Observational studyMalaria journal2018
Quality of care in integrated community case management services in Bugoye, Uganda: a retrospective observational study.
Observational study in Malaria journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 27 citations in OpenAlex.
- Trial
- Trial
- The 24, 2 hours initiative: a game changer in malaria mortality reduction.Malaria journal · 2025Review
- A cross-sectional study of point-of-care lactate testing in integrated community care management (ICCM) for children with acute respiratory illness in rural uganda.International health · 2025Article
- Targeted distribution of long-lasting insecticidal nets by community health workers to sustain household coverage: A pilot feasibility study in Western Uganda.PLOS global public health · 2025Article
- Factors associated with severe pneumonia among children <5 years, Kasese District, Uganda: a case-control study, January-April 2023.Pneumonia (Nathan Qld.) · 2024Article
- Cost-effectiveness of village health worker-led integrated community case management (iCCM) versus health facility based management for childhood illnesses in rural southwestern Uganda.Malaria journal · 2024Article
- Management of children with danger signs in integrated community case management care in rural southwestern Uganda (2014-2018).International health · 2024Observational
- Promptness in seeking treatment from Village Health workers for children under five years with malaria, diarrhoea and pneumonia in rural southwestern Uganda.Malaria journal · 2023Article
- Contribution of community health workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.Malaria journal · 2022Article
- Observational
- Article
- Health Extension Workers' diagnostic accuracy for common childhood illnesses in four regions of Ethiopia: a cross-sectional study.Acta paediatrica (Oslo, Norway : 1992) · 2019Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundVillage health workers (VHWs) in five villages in Bugoye subcounty (Kasese District, Uganda) provide integrated community case management (iCCM) services, in which VHWs evaluate and treat malaria, pneumonia, and diarrhoea in children under 5 years of age. VHWs use a "Sick Child Job Aid" that guides them through the evaluation and treatment of these illnesses. A retrospective observational study was conducted to measure the quality of iCCM care provided by 23 VHWs in 5 villages in Bugoye subcounty over a 2-year period.
methodsPatient characteristics and clinical services were summarized using existing aggregate programme data. Lot quality assurance sampling of individual patient records was used to estimate adherence to the iCCM algorithm, VHW-level quality (based on adherence to the iCCM protocol), and change over time in quality of care (using generalized estimating equations regression modelling).
resultsFor each of 23 VHWs, 25 patient visits were randomly selected from a 2-year period after iCCM care initiation. In these visits, 97% (150) of patients with diarrhoea were treated with oral rehydration and zinc, 95% (216) of patients with pneumonia were treated with amoxicillin, and 94% (240) of patients with malaria were treated with artemisinin-based combination therapy or rectal artesunate. However, only 44% (44) of patients with a negative rapid test for malaria were appropriately referred to a health facility. Overall, 75% (434) of patients received all the correct evaluation and management steps. Only 9 (39%) of the 23 VHWs met the pre-determined LQAS threshold for high-quality care over the 2-year observation period. Quality of care increased significantly in the first 6 months after initiation of iCCM services (p = 0.003), and then plateaued during months 7-24.
conclusionsQuality of care was high for uncomplicated malaria, pneumonia and diarrhoea. Overall quality of care was lower, in part because VHWs often did not follow the guidelines to refer patients with fever who tested negative for malaria. Quality of care appears to improve in the initial months after iCCM implementation, as VHWs gain initial experience in iCCM care.
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