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Table 4 Characteristics of sick children and health extension workers at baseline (December 2016 to February 2017) and end-line (December 2018 to February 2019) in the intervention and comparison areas

From: Quality of sick child management by health extension workers: role of a complex improvement intervention

Variables

Baseline survey

End-line survey

Intervention (N = 325)

Comparison (N = 295)

P-value***

Intervention (N = 395)

Comparison (N = 310)

P-value****

n

% (95% CI)

n

% (95% CI)

n

% (95% CI)

n

% (95% CI)

Sex

 Boys

173

53 (48,59)

164

56 (50,61)

0.61

206

52 (47,57)

142

46 (40,51)

0.11

 Girls

152

47 (41,52)

131

44 (39,50)

 

189

48 (43,53)

168

54 (49,60)

 

Age in months

 2–11

126

39 (34,44)

77

26 (21,31)

0.02

128

32 (28,37)

106

34 (29,40)

0.91

 12–23

94

29 (24,34)

96

32 (27,38)

 

121

31 (26,35)

89

29 (24,34)

 

 24–35

49

15 (11,19)

46

16 (12,20)

 

66

17 (13,21)

53

17 (13,22)

 

 36–47

34

10 (7,14)

41

14 (10,18)

 

46

12 (9,15)

40

13 (9,17)

 

 48–59

22

7( 4,10)

35

12 (8,16)

 

34

9 (6,12)

22

7 (5,10)

 

Region

 Amhara

157

48 (43,54)

108

37 (31,42)

0.11

183

46 (41,51)

85

27 (23,33)

0.02

 Oromia

76

23 (19,28)

121

41 (35,47)

 

119

30 (26,35)

151

49 (43,54)

 

 Tigray

32

10 (7,13)

36

12 (9,16)

 

58

15 (11,18)

66

21 (17,26)

 

 Southern Nations, Nationalities and People

60

18 (14,23)

30

10 (7,14)

 

35

9 (6,12)

8

3 (1,5)

 

Complaints/ symptomsa

 Respiratory complaints

179

55 (50,60)

180

61 (55,66)

0.43

253

64 (59,69)

196

63 (58,68)

0.35

 Diarrhoea

129

40 (34,45)

95

32 (27,38)

 

168

42 (38,48)

154

50 (44,55)

 

 Fever

87

27 (22,32)

77

26 (21,31)

 

80

20 (16,24)

58

19 (15,23)

 

 Vomiting

46

14 (11,18)

38

13 (9,17)

 

49

12 (9,16)

42

13 (10,18)

 

 Ear problem

16

5 (3,8)

21

7 (5,10)

 

20

5 (3,8)

13

4 (2,7)

 

 Other

22

7 (4,10)

18

6 (4,9)

 

50

13 (10,16)

26

8 (6,12)

 

 Average service experience (in years) of HEWs (Mean ± SD)

6.93

3.67

6.65

3.75

0.52¶

7.65

4.67

6.84

4.40

0.49¶¶

Proportion of children managed byb

 Level-3 HEWs

209

64 (59,69)

216

73(68,78)

0.25

217

55 (50,61)

148

48(42,53)

0.40

 Level-4 HEWs

116

36 (31,41)

79

27 (22,32)

 

178

45 (40,50)

162

52 (47,58)

 

Proportion of sick children managed by HEWs:

 For whom living house is provided

129

40 (34,45)

112

38 (33,44)

0.84

115

29 (25,34)

75

24 (20,29)

0.61

 Proportion of sick children managed by HEWs:

325

 

295

  

395

 

310

  

 Trained in iCCM

297

91 (88,94)

264

89 (86,93)

0.69

325

82 (78,86)

262

84 (80,88)

0.73

 That have been supervised in the past 3 months

249

77 (72, 81)

211

71 (66,76)

0.49

295

75 (70,79)

206

66 (61,71)

0.30

 That participated in PRCMMc

150

46 (41,52)

133

45 (39,51)

0.90

299

76 (71,80)

203

65 (60,71)

0.19

 That used chart booklet during consultationsd

305

94 (91,96)

263

89 (85,92)

0.24

344

87 (83,90)

284

92 (88,94)

0.33

 That used iCCM registration book during consultation

310

95 (93,97)

268

91 (87,94)

0.21

366

93 (90,95)

291

94 (91,96)

0.74

  1. CI Confidence interval, PRCMM Performance review clinical mentoring meeting, HEWs Health extension workers, iCCM integrated community case management, SD Standard deviation
  2. aA child may have more than one complaint; thus, the sum of the numbers in the individual columns be more than the total number of observed children
  3. bHealth extension workers (HEW) level of training categories: Level-3 HEWs are those who graduated with a certificate after a one-year pre-service trainings on the 17 packages of Health Extension Program. Level-4 HEWs are those who graduated with diploma after one-year additional education at a technical college
  4. cPerformance Review Clinical Mentoring Meeting (PRCMM) is a two-day performance review meeting in which the iCCM register are examined in day one, and clinical mentoring occurs on day two. Health workers trained as trainers facilitate PRCMM for 20–24 health extension workers. This event usually takes place in a meeting hall at a central town. Supervisors and peer-HEWs review the registers for consistency, completeness and caseloads (observed versus expected). It usually occurs biannually
  5. dChart booklet is a guideline or job aid that supports health extension workers in the assessment and management of sick children including referral and follow-up
  6. ***P-value for the difference between intervention and comparison groups at baseline using chi-squared test (significance level at P < 0.05)
  7. ****P-value for the difference between intervention and comparison at end-line using chi-squared test (significance level at P < 0.05)
  8. P-value for difference between intervention and comparison groups at baseline using t-test (significance level at P < 0.05)
  9. ¶¶P-value for difference between intervention and comparison groups at end-line using t-test (significance level at P < 0.05)
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BMC Health Services Research

ISSN: 1472-6963

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