Adherence to integrated management of childhood illness (IMCI) guidelines by community health workers in Kano State, Nigeria through use of a clinical decision support (CDS) platform

Autor: Megan McLaughlin, Loveth Metiboba, Aisha Giwa, Olufunke Femi-Ojo, Nirmal Ravi, Nasir Mamoud Mahmoud, Ezra Mount-Finette, Ollin Langle-Chimal, Dina Abbas, Barry Finette
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: BMC Health Services Research, Vol 24, Iss 1, Pp 1-10 (2024)
Druh dokumentu: article
ISSN: 1472-6963
DOI: 10.1186/s12913-024-11245-z
Popis: Abstract Background The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines established in 1992 to decrease preventable under-five child morbidity and mortality, was adopted by Nigeria in 1997. Over 20 years later, while under-five child mortality remains high, less than 25% of first level facilities have trained 60% of community health workers (CHW) who care for sick children with IMCI. This study investigated the impact in CHWs overall adherence to IMCI guidelines, particularly for critical danger signs, as well as usability and feasible following the implementation of THINKMD’s IMCI-based digital clinical decision support (CDS) platform. Methods Adherence to IMCI guidelines was assessed by observational and digital data acquisition of key IMCI clinical data points by 28 CHWs, prior, during, and post CDS platform implementation. Change in IMCI adherence was determined for individual CHW and for the cohort by analyzing the number of IMCI data points acquired by each CHW per clinical evaluation. Consistency of adherence was also calculated by averaging the percentage of total evaluations each data point was observed. Usability and acceptability surveys were administered following use of the CDS platform. Results THINKMD CDS platform implementation notably enhanced the CHWs’ ability to capture key IMCI clinical data elements. We observed a significant increase in the mean percentage of data points captured between the baseline period and during the CDS technology implementation (T-test, t = -31.399, p
Databáze: Directory of Open Access Journals
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