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
This 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 m...
| Main Authors: | , , , , , , |
|---|---|
| Language: | English |
| Published: |
World Bank, Washington, DC
2020
|
| Subjects: | |
| Online Access: | http://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 http://hdl.handle.net/10986/34648 |
| Summary: | This 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. |
|---|