Determinants of improvement trends in health workers' compliance with outpatient malaria case-management guidelines at health facilities with available 'test and treat' commodities in Kenya
| Autor: | Philip Bejon, Kasia Stepniewska, Beatrice Machini, Beatrice Amboko, Lucas Malla, Robert W. Snow, Dejan Zurovac |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Social Sciences Fevers 0302 clinical medicine Medical Conditions Health facility Sociology Outpatients Outcome Assessment Health Care Complaint Medicine and Health Sciences 030212 general & internal medicine Child Integrated Management of Childhood Illness Aged 80 and over Multidisciplinary 1. No poverty Drugs Middle Aged 3. Good health Child Preschool Social Systems Medicine Female Guideline Adherence Research Article Adult Patients Adolescent Fever Health Personnel Science 030231 tropical medicine Compliance (psychology) Odds 03 medical and health sciences Antimalarials Signs and Symptoms Environmental health medicine Parasitic Diseases Humans Aged Pharmacology Government Treatment Guidelines Health Care Policy business.industry Diagnostic Tests Routine Artemether Lumefantrine Drug Combination Infant Newborn Infant Odds ratio medicine.disease Tropical Diseases Kenya Malaria Health Care Cross-Sectional Studies Health Care Facilities Health Facilities Clinical Medicine business Case Management |
| Zdroj: | PLoS ONE, Vol 16, Iss 11, p e0259020 (2021) PLoS ONE, Vol 16, Iss 11 (2021) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Health workers’ compliance with outpatient malaria case-management guidelines has been improving in Africa. This study examined the factors associated with the improvements. Methods Data from 11 national, cross-sectional health facility surveys undertaken from 2010–2016 were analysed. Association between 31 determinants and improvement trends in five outpatient compliance outcomes were examined using interactions between each determinant and time in multilevel logistic regression models and reported as an adjusted odds ratio of annual trends (T-aOR). Results Among 9,173 febrile patients seen at 1,208 health facilities and by 1,538 health workers, a higher annual improvement trend in composite “test and treat” performance was associated with malaria endemicity-lake endemic (T-aOR = 1.67 annually; p25 febrile patients (T-aOR = 1.46; p = 0.003); and with under-five children compared to older patients (T-aOR = 1.07; p = 0.013). Other factors associated with the improvement trends in the “test and treat” policy components and artemether-lumefantrine administration at the facility included the absence of previous RDT stock-outs, community health workers dispensing drugs, access to malaria case-management and Integrated Management of Childhood Illness (IMCI) guidelines, health workers’ gender, correct health workers’ knowledge about the targeted malaria treatment policy, and patients’ main complaint of fever. The odds of compliance at the baseline were variable for some of the factors. Conclusions Targeting of low malaria risk areas, low caseload facilities, male and government health workers, continuous availability of RDTs, improving health workers’ knowledge about the policy considering age and fever, and dissemination of guidelines might improve compliance with malaria guidelines. For prompt treatment and administration of the first artemether-lumefantrine dose at the facility, task-shifting duties to community health workers can be considered. |
| Databáze: | OpenAIRE |
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