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Content of Care in 15,000 Sick Child Consultations in Nine Lower-Income Countries

Margaret E Kruk1, Anna D Gage1, Godfrey M Mbaruku2

  • 1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA.

Health Services Research
|March 9, 2018
PubMed

Insights

Clinical care for sick children in low-resource settings is brief, with few actions performed per visit. Increased clinical actions positively impact caregiver knowledge and satisfaction.

Area of Science:

  • Global Health
  • Pediatric Care
  • Health Services Research

Background:

  • Effective clinical care for sick children is crucial in low-resource settings.
  • Understanding the content and duration of pediatric consultations is essential for improving health outcomes.

Purpose of the Study:

  • To describe the content and duration of clinical care for sick children under 5 years in low-resource settings.
  • To assess the association between the extent of clinical actions and caregiver knowledge and satisfaction.

Main Methods:

  • Utilized nationally representative health facility surveys from nine lower-income countries (2007-2015).
  • Observed clinical visits for sick children and interviewed caregivers.
  • Analyzed the duration and number of clinical actions per visit.

Main Results:

  • Median visit duration was 8 minutes, with providers performing an average of 8.4 out of 24 possible clinical actions.
  • Content of care was only slightly greater for severely ill children.
  • Each additional clinical action correlated with a 2% increase in caregiver knowledge.

Conclusions:

  • Pediatric consultations in these nine lower-income countries are brief and limited in scope.
  • Increasing the number of clinical actions during consultations is associated with improved caregiver knowledge and satisfaction.
Abstract

Keywords:
Health care qualitychild mortality

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