PMID- 23028519
OWN - NLM
STAT- MEDLINE
DCOM- 20130306
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 9
DP  - 2012
TI  - Tracking the quality of care for sick children using lot quality assurance 
      sampling: targeting improvements of health services in Jigawa, Nigeria.
PG  - e44319
LID - 10.1371/journal.pone.0044319 [doi]
LID - e44319
AB  - BACKGROUND: In Nigeria, 30% of child deaths are due to malaria. The National 
      Malaria Control Program of Nigeria (NMCP) during 2009 initiated a program to 
      improve the quality of paediatric malaria services delivered in health facilities 
      (HF). This study reports a rapid approach used to assess the existing quality of 
      services in Jigawa state at decentralised levels of the health system. METHODS: 
      NMCP selected Lot Quality Assurance Sampling (LQAS) to identify the variation in 
      HF service quality among Senatorial Districts (SD). LQAS was selected because it 
      was affordable and could be used by local health workers (HW) in a 
      population-based survey. NMCP applied a 2-stage LQAS using a structured Rapid 
      Health Facility Assessment (R-HFA) tool to identify high and low performing SD 
      for specified indicators. FINDINGS: LQAS identified variations in HF performance 
      (n = 21) and enabled resources to be targeted to address priorities. All SD 
      exhibited deficient essential services, supplies and equipment. Only 9.7% of HF 
      had Artemisinin-based Combination Therapies and other first-line treatments for 
      childhood illnesses. No SD and few HF exhibited adequate HW performance for the 
      assessment, treatment or counselling of sick children. Using the IMCI algorithm, 
      17.5% of HW assessed the child's vaccination status, 46.8% assessed nutritional 
      status, and 65.1% assessed children for dehydration. Only 5.1% of HW treatments 
      were appropriate for the assessment. Exit interviews revealed that 5.1% of 
      caregivers knew their children's illness, and only 19.9% could accurately 
      describe how to administer the prescribed drug. CONCLUSION: This R-HFA, using 
      LQAS principles, is a rapid, simple tool for assessing malaria services and can 
      be used at scale. It identified technical deficiencies that could be corrected by 
      improved continuing medical education, targeted supervision, and recurrent R-HFA 
      assessments of the quality of services.
FAU - Oladele, Edward Adekola
AU  - Oladele EA
AD  - Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom.
FAU - Ormond, Louise
AU  - Ormond L
FAU - Adeyemi, Olusegun
AU  - Adeyemi O
FAU - Patrick, David
AU  - Patrick D
FAU - Okoh, Festus
AU  - Okoh F
FAU - Oresanya, Olusola Bukola
AU  - Oresanya OB
FAU - Valadez, Joseph J
AU  - Valadez JJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120927
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Child
MH  - Child Health Services/statistics & numerical data
MH  - Female
MH  - Health Facilities/statistics & numerical data
MH  - Humans
MH  - *Lot Quality Assurance Sampling
MH  - Malaria
MH  - Male
MH  - Nigeria
MH  - Quality Assurance, Health Care/*statistics & numerical data
PMC - PMC3459971
COIS- Competing Interests: This work was partly financed by a grant from the ExxonMobil 
      Foundation to the World Bank to support the Malaria Control Booster Project for 
      Africa, which does not alter the authors' adherence to all the PLOS ONE policies 
      on sharing data and materials.
EDAT- 2012/10/03 06:00
MHDA- 2013/03/07 06:00
PMCR- 2012/09/27
CRDT- 2012/10/03 06:00
PHST- 2012/05/13 00:00 [received]
PHST- 2012/08/01 00:00 [accepted]
PHST- 2012/10/03 06:00 [entrez]
PHST- 2012/10/03 06:00 [pubmed]
PHST- 2013/03/07 06:00 [medline]
PHST- 2012/09/27 00:00 [pmc-release]
AID - PONE-D-12-13704 [pii]
AID - 10.1371/journal.pone.0044319 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(9):e44319. doi: 10.1371/journal.pone.0044319. Epub 2012 Sep 27.