scholarly journals Can social accountability mechanisms using community scorecards improve quality of pediatric care in rural Cambodia?

2020 ◽  
Vol 32 (6) ◽  
pp. 364-372
Author(s):  
Anbrasi Edward ◽  
Younghee Jung ◽  
Chea Chhorvann ◽  
Annette E Ghee ◽  
Jane Chege
Keyword(s):  
Quality Of Care ◽  
Integrated Management ◽  
Social Accountability ◽  
Pediatric Care ◽  
Growth Chart ◽  
Danger Signs ◽  
Quasi Experimental ◽  
And Child Health ◽  
Trained Provider

Abstract Objective To determine the effect of social accountability strategies on pediatric quality of care. Design and Setting A non-randomized quasi experimental study was conducted in four districts in Cambodia and all operational public health facilities were included. Participants Five patients under 5 years and their caretakers were randomly selected in each facility. Interventions To determine the effect of maternal and child health interventions integrating citizen voice and action using community scorecards on quality of pediatric care. Outcome Measures Patient observations were conducted to determine quality of screening and counseling, followed by exit interviews with caretakers. Results Results indicated significant differences between intervention and comparison facilities; screening by Integrated Management of Childhood Illness (IMCI) trained providers (100% vs 67%, P < 0.019), screening for danger signs; ability to drink/breastfeed (100% vs 86.7%, P < 0.041), lethargy (86.7% vs 40%, P < 0.004) and convulsions (83.3 vs 46.7%, P < 0.023). Screening was significantly higher for patients in the intervention facilities for edema (56.7% vs 6.7%, P < 0.000), immunization card (90% vs 40%, P < 0.002), child weight (100 vs 86.7, P < 0.041) and checking growth chart (96.7% vs 66.7%, P < 0.035). The IMCI index, constructed from key performance indicators, was significantly higher for patients in the intervention facilities than comparison facilities (screening index 8.8 vs 7.0, P < 0.018, counseling index 2.7 vs 1.5, P < 0.001). Predictors of screening quality were child age, screening by IMCI trained provider, wealthier quintiles and intervention facilities. Conclusion The institution of social accountability mechanisms to engage communities and facility providers showed some improvements in quality of care for common pediatric conditions, but socioeconomic disparities were evident.

A History of Child Health Equity Legislation in the United States

PEDIATRICS ◽  
2003 ◽  
Vol 112 (Supplement_3) ◽  
pp. 727-730
Author(s):  
Peter C. van Dyck
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Child Health ◽  
Access To Care ◽  
Maternal And Child Health ◽  
Well Being ◽  
The United States ◽  
Pediatric Care ◽  
And Child Health

The Issue. The mission of the Maternal and Child Health Bureau (MCHB) is comprehensive in scope and establishes the capacity, structure, and function for the MCHB to continually improve the health and well-being of pregnant women and children. The MCHB works in partnership with states and has broad authority to improve access to care and ensure the provision of quality preventive and primary care services. Specific provisions of legislation establish the framework for accomplishing this mission. With the increasing recognition of the social, economic, and environmental determinants of child health and the inequities that exist in access and quality of care for children, the Maternal and Child Health Bureau (MCHB) has set the following 3 goals for year 2003: 1) To eliminate disparities in health status outcomes through the removal of economic, social, and cultural barriers to receiving comprehensive, timely, and appropriate health care; 2) To ensure the highest quality of care through the development of practice guidance and data monitoring and evaluation tools; the use of evidence-based research; and the availability of a well-trained, culturally diverse workforce; and 3) To facilitate access to care through the development and improvement of the maternal and child health infrastructure and systems of care to enhance the provision of necessary, coordinated, quality health care. Priority MCHB strategies to accomplish these goals include improving and expanding 1) the cultural competence of providers (in particular to decrease sudden infant death syndrome [SIDS] among minorities), 2) emergency medical services for children, 3) health and safety in child care, 4) quality of primary pediatric care, and 5) the providing of every child with a medical home.

scholarly journals Facilitators and barriers to quality of care in maternal, newborn and child health: a global situational analysis through metareview

BMJ Open ◽  
2014 ◽  
Vol 4 (5) ◽  
pp. e004749 ◽  
Author(s):  
Manisha Nair ◽  
Sachiyo Yoshida ◽  
Thierry Lambrechts ◽  
Cynthia Boschi-Pinto ◽  
Krishna Bose ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Child Health ◽  
Situational Analysis ◽  
Newborn And Child Health ◽  
Facilitators And Barriers ◽  
And Child Health

scholarly journals Quality of Maternity Care and Client Satisfaction

2019 ◽  
Vol 2 (1) ◽  
pp. 73-76
Author(s):  
Saraswoti Kumari Gautam Bhattarai ◽  
Kanchan Gautam
Keyword(s):  
Quality Of Care ◽  
Child Health ◽  
Pregnant Women ◽  
Maternal And Child Health ◽  
Maternity Care ◽  
Client Satisfaction ◽  
Care Service ◽  
Postnatal Period ◽  
And Child Health

Health service provided to pregnant women during antenatal, childbirth and postnatal period is essential for maternal and child health. Proper care during pregnancy, childbirth and postnatal period are important for the health of mother and baby. High maternal, infant and child morbidity and mortality demand improved healthcare which does not concern to coverage of health services alone. The health issues of pregnant women, mothers, infants and children need to be addressed with the attention to the quality of care (QoC).  The Nepal Health Sector Strategy (NHSS) also identifies equity and quality of care gaps as areas of concern for achieving the maternal health sustainable development goal (SDG) target. So this review aims to sensitize and draw attention to the quality of maternity care and client satisfaction to improve maternal and child health. For this article, different studies related to the quality of maternity care and satisfaction from care service received on maternity care are reviewed.

scholarly journals PACK Child: the development of a practical guide to extend the scope of integrated primary care for children and young adolescents

2018 ◽  
Vol 3 (Suppl 5) ◽  
pp. e000957 ◽  
Author(s):  
Sandy Picken ◽  
Juliet Hannington ◽  
Lara Fairall ◽  
Tanya Doherty ◽  
Eric Bateman ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Low Income ◽  
Integrated Management ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Childhood Mortality ◽  
Middle Income ◽  
Support Tool

Pioneering strategies like WHO’s Integrated Management of Childhood Illness (IMCI) have resulted in substantial progress in addressing infant and child mortality. However, large inequalities exist in access to and the quality of care provided in different regions of the world. In many low-income and middle-income countries, childhood mortality remains a major concern, and the needs of children present a large burden upon primary care services. The capacity of services and quality of care offered require greater support to address these needs and extend integrated curative and preventive care, specifically, for the well child, the child with a long-term health need and the child older than 5 years, not currently included in IMCI. In response to these needs, we have developed an innovative method, based on experience with a similar approach in adults, that expands the scope and reach of integrated management and training programmes for paediatric primary care. This paper describes the development and key features of the PACK Child clinical decision support tool for the care of children up to 13 years, and lessons learnt during its development.

scholarly journals Factors associated with adherence to the Integrated Management of Childhood Illness (IMCI) guidelines for under-five years’ old care in Burkina Faso primary health care facilities

2019 ◽  
Author(s):  
Sabere Anselme Traoré ◽  
Serge M.A. Somda ◽  
Joël Arthur Kiendrébéogo ◽  
Jean-Louis Kouldiati ◽  
Paul Jacob Robyn ◽  
...  
Keyword(s):  
Health Care ◽  
Health Workers ◽  
Integrated Management ◽  
Health Care Facilities ◽  
Childhood Illness ◽  
Under Five ◽  
Danger Signs ◽  
Primary Health ◽  
Primary Health Care Facilities

AbstractObjectiveTo assess the adherence to Integrated Management of Childhood Illness (IMCI) guidelines in primary health care facilities in Burkina Faso and to determine the factors associated.Materials and MethodsWe used data from a large survey on health facilities, held from October 2013 to April 2014. Primary health facilities were evaluated, health workers interviewed and consultations observed. The standard guideline for an under five year’s old child consultation was the Integrated Management of Childhood Illness (IMCI).Results1,571 consultations were observed, carried out by 522 different practitioners. The danger signs were usually not checked (13.9% only checking for at least three general danger signs). The adherence for cough (74.8%), diarrhoea (64.9%), fever (83.8%) and anaemia (70.3%) was higher. The principal factors found to be associated with poorer adherence to guidelines of consultation were female sex (Rate Ratio (RR) = 0.91; 95% CI 0.86 – 0.95), non-nurse practitioner (RR=0.93; 95% CI 0.88 – 0.97), IMCI training (RR=1.06; 95% CI 1.01 – 1.11), non-satisfaction of the salary (RR=0.95 95% CI 0.91 – 0.99).ConclusionThis study highlights a poor adherence to the IMCI guidelines and by then, revealing a poor quality of under-five care. Indeed, many characteristics of health workers including gender, type of profession, training satisfaction with salary were found to be associated with this adherence. Therefore, more initiatives aiming at improving the quality of care should be developed and implemented for improving the child health care.

scholarly journals Integrated Management of Childhood Illnesses (IMCI): a mixed-methods study on implementation, knowledge and resource availability in Malawi

2021 ◽  
Vol 5 (1) ◽  
pp. e001044
Author(s):  
Kim Kilov ◽  
Helena Hildenwall ◽  
Albert Dube ◽  
Beatiwel Zadutsa ◽  
Lumbani Banda ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Resource Availability ◽  
Quantitative Data ◽  
Integrated Management ◽  
Knowledge Score ◽  
Holistic Approach ◽  
Mixed Methods Study ◽  
Childhood Illnesses

BackgroundThe introduction of the WHO’s Integrated Management of Childhood Illnesses (IMCI) guidelines in the mid-1990s contributed to global reductions in under-five mortality. However, issues in quality of care have been reported. We aimed to determine resource availability and healthcare worker knowledge of IMCI guidelines in two districts in Malawi.MethodsWe conducted a mixed-methods study, including health facility audits to record availability and functionality of essential IMCI equipment and availability of IMCI drugs, healthcare provider survey and focus group discussions (FGDs) with facility staff. The study was conducted between January and April 2019 in Mchinji (central region) and Zomba (southern region) districts. Quantitative data were described using proportions and χ2 tests; linear regression was conducted to explore factors associated with IMCI knowledge. Qualitative data were analysed using a pragmatic framework approach. Qualitative and quantitative data were analysed and presented separately.ResultsForty-seven health facilities and 531 healthcare workers were included. Lumefantrine-Artemether and cotrimoxazole were the most available drugs (98% and 96%); while amoxicillin tablets and salbutamol nebuliser solution were the least available (28% and 36%). Respiratory rate timers were the least available piece of equipment, with only 8 (17%) facilities having a functional device. The mean IMCI knowledge score was 3.96 out of 10, and there was a statistically significant association between knowledge and having received refresher training (coeff: 0.42; 95% CI 0.01 to 0.82). Four themes were identified in the FGDs: IMCI implementation and practice, barriers to IMCI, benefits of IMCI and sustainability.ConclusionWe found key gaps in IMCI implementation; however, these were not homogenous across facilities, suggesting opportunities to learn from locally adapted IMCI best practices. Improving on-going mentorship, training and supervision should be explored to improve quality of care, and programming which moves away from vertical financing with short-term support, to a more holistic approach with embedded sustainability may address the balance of resources for different conditions.

scholarly journals The Web-Based Osteoarthritis Management Resource My Joint Pain Improves Quality of Care: A Quasi-Experimental Study

2015 ◽  
Vol 17 (7) ◽  
pp. e167 ◽  
Author(s):  
Hema Umapathy ◽  
Kim Bennell ◽  
Chris Dickson ◽  
Fiona Dobson ◽  
Marlene Fransen ◽  
...  
Keyword(s):  
Experimental Study ◽  
Quality Of Care ◽  
Joint Pain ◽  
Web Based ◽  
Quasi Experimental ◽  
The Web

scholarly journals Quality of Care for Children Under Five with Malaria Using IMCI Approach at Public Health Centre: Literature Review

2022 ◽  
Author(s):  
Orpa Diana Suek ◽  
Moses Pandin
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Services ◽  
Integrated Management ◽  
Childhood Illness ◽  
Public Health Centre ◽  
Children Under Five ◽  
Under Five ◽  
Care Services

Integrated Management of Childhood Illness is one of the strategies in health care services for infants and children under five at primary health care facilities. Children with fever in high malaria endemic areas must have a blood test done to check whether the children have malaria or not. IMCI is one of the interventions recommended by WHO to screen and also ensure that children receive proper initial treatment at first-level health facilities. This article aims to discuss the quality of care for children under five with malaria using IMCI approach. This is a systematic review by searching 4 databases including Scopus, Web of Science, SAGE and Proquest. Health care services for children under five with an integrated management of childhood illness are intended to provide immediate and appropriate treatment. The guideline for treating children under five with malaria using IMCI approach is very helpful for nurses both in assessing, classifying, treating/curing and making decisions for pre-referral measures for severe cases. Several factors to support quality of care are trained officers, supervision and procurement of essential medicines, RDT and malaria microscopy. Enforcement of the right diagnosis will improve the quality of life of children and prevent death in children under five. Keywords: IMCI, Malaria, Children under five

scholarly journals Completitude e concordância dos instrumentos da vigilância do óbito infantil: estudo transversal

2016 ◽  
Vol 15 ◽  
pp. 538
Author(s):  
Lays Prazeres Marques ◽  
Conceição Maria de Oliveira ◽  
Cristine Vieira do Bonfim
Keyword(s):  
Quality Of Care ◽  
Fetal Death ◽  
Intraclass Correlation ◽  
Vital Statistics ◽  
Kappa Index ◽  
Cross Sectional ◽  
Summary Sheet ◽  
One Year ◽  
And Child Health

Aim:  to  evaluate  the  completeness  and  compliance  of  research instruments  for  the  Surveillance  of  Child  and  Fetal  Death.  Method:  This  is  a  cross-sectional census study in which all 183 Confidential Sheets and Synthese Records of the Investigation of Death Surveillance of Fetuses and Infants under one year of life in Recife (PE)  in  2014  will  be  analyzed.  The  completeness  of  the  variables  on  Confidential Research  Records  will  be  assessed  from  the  proportion  of  ignored  and/or blank  fields. The Summary Sheet Research will have the agreement verified by the Kappa Index and the intraclass  correlation  coefficient.  Expected results:  The  intention  is  to  contribute  to the improvement of surveillance, by improving the quality of care for maternal and child health, with the improvement of vital statistics and the prevention of avoidable deaths.

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