Evaluation of clinical management training programme for diarrhoea

Area of Science:

• Public Health
• Pediatrics
• Medical Education

Background:

• Infantile diarrhea remains a significant global health challenge, particularly in resource-limited settings.
• Effective clinical management, including appropriate use of oral rehydration therapy (ORT) and judicious antibiotic use, is crucial for reducing morbidity and mortality.
• Healthcare provider training is essential for disseminating evidence-based practices in pediatric care.

Purpose of the Study:

• To evaluate the effectiveness of a training program on the clinical management of infantile diarrhea.
• To assess the impact of the training on healthcare providers' knowledge, attitudes, and practices (KAP) regarding diarrhea management.
• To determine changes in the utilization of key interventions like ORT and antibiotic prescribing patterns.

Main Methods:

• A mixed-methods approach was employed, including pre- and post-training knowledge tests.
• Knowledge, Attitude, and Practice (KAP) questionnaires were administered to assess understanding and beliefs.
• Observational surveys were conducted to evaluate actual clinical practices in health facilities.

Main Results:

• Significant improvements were observed in medical knowledge related to diarrhea management, particularly concerning ORT and drug therapy.
• While observational data showed a significant increase in ORT use at health facilities (2.9% to 23.6%, p = 0.007), this rate was still low compared to high KAP scores for ORT.
• A significant reduction in antibiotic prescriptions for inpatient diarrhea cases was noted (85.7% to 64.8%, p = 0.025).
• The training successfully promoted the establishment of Oral Rehydration Units in participating health facilities.

Conclusions:

• The training program effectively enhanced healthcare providers' knowledge and led to improved clinical practices in managing infantile diarrhea.
• Despite increased knowledge, the translation of ORT knowledge into consistent practice remains a challenge.
• The program demonstrated success in reducing unnecessary antibiotic use and facilitating the implementation of essential care structures like ORUs.