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Quality of Clinical Assessment and Child Mortality: A Three-Country Cross-Sectional Study

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dc.contributor.authorPerales, Nicole A.
dc.contributor.authorWei, Dorothy
dc.contributor.authorKhadka, Aayush
dc.contributor.authorLeslie, Hannah H.
dc.contributor.authorHamadou, Saidou
dc.contributor.authorChamberlin Yama, Gervais
dc.contributor.authorRobyn, Paul Jacob
dc.contributor.authorShapira, Gil
dc.contributor.authorKruk, Margaret E.
dc.contributor.authorFink, Gunther
dc.date.accessioned2021-12-14T19:39:49Z
dc.date.available2021-12-14T19:39:49Z
dc.date.issued2020-06
dc.description.abstractThis analysis describes specific gaps in the quality of health care in Central Africa and assesses the association between quality of clinical care and mortality at age 2–59 months. Regionally representative facility and household surveys for the Democratic Republic of the Congo, Cameroon and Central African Republic were collected between 2012 and 2016. These data are novel in linking facilities with households in their catchment area. Compliance with diagnostic and danger sign protocols during sick-child visits was observed by trained assessors. We computed facility- and district-level compliance indicators for patients aged 2–59 months and used multivariate multi-level logistic regression models to estimate the association between clinical assessment quality and mortality at age 2–59 months in the catchment areas of the observed facilities. A total of 13 618 live births were analysed and 1818 sick-child visits were directly observed and used to rate 643 facilities. Eight percent of observed visits complied with 80% of basic diagnostic protocols, and 13% of visits fully adhered to select general danger sign protocols. A 10% greater compliance with diagnostic protocols was associated with a 14.1% (adjusted odds ratio (aOR) 95% CI: 0.025–0.244) reduction in the odds of mortality at age 2–59 months; a 10% greater compliance with select general danger sign protocols was associated with a 15.3% (aOR 95% CI: 0.058–0.237) reduction in the same odds. The results of this article suggest that compliance with recommended clinical protocols remains poor in many settings and improvements in mortality at age 2–59 months could be possible if compliance were improved.en
dc.identifier.citationHealth Policy and Planning
dc.identifier.doi10.1596/36729
dc.identifier.urihttps://hdl.handle.net/10986/36729
dc.publisherOxford University Press
dc.rightsCC BY-NC-ND 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/-nc-nd3.0/igo
dc.subjectCHILD HEALTH
dc.subjectQUALITY OF HEALTH CARE
dc.subjectCLINICAL PROTOCOL
dc.subjectCHILD MORTALITY
dc.titleQuality of Clinical Assessment and Child Mortalityen
dc.title.subtitleA Three-Country Cross-Sectional Studyen
dc.typeJournal Articleen
dc.typeArticle de journalfr
dc.typeArtículo de revistaes
dspace.entity.typePublication
okr.associatedcontenthttps://academic.oup.com/heapol/article-abstract/35/7/878/5861734 Journal website (version of record)en
okr.date.disclosure2021-12-14
okr.date.doiregistration2025-05-06T11:12:27.525996Z
okr.doctypePublications & Research
okr.doctypePublications & Research::Journal Article
okr.externalcontentExternal Content
okr.guid908871643350496937
okr.identifier.doi10.1093/heapol/czaa048
okr.identifier.report168219
okr.journal.nbpages878-87
okr.language.supporteden
okr.peerreviewAcademic Peer Review
okr.region.administrativeAfrica
okr.region.administrativeAfrica Eastern and Southern (AFE)
okr.region.administrativeAfrica Western and Central (AFW)
okr.region.countryCameroon
okr.region.countryCentral African Republic
okr.region.countryCongo, Democratic Republic of
okr.topicHealth, Nutrition and Population::Early Child and Children's Health
okr.topicHealth, Nutrition and Population::Health Systems Development & Reform
okr.unitDevelopment Research Group, Development Economics
okr.volume35(7)
relation.isAuthorOfPublication41f6725d-021b-5878-8750-949260b0f2ca
relation.isAuthorOfPublication.latestForDiscovery41f6725d-021b-5878-8750-949260b0f2ca
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