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Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda
BACKGROUND: Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. METHODS: We conducted...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528317/ https://www.ncbi.nlm.nih.gov/pubmed/34669729 http://dx.doi.org/10.1371/journal.pone.0257851 |
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author | Mwanga-Amumpaire, Juliet Ndeezi, Grace Källander, Karin Obua, Celestino Migisha, Richard Nkeramahame, Juvenal Stålsby Lundborg, Cecilia Kalyango, Joan Nakayaga Alfvén, Tobias |
author_facet | Mwanga-Amumpaire, Juliet Ndeezi, Grace Källander, Karin Obua, Celestino Migisha, Richard Nkeramahame, Juvenal Stålsby Lundborg, Cecilia Kalyango, Joan Nakayaga Alfvén, Tobias |
author_sort | Mwanga-Amumpaire, Juliet |
collection | PubMed |
description | BACKGROUND: Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. METHODS: We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections. RESULTS: Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed. CONCLUSION: Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides. |
format | Online Article Text |
id | pubmed-8528317 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-85283172021-10-21 Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda Mwanga-Amumpaire, Juliet Ndeezi, Grace Källander, Karin Obua, Celestino Migisha, Richard Nkeramahame, Juvenal Stålsby Lundborg, Cecilia Kalyango, Joan Nakayaga Alfvén, Tobias PLoS One Research Article BACKGROUND: Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds. METHODS: We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections. RESULTS: Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed. CONCLUSION: Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides. Public Library of Science 2021-10-20 /pmc/articles/PMC8528317/ /pubmed/34669729 http://dx.doi.org/10.1371/journal.pone.0257851 Text en © 2021 Mwanga-Amumpaire et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Mwanga-Amumpaire, Juliet Ndeezi, Grace Källander, Karin Obua, Celestino Migisha, Richard Nkeramahame, Juvenal Stålsby Lundborg, Cecilia Kalyango, Joan Nakayaga Alfvén, Tobias Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title | Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title_full | Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title_fullStr | Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title_full_unstemmed | Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title_short | Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda |
title_sort | capacity to provide care for common childhood infections at low-level private health facilities in western, uganda |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8528317/ https://www.ncbi.nlm.nih.gov/pubmed/34669729 http://dx.doi.org/10.1371/journal.pone.0257851 |
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