Abstract
ObjectiveTo compare caretakers’ perceived quality of care (PQC) for under-fives treated for malaria, pneumonia and diarrhoea by community health workers (CHWs) and primary health facility workers (PHFWs).MethodsCaretaker rated PQC for children aged (2-59) months treated by either CHWs or PHFWs for a bought of malaria, pneumonia or diarrhoea was cross-sectionally compared in quality domains of accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment and trust. Child samples were randomly drawn from CHW (419) and clinic (399) records from eight Midwestern Uganda districts. An overall PQC score was predicted through factor analysis. PQC scores were compared for CHWs and PHFWs using Wilcoxon rank-sum test. Multinomial logistic regression models were used to specify the association between categorized PQC and service providers for each quality domain. Finally, overall PQC was dichotomized into “high” and “low” based on median score and relative risks (RR) for PQC-service provider association were modeled in a “modified” Poisson regression model.ResultsMean (SD) overall PQC was significantly higher for CHWs 0.58 (0 .66) compared to PHFWs -0.58 (0.94), p<0.0001. In “modified” Poisson regression, the proportion of caretakers reporting high PQC was higher for CHWS compared to PHFWs, RR=3.1, 95%CI(2.5-3.8). In multinomial models PQC was significantly higher for CHWs compared to PHFWs in all domains except for continuity.ConclusionPQC was significantly higher for CHWs compared to PHFWs in this resource constrained setting. CHWs should be tapped human resources for universal health coverage while scaling up basic child intervention as PQC might improve intervention utilization.
Highlights
In order to address childhood mortality, scarcity of human resources for health and inequalities in access to health care, approaches like the integrated community case management of childhood illnesses have been recommended by the World Health Organisation [1,2,3]. iCCM entails use of community health workers (CHWs) in the management of uncomplicated childhood illnesses including malaria, pneumonia, diarrhoea and newborn referral [3,4,5]
This study reports on a cross-sectional comparison of the perceived quality of care (PQC) among caretakers of children treated for malaria, pneumonia and diarrhoea by CHWs and by primary health facility workers (PFHWs)
Data were drawn from caretakers of children with complete data and whose last visit was with a primary health facility workers (PHFWs) (376/399; 94.2%) or CHWs (377/419; 90.0%)
Summary
The quality of primary health care for children has been evaluated in both integrated management of childhood illnesses provided at health facilities and iCCM provided in the communities [22,23,24,25,26]. This evaluation was limited in that it was hinged on structural and provider assessments and not PQC at the user level. This study reports on a cross-sectional comparison of the PQC among caretakers of children treated for malaria, pneumonia and diarrhoea by CHWs and by primary health facility workers (PFHWs)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
