Assessing the quality of care in sick child services at health facilities in Ethiopia

Table 4 Adherence to IMCI assessment, physical examination, and treatment among sick children. Ethiopian Service Provision Assessment Plus Survey 2014

Components of consultation	Pneumonia/ Broncho- pneumonia	Bronchial spasm/asthma	Cough or other upper respiratory illness	Fever	Measles	Malaria^d	Any diarrhea without dehydration	Any diarrhea with dehydration	Ear infection	Malnutrition	All observed children
IMCI assessment
3 main symptoms^a	55	53	55	27	61	51	65	43	35	49	44
3 general danger signs^b	3	0	6	3	0	4	1	23	8	6	4
Current eating or drinking habits	30	45	25	25	30	28	25	50	20	62	27
Caretaker advised to continue feeding and to increase fluid intake	12	3	16	19	22	23	20	43	17	38	17
Physical examination
Temperature	77	43	87	92	67	91	88	74	72	74	74
Respiratory rate	56	13	48	47	46	32	22	11	16	31	29
Dehydration	20	9	17	38	60	28	56	54	19	29	23
Anemia	33	25	24	47	38	39	43	44	35	37	30
Ear (looked in ear/ felt behind ear)	9	37	13	11	9	11	14	0	69	7	11
Edema	4	9	3	10	9	7	0	13	3	35	7
Referred for any laboratory test	18	19	18	33	24	43	16	27	13	7	21
Treatment
Referred outside or admitted	19	0	5	3	22	2	1	17	11	21	9
Any antibiotic	84	89	63	60	94	52	62	80	92	43	58
Injectable antibiotic	9	8	2	3	26	2	1	11	15	4	4
Oral antibiotic	78	80	62	59	90	50	61	76	86	41	56
Any antimalarial	3	0	3	6	3	36	0	0	2	2	4
ACT	1	0	1	1	3	16	0	0	0	1	2
Oral non-ACT	2	0	2	4	0	18	0	0	1	1	2
Injectable artesunate	0	0	0	0	0	0	0	0	0	0	0
Quinine	0	0	0	1	0	1	0	0	0	0	0
Oral bronchodilator	5	46	1	0	0	0	0	0	0	0	1
Oral medication for symptomatic treatment	47	46	48	65	42	55	23	26	40	12	35
Oral rehydration solution (ORS)	18	1	8	33	31	22	76	67	14	16	19
Intravenous fluid	0	0	0	0	0	0	0	0	0	0	0
Zinc	7	1	2	8	1	10	13	8	3	9	6
Described signs or symptoms requiring immediate return	21	16	21	24	0	30	20	17	16	16	19
Discussed follow-up visit	17	24	29	21	1	29	42	28	35	26	25
Number of children^c	299	11	289	197	8	201	72	24	58	146	1908

Note: ACT artemisinin combination therapy
^a The three IMCI main symptoms are cough/difficulty breathing, diarrhea, and fever
^b The three IMCI general danger signs are inability to eat/drink anything, vomiting everything, and febrile convulsion
^c A child may be classified under more than one diagnosis; therefore, the numbers in the individual columns are not mutually exclusive and may add to more than the total number of observed children
^d Malaria reflects the provider-reported diagnosis, which may have been based on rapid diagnostic test (RDT), microscopy, or clinical diagnosis. The interviewing team did not verify this information

ISSN: 1472-6963