Are children presenting with non-IMCI complaints at greater risk for suboptimal screening? An analysis of outpatient visits in Afghanistan

Maya Venkataramani, Anbrasi Magdalene Edward, Paul Ickx, Motawali Younusi, Syed Ali Shah Alawi, David Peters

Research output: Contribution to journalArticle

Abstract

Objective: To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions Design: Cross-sectional study. Setting: Thirty-three provinces in Afghanistan. Participants: Observation of 3072 sick child visits selected by systematic random sampling. Main outcome measure(s): A 10 point IMCI assessment index. Results: One hundred and thirty-one (4.3%) of the 3072 sick child visits involved no IMCI-related complaints. The mean assessment index for all sick child visits was 4.81 (SD 2.41). Visits involving any IMCI-related complaint were associated with a 1.02 point higher mean assessment index than those without IMCI-related complaints (95% CI, 0.52-1.53; P < 0.001). After adjusting for relevant covariates including patient age, caretaker gender, provider type, provider gender, provider IMCI training status and IMCI guideline availability, we found that children with IMCI-related presenting complaints had a significantly better quality of IMCI screening, than those without IMCI presenting complaints (by 0.75 points; 95% CI, 0.25-1.26; P = 0.003) Conclusions: Our study indicates that children with non-IMCI presenting complaints are at greater risk of suboptimal screening compared to children with IMCI-related presenting complaints. The premise of IMCI is to routinely screen all children for conditions responsible for the major burden of childhood disease in countries like Afghanistan. The study illustrates an important finding that facility and provider capacity needs to be improved, particularly during training, supervision and guideline dissemination to ensure that all children receive routine screening for common IMCI conditions.

Original languageEnglish (US)
Pages (from-to)662-668
Number of pages7
JournalInternational Journal for Quality in Health Care
Volume29
Issue number5
DOIs
StatePublished - Oct 1 2017

Fingerprint

Afghanistan
Outpatients
Guidelines
antineoplaston A10
Cross-Sectional Studies
Observation
Outcome Assessment (Health Care)

Keywords

  • Afghanistan
  • IMCI
  • Quality of care

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

@article{39004bd5ec194241b226a9106ea13450,
title = "Are children presenting with non-IMCI complaints at greater risk for suboptimal screening? An analysis of outpatient visits in Afghanistan",
abstract = "Objective: To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions Design: Cross-sectional study. Setting: Thirty-three provinces in Afghanistan. Participants: Observation of 3072 sick child visits selected by systematic random sampling. Main outcome measure(s): A 10 point IMCI assessment index. Results: One hundred and thirty-one (4.3{\%}) of the 3072 sick child visits involved no IMCI-related complaints. The mean assessment index for all sick child visits was 4.81 (SD 2.41). Visits involving any IMCI-related complaint were associated with a 1.02 point higher mean assessment index than those without IMCI-related complaints (95{\%} CI, 0.52-1.53; P < 0.001). After adjusting for relevant covariates including patient age, caretaker gender, provider type, provider gender, provider IMCI training status and IMCI guideline availability, we found that children with IMCI-related presenting complaints had a significantly better quality of IMCI screening, than those without IMCI presenting complaints (by 0.75 points; 95{\%} CI, 0.25-1.26; P = 0.003) Conclusions: Our study indicates that children with non-IMCI presenting complaints are at greater risk of suboptimal screening compared to children with IMCI-related presenting complaints. The premise of IMCI is to routinely screen all children for conditions responsible for the major burden of childhood disease in countries like Afghanistan. The study illustrates an important finding that facility and provider capacity needs to be improved, particularly during training, supervision and guideline dissemination to ensure that all children receive routine screening for common IMCI conditions.",
keywords = "Afghanistan, IMCI, Quality of care",
author = "Maya Venkataramani and Edward, {Anbrasi Magdalene} and Paul Ickx and Motawali Younusi and Alawi, {Syed Ali Shah} and David Peters",
year = "2017",
month = "10",
day = "1",
doi = "10.1093/intqhc/mzx084",
language = "English (US)",
volume = "29",
pages = "662--668",
journal = "International Journal for Quality in Health Care",
issn = "1353-4505",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Are children presenting with non-IMCI complaints at greater risk for suboptimal screening? An analysis of outpatient visits in Afghanistan

AU - Venkataramani, Maya

AU - Edward, Anbrasi Magdalene

AU - Ickx, Paul

AU - Younusi, Motawali

AU - Alawi, Syed Ali Shah

AU - Peters, David

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective: To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions Design: Cross-sectional study. Setting: Thirty-three provinces in Afghanistan. Participants: Observation of 3072 sick child visits selected by systematic random sampling. Main outcome measure(s): A 10 point IMCI assessment index. Results: One hundred and thirty-one (4.3%) of the 3072 sick child visits involved no IMCI-related complaints. The mean assessment index for all sick child visits was 4.81 (SD 2.41). Visits involving any IMCI-related complaint were associated with a 1.02 point higher mean assessment index than those without IMCI-related complaints (95% CI, 0.52-1.53; P < 0.001). After adjusting for relevant covariates including patient age, caretaker gender, provider type, provider gender, provider IMCI training status and IMCI guideline availability, we found that children with IMCI-related presenting complaints had a significantly better quality of IMCI screening, than those without IMCI presenting complaints (by 0.75 points; 95% CI, 0.25-1.26; P = 0.003) Conclusions: Our study indicates that children with non-IMCI presenting complaints are at greater risk of suboptimal screening compared to children with IMCI-related presenting complaints. The premise of IMCI is to routinely screen all children for conditions responsible for the major burden of childhood disease in countries like Afghanistan. The study illustrates an important finding that facility and provider capacity needs to be improved, particularly during training, supervision and guideline dissemination to ensure that all children receive routine screening for common IMCI conditions.

AB - Objective: To determine if children presenting without complaints related to the Integrated Management of Childhood Illness (IMCI) are at greater risk for suboptimal screening for IMCI conditions Design: Cross-sectional study. Setting: Thirty-three provinces in Afghanistan. Participants: Observation of 3072 sick child visits selected by systematic random sampling. Main outcome measure(s): A 10 point IMCI assessment index. Results: One hundred and thirty-one (4.3%) of the 3072 sick child visits involved no IMCI-related complaints. The mean assessment index for all sick child visits was 4.81 (SD 2.41). Visits involving any IMCI-related complaint were associated with a 1.02 point higher mean assessment index than those without IMCI-related complaints (95% CI, 0.52-1.53; P < 0.001). After adjusting for relevant covariates including patient age, caretaker gender, provider type, provider gender, provider IMCI training status and IMCI guideline availability, we found that children with IMCI-related presenting complaints had a significantly better quality of IMCI screening, than those without IMCI presenting complaints (by 0.75 points; 95% CI, 0.25-1.26; P = 0.003) Conclusions: Our study indicates that children with non-IMCI presenting complaints are at greater risk of suboptimal screening compared to children with IMCI-related presenting complaints. The premise of IMCI is to routinely screen all children for conditions responsible for the major burden of childhood disease in countries like Afghanistan. The study illustrates an important finding that facility and provider capacity needs to be improved, particularly during training, supervision and guideline dissemination to ensure that all children receive routine screening for common IMCI conditions.

KW - Afghanistan

KW - IMCI

KW - Quality of care

UR - http://www.scopus.com/inward/record.url?scp=85031733046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85031733046&partnerID=8YFLogxK

U2 - 10.1093/intqhc/mzx084

DO - 10.1093/intqhc/mzx084

M3 - Article

C2 - 28992150

AN - SCOPUS:85031733046

VL - 29

SP - 662

EP - 668

JO - International Journal for Quality in Health Care

JF - International Journal for Quality in Health Care

SN - 1353-4505

IS - 5

ER -