Background
Methods
Conceptual framework
Context, study design and sampling
Data collection
Data analysis
Results
Sociodemographic characteristics of CHWs
Characteristics of children who received SMC by age and sex
Sociodemographic characteristics of child caregivers
Quality criterion | Positive answers | Negative answers | Total answers | % of positive responses | Score |
---|---|---|---|---|---|
Organization of CDs’ work | |||||
There are two CDs per team | 140 | 0 | 140 | 100 | 3 |
CDs are both trained | 140 | 0 | 140 | 100 | 3 |
Tasks are distributed | 110 | 30 | 140 | 100 | 2 |
Availability of care equipment | 140 | 0 | 140 | 100 | 3 |
Availability of drugs | 140 | 0 | 140 | 100 | 3 |
All target children have access to care sssstraitement | 140 | 0 | 140 | 100 | 3 |
All tools are used correctly | 96 | 44 | 140 | 69 | 2 |
Total | 906 | 74 | 92 | 92 | 19 |
Interpersonal relationship between CD and child caregivers | |||||
Greetings from the caregivers | 117 | 23 | 140 | 83 | 3 |
Using a simple vocabulary | 110 | 30 | 140 | 78 | 2 |
No conflict situations | 140 | 0 | 140 | 100 | 3 |
Total | 574 | 126 | 700 | 82 | 12 |
Technical skills of CDs | |||||
CDs are looking for all children under 5 years | 136 | 4 | 140 | 97 | 3 |
They ask the age of the children | 137 | 3 | 140 | 98 | 3 |
They are looking for allergic reactions | 43 | 97 | 140 | 31 | 1 |
They ask if the child has already received SMC | 44 | 96 | 140 | 31 | 1 |
They administer effectively and gently | 106 | 34 | 140 | 76 | 2 |
They respect the doses of the drugs | 120 | 20 | 140 | 86 | 3 |
They provide and give information about taking the 2nd and 3rd doses | 140 | 0 | 140 | 100 | 3 |
They refer to ineligible children (sick) | 106 | 43 | 140 | 76 | 2 |
They fill the tools correctly | 109 | 33 | 140 | 78 | 2 |
They talk about possible allergic reactions | 41 | 99 | 140 | 29 | 1 |
They do the marking of the Households | 107 | 33 | 140 | 76 | 2 |
Total | 1089 | 451 | 1540 | 71 | 23 |
Care safety for children | |||||
CDs are dressed correctly | 86 | 54 | 140 | 61 | 2 |
Cleanliness of the place of administration | 107 | 33 | 140 | 76 | 2 |
They wash their hands with soap | 60 | 80 | 140 | 43 | 1 |
They use clean water | 110 | 30 | 140 | 78 | 2 |
They use clean equipment | 80 | 60 | 140 | 57 | 1 |
They dilute the drugs correctly | 110 | 30 | 140 | 79 | 2 |
The material is washed after each treatment | 28 | 112 | 140 | 20 | 1 |
They observe 30 min after the administration | 16 | 124 | 140 | 11 | 1 |
Total | 597 | 523 | 1120 | 53 | 12 |
Assessment of quality of care according to organizational accessibility
“We are two here, there is one who administers the treatment to the children, and there is one who keeps a card, and then he marks there, to facilitate the tasks. But we work together. If someone forgets something the other can do it. Ha!! It will be difficult; if it’s one person, it will be too difficult”. (CHW 17)
Assessment of the quality of care according to the interpersonal relationship
“Ah! When we go back there [in a concession], we greet the parents of the children first, after we explain them why we are there and what medicine we want to give to children. If the parents there accept, they will bring the children we will give them medicine”. (CHW 18)
Assessment of the quality of care according to technical competence
“Well, we ask mum first to know the age of the child. But if she does not know it, one asks at the same time the vaccination card of the child, or if the child has health record also, it is good. But sometimes the child is also asked to take his left hand to touch his right ear through the top of his head; if his left hand touches the ear, the child does not take. But if it does not touch it, it means that he is not yet 5 years old, we can give him now”. (CHW 22)
Assessment of the quality dimension according to care safety
“We have not been given even soap, what you see there, it is with our own money that we managed to buy it. Well, that’s why..., we cannot properly apply the techniques that Commandant [Head Nurse] showed us at HSPC (the Health and Social Promotion Center) when we were having training there”. (CHW 18)
Assessment of quality according to the satisfaction dimension of the managers
“Yes, we know that it is to fight against malaria for children. It works well eh, since it came to our village here, children do not get sick like that. That’s why every time when it comes that way, the Commandant [the head nurse] comes to tell me that we will tell the people of the village that it started. They will stay with the children at home so that the CHWs there will come and give them drugs”. (CL 1)
Overall quality of care assessment of SMC
“Yes, that’s what I said; we do not have much time, we have to do 50 children a day. And then you can get up in the morning at 6 o’clock and then there is rain too, which is there, the time also ahead. So, oh when we start there, we cannot spend all the time at one place like that. Well, sometimes we cannot take our time to do the job well” (CHW 10).
Dimensions of care quality | Expected maximum Scores | Obtained maximum Scores | Ratio obtained Score on expected score |
---|---|---|---|
Organizational accessibility | 21 | 19 | 0.90 |
Interpersonal Relationship | 15 | 12 | 0.80 |
Technical Skills | 33 | 23 | 0.70 |
Care Security | 24 | 12 | 0.50 |
Satisfaction of leaders | 330 | 267 | 0.81 |