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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...

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Autores principales: Mwanga-Amumpaire, Juliet, Ndeezi, Grace, Källander, Karin, Obua, Celestino, Migisha, Richard, Nkeramahame, Juvenal, Stålsby Lundborg, Cecilia, Kalyango, Joan Nakayaga, Alfvén, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
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.
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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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