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Predictors of health worker performance after Integrated Management of Childhood Illness training in Benin: a cohort study

Overview of attention for article published in BMC Health Services Research, July 2015
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Title
Predictors of health worker performance after Integrated Management of Childhood Illness training in Benin: a cohort study
Published in
BMC Health Services Research, July 2015
DOI 10.1186/s12913-015-0910-4
Pubmed ID
Authors

Laura C. Steinhardt, Faustin Onikpo, Julien Kouamé, Emily Piercefield, Marcel Lama, Michael S. Deming, Alexander K. Rowe

Abstract

Correct treatment of potentially life-threatening illnesses (PLTIs) in children under 5 years, such as malaria, pneumonia, and diarrhea, can substantially reduce mortality. The Integrated Management of Childhood Illness (IMCI) strategy has been shown to improve treatment of child illnesses, but multiple studies have shown that gaps in health worker performance remain after training. To better understand factors related to health worker performance, we analyzed 9,330 patient consultations in Benin from 2001-2002, after training one of the first cohorts of 32 health workers in IMCI. With data abstracted from patient registers specially designed for IMCI-trained health workers, we examined associations between health facility-, health worker-, and patient-level factors and 10 case-management outcomes for PLTIs. Altogether, 63.6 % of children received treatment for all their PLTIs in accordance with IMCI guidelines, and 77.8 % received life-saving treatment (i.e., clinically effective treatment, even if not exactly in accordance with IMCI guidelines). Performance of individual health workers varied greatly, from 15-88 % of patients treated correctly, on average. Multivariate regression analyses identified several factors that might have influenced case-management quality, many outside a manager's direct control. Younger health workers significantly outperformed older ones, and infants received better care than older children. Children with danger signs, those with more complex illnesses, and those with anemia received worse care. Health worker supervision was associated with improved performance for some outcomes. A variety of factors, some outside the direct control of program managers, can influence health worker practices. An understanding of these influences can help inform the development of strategies to improve performance.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 48 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 13%
Student > Master 6 13%
Lecturer 5 10%
Other 5 10%
Student > Ph. D. Student 4 8%
Other 8 17%
Unknown 14 29%
Readers by discipline Count As %
Medicine and Dentistry 14 29%
Nursing and Health Professions 7 15%
Agricultural and Biological Sciences 3 6%
Business, Management and Accounting 2 4%
Social Sciences 2 4%
Other 5 10%
Unknown 15 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 July 2015.
All research outputs
#18,418,919
of 22,817,213 outputs
Outputs from BMC Health Services Research
#6,473
of 7,636 outputs
Outputs of similar age
#189,743
of 264,068 outputs
Outputs of similar age from BMC Health Services Research
#101
of 114 outputs
Altmetric has tracked 22,817,213 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,636 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
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We're also able to compare this research output to 114 others from the same source and published within six weeks on either side of this one. This one is in the 6th percentile – i.e., 6% of its contemporaries scored the same or lower than it.