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An Analysis of Clinical Knowledge, Absenteeism, and Availability of Resources for Maternal and Child Health: A Cross-Sectional Quality of Care Study in 10 African Countries

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dc.contributor.authorDi Giorgio, Laura
dc.contributor.authorEvans, David K.
dc.contributor.authorLindelow, Magnus
dc.contributor.authorNguyen, Son Nam
dc.contributor.authorSvensson, Jakob
dc.contributor.authorWane, Waly
dc.contributor.authorTarneberg, Anna Welander
dc.date.accessioned2020-10-22T16:19:48Z
dc.date.available2020-10-22T16:19:48Z
dc.date.issued2020-10
dc.description.abstractThis paper assesses the quality of health care across African countries based on health providers' clinical knowledge, their clinic attendance, and drug availability, with a focus on seven conditions accounting for a large share of child and maternal mortality: malaria, tuberculosis, diarrhea, pneumonia, diabetes, neonatal asphyxia, and postpartum hemorrhage. With nationally representative, cross-sectional data from 10 countries in Sub-Saharan Africa, collected using clinical vignettes, unannounced visits, and visual inspections of facilities, this study assesses whether health providers are available and have sufficient knowledge and means to diagnose and treat patients suffering from common conditions amenable to primary health care. The study draws on data from 8,061 primary and secondary care facilities in Kenya, Madagascar, Mozambique, Nigeria, Niger, Senegal, Sierra Leone, Tanzania, Togo, and Uganda, and 22,746 health workers. These data were gathered under the Service Delivery Indicators program. Across all conditions and countries, health care providers were able to correctly diagnose 64 percent of the clinical vignette cases, and in 45 percent of the cases, the treatment plan was aligned with the correct diagnosis. For diarrhea and pneumonia, two common causes of under-five deaths, 27 percent of the providers correctly diagnosed and prescribed the appropriate treatment for both conditions. On average, 70 percent of health workers were present in the facilities to provide care during facility hours when those workers were scheduled to be on duty. Taken together, the estimated likelihood that a facility has at least one staff present with competency and the key inputs required to provide child, neonatal, and maternity care that meets minimum quality standards is 14 percent. Poor clinical knowledge is a greater constraint in care readiness than drug availability or health workers' absenteeism in the 10 countries. However, the paper documents substantial heterogeneity across countries.en
dc.identifierhttp://documents.worldbank.org/curated/en/609841602788157350/An-Analysis-of-Clinical-Knowledge-Absenteeism-and-Availability-of-Resources-for-Maternal-and-Child-Health-A-Cross-Sectional-Quality-of-Care-Study-in-10-African-Countries
dc.identifier.doi10.1596/1813-9450-9440
dc.identifier.urihttps://hdl.handle.net/10986/34648
dc.languageEnglish
dc.publisherWorld Bank, Washington, DC
dc.relation.ispartofseriesPolicy Research Working Paper;No. 9440
dc.rightsCC BY 3.0 IGO
dc.rights.holderWorld Bank
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo
dc.subjectMATERNAL HEALTH
dc.subjectCHILD HEALTH
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectQUALITY OF HEALTH CARE
dc.subjectCHILDHOOD ILLNESS
dc.subjectABSENTEEISM
dc.subjectCOMMUNITY HEALTH WORKERS
dc.titleAn Analysis of Clinical Knowledge, Absenteeism, and Availability of Resources for Maternal and Child Healthen
dc.title.subtitleA Cross-Sectional Quality of Care Study in 10 African Countriesen
dc.typeWorking Paperen
dc.typeDocument de travailfr
dc.typeDocumento de trabajoes
dspace.entity.typePublication
okr.crossref.titleAn Analysis of Clinical Knowledge, Absenteeism, and Availability of Resources for Maternal and Child Health : A Cross-Sectional Quality of Care Study in 10 African Countries
okr.date.disclosure2020-10-15
okr.doctypePublications & Research
okr.doctypePublications & Research::Policy Research Working Paper
okr.docurlhttp://documents.worldbank.org/curated/en/609841602788157350/An-Analysis-of-Clinical-Knowledge-Absenteeism-and-Availability-of-Resources-for-Maternal-and-Child-Health-A-Cross-Sectional-Quality-of-Care-Study-in-10-African-Countries
okr.guid609841602788157350
okr.identifier.doi10.1596/1813-9450-9440
okr.identifier.externaldocumentum090224b087ebcc07_1_0
okr.identifier.internaldocumentum32489636
okr.identifier.reportWPS9440
okr.importedtrueen
okr.language.supporteden
okr.pdfurlhttp://documents.worldbank.org/curated/en/609841602788157350/pdf/An-Analysis-of-Clinical-Knowledge-Absenteeism-and-Availability-of-Resources-for-Maternal-and-Child-Health-A-Cross-Sectional-Quality-of-Care-Study-in-10-African-Countries.pdfen
okr.region.administrativeAfrica
okr.region.countryKenya
okr.region.countryMadagascar
okr.region.countryMozambique
okr.region.countryNiger
okr.region.countryNigeria
okr.region.countrySenegal
okr.region.countrySierra Leone
okr.region.countryTanzania
okr.region.countryTogo
okr.region.countryUganda
okr.statistics.combined1102
okr.statistics.dr609841602788157350
okr.statistics.drstats674
okr.topicHealth, Nutrition and Population::Early Child and Children's Health
okr.topicHealth, Nutrition and Population::Health Service Management and Delivery
okr.topicHealth, Nutrition and Population::Reproductive Health
okr.topicIndustry::Health Care Services Industry
okr.unitHealth, Nutrition and Population Global Practice
relation.isAuthorOfPublication837cee1f-30d9-57f4-bb0a-575f65176b3e
relation.isAuthorOfPublicationd6df2a53-bb3c-5376-8494-5d7b3af636f6
relation.isAuthorOfPublication.latestForDiscovery837cee1f-30d9-57f4-bb0a-575f65176b3e
relation.isSeriesOfPublication26e071dc-b0bf-409c-b982-df2970295c87
relation.isSeriesOfPublication.latestForDiscovery26e071dc-b0bf-409c-b982-df2970295c87
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