Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.

<h4>Background</h4>Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds.<...

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Autores principales:	Juliet Mwanga-Amumpaire, Grace Ndeezi, Karin Källander, Celestino Obua, Richard Migisha, Juvenal Nkeramahame, Cecilia Stålsby Lundborg, Joan Nakayaga Kalyango, Tobias Alfvén
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f8a4ac9259a74741a1cf955161ea8fca
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spelling	oai:doaj.org-article:f8a4ac9259a74741a1cf955161ea8fca2021-12-02T20:16:44ZCapacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.1932-620310.1371/journal.pone.0257851https://doaj.org/article/f8a4ac9259a74741a1cf955161ea8fca2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257851https://doaj.org/toc/1932-6203<h4>Background</h4>Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds.<h4>Methods</h4>We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections.<h4>Results</h4>Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed.<h4>Conclusion</h4>Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.Juliet Mwanga-AmumpaireGrace NdeeziKarin KällanderCelestino ObuaRichard MigishaJuvenal NkeramahameCecilia Stålsby LundborgJoan Nakayaga KalyangoTobias AlfvénPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0257851 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juliet Mwanga-Amumpaire Grace Ndeezi Karin Källander Celestino Obua Richard Migisha Juvenal Nkeramahame Cecilia Stålsby Lundborg Joan Nakayaga Kalyango Tobias Alfvén Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
description	<h4>Background</h4>Low-level private health facilities (LLPHFs) handle a considerable magnitude of sick children in low-resource countries. We assessed capacity of LLPHFs to manage malaria, pneumonia, diarrhea, and, possible severe bacterial infections (PSBIs) in under-five-year-olds.<h4>Methods</h4>We conducted a cross-sectional survey in 110 LLPHFs and 129 health workers in Mbarara District, Uganda between May and December 2019. Structured questionnaires and observation forms were used to collect data on availability of treatment guidelines, vital medicines, diagnostics, and equipment; health worker qualifications; and knowledge of management of common childhood infections.<h4>Results</h4>Amoxicillin was available in 97%, parental ampicillin and gentamicin in 77%, zinc tablets and oral rehydration salts in >90% while artemether-lumefantrine was available in 96% of LLPHF. About 66% of facilities stocked loperamide, a drug contraindicated in the management of diarrhoea in children. Malaria rapid diagnostic tests and microscopes were available in 86% of the facilities, timers/clocks in 57% but only 19% of the facilities had weighing scales and 6% stocked oxygen. Only 4% of the LLPHF had integrated management of childhood illness (IMCI) booklets and algorithm charts for management of common childhood illnesses. Of the 129 health workers, 52% were certificate nurses/midwives and (26% diploma nurses/clinical officers; 57% scored averagely for knowledge on management of common childhood illnesses. More than a quarter (38%) of nursing assistants had low knowledge scores. No notable significant differences existed between rural and urban LLPHFs in most parameters assessed.<h4>Conclusion</h4>Vital first-line medicines for treatment of common childhood illnesses were available in most of the LLPHFs but majority lacked clinical guidelines and very few had oxygen. Majority of health workers had low to average knowledge on management of the common childhood illnesses. There is need for innovative knowledge raising interventions in LLPHFs including refresher trainings, peer support supervision and provision of job aides.
format	article
author	Juliet Mwanga-Amumpaire Grace Ndeezi Karin Källander Celestino Obua Richard Migisha Juvenal Nkeramahame Cecilia Stålsby Lundborg Joan Nakayaga Kalyango Tobias Alfvén
author_facet	Juliet Mwanga-Amumpaire Grace Ndeezi Karin Källander Celestino Obua Richard Migisha Juvenal Nkeramahame Cecilia Stålsby Lundborg Joan Nakayaga Kalyango Tobias Alfvén
author_sort	Juliet Mwanga-Amumpaire
title	Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
title_short	Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
title_full	Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
title_fullStr	Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
title_full_unstemmed	Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.
title_sort	capacity to provide care for common childhood infections at low-level private health facilities in western, uganda.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f8a4ac9259a74741a1cf955161ea8fca
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Capacity to provide care for common childhood infections at low-level private health facilities in Western, Uganda.

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