Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.

<h4>Background</h4>The currently recommended approach for preventing malaria in pregnancy (MiP), intermittent preventive treatment with sulphadoxine-pyrimethamine (SP-IPT), has been questioned due to the spread of resistance to SP. Whilst trials are underway to test the efficacy of futur...

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Autores principales:	Mylene Lagarde, Lucy Smith Paintain, Gifti Antwi, Caroline Jones, Brian Greenwood, Daniel Chandramohan, Harry Tagbor, Jayne Webster
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e9101ffb049246f9b4e3e6dc41eda671
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spelling	oai:doaj.org-article:e9101ffb049246f9b4e3e6dc41eda6712021-11-18T06:47:36ZEvaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.1932-620310.1371/journal.pone.0023588https://doaj.org/article/e9101ffb049246f9b4e3e6dc41eda6712011-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21886800/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The currently recommended approach for preventing malaria in pregnancy (MiP), intermittent preventive treatment with sulphadoxine-pyrimethamine (SP-IPT), has been questioned due to the spread of resistance to SP. Whilst trials are underway to test the efficacy of future alternative approaches, it is important to start exploring the feasibility of their implementation.<h4>Methods and findings</h4>This study uses a discrete choice experiment (DCE) method to assess the potential resistance of health workers to changing strategies for control of MiP. In Ashanti region in Ghana, 133 antenatal clinic health workers were presented with 16 choice sets of two alternative policy options, each consisting of a bundle of six attributes representing certain clinical guidelines for controlling MiP (type of approach and drug used), possible associated maternal and neo-natal outcomes, workload and financial incentives. The data were analysed using a random effects logit model. Overall, staff showed a preference for a curative approach with pregnant women tested for malaria parasites and treated only if positive, compared to a preventive approach (OR 1.6; p = 0.001). Increasing the incidence of low birth weight or severe anaemia by 1% would reduce the odds of preferring an approach by 18% and 10% respectively. Midwives were more resistant to potential changes to current guidelines than lower-level cadres.<h4>Conclusions</h4>In Ashanti Region, resistance to change by antenatal clinic workers from a policy of SP-IPT to IST would generally be low, and it would disappear amongst midwives if health outcomes for the mother and baby were improved by the new strategy. DCEs are a promising approach to identifying factors that will increase the likelihood of effective implementation of new interventions immediately after their efficacy has been proven.Mylene LagardeLucy Smith PaintainGifti AntwiCaroline JonesBrian GreenwoodDaniel ChandramohanHarry TagborJayne WebsterPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 6, Iss 8, p e23588 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mylene Lagarde Lucy Smith Paintain Gifti Antwi Caroline Jones Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
description	<h4>Background</h4>The currently recommended approach for preventing malaria in pregnancy (MiP), intermittent preventive treatment with sulphadoxine-pyrimethamine (SP-IPT), has been questioned due to the spread of resistance to SP. Whilst trials are underway to test the efficacy of future alternative approaches, it is important to start exploring the feasibility of their implementation.<h4>Methods and findings</h4>This study uses a discrete choice experiment (DCE) method to assess the potential resistance of health workers to changing strategies for control of MiP. In Ashanti region in Ghana, 133 antenatal clinic health workers were presented with 16 choice sets of two alternative policy options, each consisting of a bundle of six attributes representing certain clinical guidelines for controlling MiP (type of approach and drug used), possible associated maternal and neo-natal outcomes, workload and financial incentives. The data were analysed using a random effects logit model. Overall, staff showed a preference for a curative approach with pregnant women tested for malaria parasites and treated only if positive, compared to a preventive approach (OR 1.6; p = 0.001). Increasing the incidence of low birth weight or severe anaemia by 1% would reduce the odds of preferring an approach by 18% and 10% respectively. Midwives were more resistant to potential changes to current guidelines than lower-level cadres.<h4>Conclusions</h4>In Ashanti Region, resistance to change by antenatal clinic workers from a policy of SP-IPT to IST would generally be low, and it would disappear amongst midwives if health outcomes for the mother and baby were improved by the new strategy. DCEs are a promising approach to identifying factors that will increase the likelihood of effective implementation of new interventions immediately after their efficacy has been proven.
format	article
author	Mylene Lagarde Lucy Smith Paintain Gifti Antwi Caroline Jones Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster
author_facet	Mylene Lagarde Lucy Smith Paintain Gifti Antwi Caroline Jones Brian Greenwood Daniel Chandramohan Harry Tagbor Jayne Webster
author_sort	Mylene Lagarde
title	Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
title_short	Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
title_full	Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
title_fullStr	Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
title_full_unstemmed	Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
title_sort	evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/e9101ffb049246f9b4e3e6dc41eda671
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Evaluating health workers' potential resistance to new interventions: a role for discrete choice experiments.

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