Premium
Content of Care in 15,000 Sick Child Consultations in Nine Lower‐Income Countries
Author(s) -
Kruk Margaret E.,
Gage Anna D.,
Mbaruku Godfrey M.,
Leslie Hannah H.
Publication year - 2018
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12842
Subject(s) - sick child , low and middle income countries , medicine , child care , family medicine , pediatrics , environmental health , developing country , economic growth , economics
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.