Table 2.
Proportion of health-care workers observed who performed clinical checklist steps correctly: first, second, and third visit (total number of observations: 4,134)
| Clinical observation checklist step | Visit number | Percentage point change in score | ||||
|---|---|---|---|---|---|---|
| First | Second | Third | First to second | Second to third | First to third | |
| Number of observations | 1,352 | 1,357 | 1,395 | – | – | – |
| Determines the age of the patient | 88.5% | 92.5% | 93.3% | +4.0% | +0.8% | +4.8% |
| Determines the weight of the patient | 80.3% | 85.4% | 85.4% | +5.1% | 0.0% | +5.1% |
| Asks whether the patient is pregnant (count as yes if male or not of reproductive age) | 81.1% | 85.4% | 87.4% | +4.3% | +2.0% | +6.3% |
| Asks about current or recent fever | 94.7% | 96.4% | 96.1% | +1.7% | −0.3% | +1.4% |
| Asks about diarrhea | 59.1% | 68.0% | 74.6% | +8.9% | +6.6% | +15.5% |
| Asks about vomiting | 67.7% | 75.8% | 79.4% | +8.1% | +3.6% | +11.7% |
| Asks about coughing | 67.9% | 75.6% | 77.8% | +7.7% | +2.2% | +9.9% |
| Asks about any other symptoms | 38.9% | 49.3% | 49.5% | +10.4% | +0.2% | +10.6% |
| Asks whether the patient was treated before visit (at home or another facility) | 56.3% | 65.1% | 67.0% | +8.8% | +1.9% | +10.7% |
| Checks for at least one sign of severe malaria (or apparent) | 72.9% | 86.2% | 85.5% | +13.3% | −0.7% | +12.6% |
| Checks for evidence of anemia | 77.2% | 84.0% | 86.4% | +6.8% | +2.4% | +9.2% |
| Checks for fast breathing or chest indrawing | 41.9% | 57.1% | 60.0% | +15.2% | +2.9% | +18.1% |
| Checks the heart rate | 30.0% | 46.6% | 47.2% | +16.6% | +0.6% | +17.2% |
| Takes temperature | 73.9% | 83.4% | 83.5% | +9.5% | +0.1% | +9.6% |
| Conducts neck examination/checks for stiffness | 27.9% | 41.1% | 46.4% | +13.2% | +5.3% | +18.5% |
| Conducts lung examination | 28.4% | 42.1% | 44.7% | +13.7% | +2.6% | +16.3% |
| Conducts abdominal examination/checks for abdominal stiffness | 35.2% | 51.9% | 54.3% | +16.7% | +2.4% | +19.1% |
| Conducts skin examination/checks for rash or dehydration | 37.4% | 54.6% | 58.1% | +17.2% | +3.5% | +20.7% |
| Checks for altered consciousness | 37.5% | 48.1% | 54.0% | +10.6% | +5.9% | +16.5% |
| Supervisor agrees with whether a malaria test should be ordered* | 93.4% | 95.4% | 95.7% | +2.0% | +0.3% | +2.3% |
| Supervisor agrees with the final diagnosis and severity assessment | 93.3% | 95.7% | 96.3% | +2.4% | +0.6% | +3.0% |
| Correct prescription per test result and diagnosis | 94.0% | 94.2% | 96.4% | +0.2% | +2.2% | +2.4% |
| Informs the caregiver on what is wrong with the patient | 83.9% | 90.4% | 90.3% | +6.5% | −0.1% | +6.4% |
| Gives advice on how to take the prescribed medications (outpatients) or informs the caregiver of transfer (inpatients) | 79.5% | 86.0% | 87.0% | +6.5% | +1.0% | +7.5% |
| Asks the caregiver/patient whether they have any questions | 33.7% | 46.0% | 45.7% | +12.3% | −0.3% | +12.0% |
Note: Checklist steps in bold (“minimum standard steps”) are considered more important and are collectively weighted twice as much as the other steps when calculating scores.
* Counted as yes if no test is available. The proportion that did not have a rapid diagnostic test or microscopy test available was 7.0%, 2.5%, and 1.2%, at the first, second, and third visits, respectively.