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dc.contributor.authorWasunna, Beatriceen_US
dc.contributor.authorZurovac, Dejanen_US
dc.contributor.authorBruce, Janeen_US
dc.contributor.authorJones, Carolineen_US
dc.contributor.authorWebster, Jayneen_US
dc.contributor.authorSnow, Robert Wen_US
dc.date.accessioned2012-01-11T21:43:53Z
dc.date.available2012-01-11T21:43:53Z
dc.date.copyright2010en_US
dc.date.issued2010-9-18en_US
dc.identifier.citationWasunna, Beatrice, Dejan Zurovac, Jane Bruce, Caroline Jones, Jayne Webster, Robert W Snow. "Health worker performance in the management of paediatric fevers following in-service training and exposure to job aids in Kenya" Malaria Journal 9:261. (2010)en_US
dc.identifier.issn1475-2875en_US
dc.identifier.urihttp://hdl.handle.net/2144/3242
dc.description.abstractBACKGROUND Improving the way artemether-lumefantrine (AL) is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. METHODS An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. RESULTS At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1) no health facility or health worker was exposed to all components of the intervention; 2) the proportion of health workers who received the enhanced in-service training was 67%; 3) the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL), at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1) to 87.6% (95% CI: 82.5, 91.5); 4) there were modest but non-significant improvements in dispensing and counseling practices; and 5) when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. CONCLUSION In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and counseling tasks necessary to change malaria case-management practices and the inclusion of supervision and post-training follow-up should be considered in future clinical practice change initiatives.en_US
dc.description.sponsorshipPfizer Inc's Mobilize Against Malaria initiative (88A732140); Wellcome Trust UK (084253); Wellcome Trust Principal Research Fellow (079080); Kenya Medical Research Instituteen_US
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.rightsCopyright 2010 Wasunna et al; licensee BioMed Central Ltd.en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_US
dc.titleHealth Worker Performance in the Management of Paediatric Fevers Following In-Service Training and Exposure to Job Aids in Kenyaen_US
dc.typearticleen_US
dc.identifier.doi10.1186/1475-2875-9-261en_US
dc.identifier.pubmedid20849650en_US
dc.identifier.pmcid2955674en_US


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Copyright 2010 Wasunna et al; licensee BioMed Central Ltd.
Except where otherwise noted, this item's license is described as Copyright 2010 Wasunna et al; licensee BioMed Central Ltd.