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Management of common potentially serious paediatric illnesses by aid post orderlies at Tari, Southern Highlands
1Papua New Guinea Institute of Medical Research, Tari District Hospital.
Insights
Aid post orderlies (APOs) often neglected patient examinations and provided incorrect drug dosages when managing childhood illnesses. This highlights the need for improved training and on-site performance assessments for health workers.
Area of Science:
- Pediatrics
- Public Health
- Health Services Research
Background:
- Common childhood illnesses like cough, fever, and diarrhea pose significant health risks.
- Aid post orderlies (APOs) are crucial in managing these illnesses in resource-limited settings.
- Evaluating APO performance against established guidelines is essential for quality healthcare.
Purpose of the Study:
- To assess the on-site performance of APOs in managing common childhood illnesses.
- To compare APO practices with recommended management guidelines.
- To identify areas for improvement in APO training and practice.
Main Methods:
- Systematic observations of APOs managing pediatric patients with cough, fever, and diarrhea.
- Evaluation of history taking, physical examination, diagnosis, prescription, and patient education.
- Comparison of observed practices against "Diagnosis and Treatment of Common Childhood Illnesses for APOs" guidelines.
Main Results:
- History taking was brief and examinations were often neglected.
- Prescriptions were generally appropriate, but dosages were frequently incorrect.
- Treatment principles were rarely explained, and preventive health was seldom addressed.
Conclusions:
- On-site assessment of paramedical worker performance is necessary.
- Priority demands for continuing education of health workers were identified.
- A framework for competency-based problem-solving activities was provided.
Abstract:
Systematic observations were made of a small number of aid post orderlies (APOs) managing children with the common but potentially serious symptoms of cough, fever and diarrhoea. On-site performance was evaluated against recommended management guidelines set out in Dr Keith Edwards' Diagnosis and Treatment of Common Childhood Illnesses for APOs. History taking at the aid post was brief and usually non-exploratory; examination of patients was often neglected. Drug prescription was generally appropriate for the diagnosis made, but drug dosages were often incorrect and treatment principles were rarely explained to guardians. Preventive health issues were rarely tackled. Our study reaffirms the need for on-site assessment of the performance of paramedical workers, sets priority demands for continuing education of health workers, and provides a framework for competency-based problem-solving activities within this context.