Adherence to the national guidelines for management of children with pneumonia at Garrisa Provincial General Hospital.
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Date
2013Author
Mutinda, Catherine
Type
ThesisLanguage
enMetadata
Show full item recordAbstract
Background: Clinical Practice Guidelines for childhood illnesses including
pneumonia in Kenya are contained in the basic paediatric protocols. These have
been disseminated through the ETAT + course since 2007. Implementation of
guidelines into care has been shown to reduce case fatality from pneumonia by 36%.
Objectives: The study set to establish the level of and factors associated with
adherence to the National guidelines on management of pneumonia in children aged
2 – 59 months.
Design: Hospital based cross sectional study.
Setting: The paediatric department of Garissa Provincial General Hospital (PGH)
in Kenya.
Subjects: Clinical records of patients aged 2- 59 months diagnosed with
pneumonia from January to June 2012 were reviewed. Health workers who
participated in the care of these patients completed a self administered structured
questionnaire.
Results: Guideline adherence was assessed at three levels; assessment of clinical
signs and symptoms found to be 42.9% (SD ±17.3), correct classification of disease
severity was 56.6% and recommended treatment of pneumonia was 27.7%. The
presence of a co-morbidity and severe disease was associated with better
adherence to the assessment tasks (p = 0.033 and p =0.021 respectively). Disease
severity was associated with better adherence to the disease classification task (p =
<0.001) and treatment task (p = 0.02).
Health workers who participated in the study (n = 27) felt confident and equipped to
use the guidelines.
Conclusion: The levels of adherence were low. Diseases severity was
associated with better adherence at all levels. Assessment of pneumonia was
improved in the presence of co morbidity.
Citation
Master of Medicine (Pediatrics and Child Health),University of Nairobi. 2013Publisher
University of Nairobi, School of Medicine,