Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries

Health Serv Res. 2018 Aug;53(4):2084-2098. doi: 10.1111/1475-6773.12842. Epub 2018 Mar 7.

Abstract

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.

Keywords: Health care quality; child mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Africa
  • Caregivers / psychology*
  • Child Health Services* / standards
  • Child Mortality / trends
  • Child, Preschool
  • Female
  • Haiti
  • Health Facilities
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Infant
  • Infant, Newborn
  • Interviews as Topic
  • Male
  • Nepal
  • Poverty
  • Quality of Health Care / standards*
  • Referral and Consultation / statistics & numerical data*