Improving private practitioner sick-child case management in two urban communities in Pakistan

Tropical Medicine & International Health : TM & IH
Stephen LubyRobert Northrup

Abstract

To evaluate if INFECTOM, a multicomponent behaviour change strategy, would alter the care received by children visiting private healthcare providers so that it was more consistent with the IMCI algorithm. Community surveys in two low income communities in Pakistan identified children who had visited healthcare providers in the preceding 2 weeks complaining of diarrhoea, cough or rapid breathing, or fever. Interviewers asked the mothers of these children whether providers performed specific behaviours recommended by the Integrated Management of Childhood Illness (IMCI) algorithm. These data were analysed to generate provider-specific IMCI-related behaviour profiles. A team including community representatives met with the providers, discussed the correct IMCI algorithm behaviour, reviewed the percentage of time each of their practices was consistent with IMCI recommendations, and negotiated a contract with a numerical target for improved practices. This cycle of survey, discussion of results and contracting was repeated three times over 10 months. Twenty-two providers, 13 of whom (59%) had a medical degree, regularly treated children in the two communities. Sixteen of the 21 targeted behaviours (76%) occurred with significantly i...Continue Reading

References

Oct 7, 1983·JAMA : the Journal of the American Medical Association·W SchaffnerW O Miller
Aug 25, 1993·JAMA : the Journal of the American Medical Association·S B SoumeraiM A Popovsky
Aug 5, 1996·Health Policy and Planning·D Ross-DegnanR Hogan
Dec 22, 2000·Health Policy and Planning·S ChakrabortyR S Northrup

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Citations

Dec 18, 2004·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Stephen LubyYvan Hutin
May 6, 2006·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Sarah L Barber

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