not frequently identified. The identification of malnutrition was especially at fault. These findings suggest that a significant number of sick children were undiagnosed that could lead to absent or incorrect management and treatment.
Highlights
The global under-five mortality rate has dropped from 69 deaths per 1,000 live births in 2000 to 38 in 2016
Aim: The Ethiopian primary care of sick children is provided within the integrated Community Case Management of childhood illnesses by Health Extension Workers (HEW)
The identification of malnutrition was especially at fault. These findings suggest that a significant number of sick children were undiagnosed that could lead to absent or incorrect management and treatment
Summary
The global under-five mortality rate has dropped from 69 deaths per 1,000 live births in 2000 to 38 in 2016. The success of reducing the under-five mortality by two-thirds over the past 20 years could be attributed to improvements in multiple sectors including increased access to lifesaving health system interventions (2). These interventions include improved availability of outpatient care for sick children, expanded coverage of immunizations, and an increased number of facilities that provide treatment, growth monitoring, and nutrition services (3). Despite this improvement, the under-five mortality in Ethiopia remains high. Malnutrition is a major contributing cause to the under-five deaths (4)
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