Abstract
Objective: To determine the quality of outpatient hospital care for children under 5 years in Afghanistan. Design: Case management observations were conducted on 10-12 children under five selected by systematic random sampling in 31 outpatient hospital clinics across the country, followed by interviews with caretakers and providers. Main Outcome Measures: Quality of care defined as adherence to the clinical standards described in the Integrated Management of Childhood Illness. Results: Overall quality of outpatient care for children was suboptimal based on patient examination and caretaker counseling (median score: 27.5 on a 100 point scale). Children receiving care from female providers had better care than those seen by male providers (OR: 6.6, 95% CI: 2.0-21.9, P = 0.002), and doctors provided better quality of care than other providers (OR: 2.7, 95% CI: 1.1-6.4, P = 0.02). The poor were more likely to receive better care in hospitals managed by non-governmental organizations than those managed by other mechanisms (OR: 15.2, 95% CI: 1.2-200.1, P = 0.04). Conclusions: Efforts to strengthen optimal care provision at peripheral health clinics must be complemented with investments at the referral and tertiary care facilities to ensure care continuity. The findings of improved care by female providers, doctors and NGO's for poor patients, warrant further empirical evidence on care determinants. Optimizing care quality at referral hospitals is one of the prerequisites to ensure service utilization and outcomes for the achievement of the Child health Millennium Development Goals for Afghanistan.
| Original language | English (US) |
|---|---|
| Article number | mzq081 |
| Pages (from-to) | 108-116 |
| Number of pages | 9 |
| Journal | International Journal for Quality in Health Care |
| Volume | 23 |
| Issue number | 2 |
| DOIs | |
| State | Published - Apr 2011 |
Fingerprint
Keywords
- Afghanistan
- Child health
- Hospitals
- IMCI
- Quality of care
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health
Cite this
Quality of outpatient hospital care for children under 5 years in Afghanistan. / Lind, Allison; Edward, Anbrasi Magdalene; Bonhoure, Philippe; Mustafa, Lais; Hansen, Peter; Burnham, Gilbert M; Peters, David.
In: International Journal for Quality in Health Care, Vol. 23, No. 2, mzq081, 04.2011, p. 108-116.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Quality of outpatient hospital care for children under 5 years in Afghanistan
AU - Lind, Allison
AU - Edward, Anbrasi Magdalene
AU - Bonhoure, Philippe
AU - Mustafa, Lais
AU - Hansen, Peter
AU - Burnham, Gilbert M
AU - Peters, David
PY - 2011/4
Y1 - 2011/4
N2 - Objective: To determine the quality of outpatient hospital care for children under 5 years in Afghanistan. Design: Case management observations were conducted on 10-12 children under five selected by systematic random sampling in 31 outpatient hospital clinics across the country, followed by interviews with caretakers and providers. Main Outcome Measures: Quality of care defined as adherence to the clinical standards described in the Integrated Management of Childhood Illness. Results: Overall quality of outpatient care for children was suboptimal based on patient examination and caretaker counseling (median score: 27.5 on a 100 point scale). Children receiving care from female providers had better care than those seen by male providers (OR: 6.6, 95% CI: 2.0-21.9, P = 0.002), and doctors provided better quality of care than other providers (OR: 2.7, 95% CI: 1.1-6.4, P = 0.02). The poor were more likely to receive better care in hospitals managed by non-governmental organizations than those managed by other mechanisms (OR: 15.2, 95% CI: 1.2-200.1, P = 0.04). Conclusions: Efforts to strengthen optimal care provision at peripheral health clinics must be complemented with investments at the referral and tertiary care facilities to ensure care continuity. The findings of improved care by female providers, doctors and NGO's for poor patients, warrant further empirical evidence on care determinants. Optimizing care quality at referral hospitals is one of the prerequisites to ensure service utilization and outcomes for the achievement of the Child health Millennium Development Goals for Afghanistan.
AB - Objective: To determine the quality of outpatient hospital care for children under 5 years in Afghanistan. Design: Case management observations were conducted on 10-12 children under five selected by systematic random sampling in 31 outpatient hospital clinics across the country, followed by interviews with caretakers and providers. Main Outcome Measures: Quality of care defined as adherence to the clinical standards described in the Integrated Management of Childhood Illness. Results: Overall quality of outpatient care for children was suboptimal based on patient examination and caretaker counseling (median score: 27.5 on a 100 point scale). Children receiving care from female providers had better care than those seen by male providers (OR: 6.6, 95% CI: 2.0-21.9, P = 0.002), and doctors provided better quality of care than other providers (OR: 2.7, 95% CI: 1.1-6.4, P = 0.02). The poor were more likely to receive better care in hospitals managed by non-governmental organizations than those managed by other mechanisms (OR: 15.2, 95% CI: 1.2-200.1, P = 0.04). Conclusions: Efforts to strengthen optimal care provision at peripheral health clinics must be complemented with investments at the referral and tertiary care facilities to ensure care continuity. The findings of improved care by female providers, doctors and NGO's for poor patients, warrant further empirical evidence on care determinants. Optimizing care quality at referral hospitals is one of the prerequisites to ensure service utilization and outcomes for the achievement of the Child health Millennium Development Goals for Afghanistan.
KW - Afghanistan
KW - Child health
KW - Hospitals
KW - IMCI
KW - Quality of care
UR - http://www.scopus.com/inward/record.url?scp=79952609428&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79952609428&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzq081
DO - 10.1093/intqhc/mzq081
M3 - Article
C2 - 21242157
AN - SCOPUS:79952609428
VL - 23
SP - 108
EP - 116
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
SN - 1353-4505
IS - 2
M1 - mzq081
ER -