Table 1.
Comparison of HSA characteristics in districts Using the iCCM mobile application and paper tools
| Characteristics |
iCCM application (N = 137) |
Paper tools (N = 113) |
P-value |
||||
|---|---|---|---|---|---|---|---|
|
N |
Weighted % |
95% CI |
N |
Weighted % |
95% CI |
||
| Age (years, mean) |
137 |
36.0 |
33.8, 38.2 |
110 |
38.0 |
37.0, 39.0 |
0.113 |
| Gender: | |||||||
| -Female |
39 |
35.1 |
19.0, 55.5 |
25 |
14.7 |
7.6, 26.6 |
0.042 |
| -Male |
98 |
64.9 |
44.5, 81.0 |
88 |
85.3 |
73.4, 92.4 |
|
| Highest level of education completed: | |||||||
| -At most two years of secondary school |
37 |
24.4 |
13.4, 40.4 |
34 |
26.5 |
15.7, 41.1 |
0.828 |
| -Secondary school or higher |
100 |
75.6 |
59.6, 86.6 |
79 |
73.5 |
58.9, 84.3 |
|
| Years providing iCCM services as HSA (mean) |
137 |
5.4 |
4.3, 6.6 |
113 |
4.7 |
4.2, 5.2 |
0.273 |
| Lives in village clinic catchment area |
118 |
76.4 |
59.3, 87.8 |
68 |
77.3 |
57.2, 89.7 |
0.930 |
| Sick children seen per day (mean): | |||||||
| -Rainy season |
137 |
16.3 |
12.1, 20.6 |
113 |
19.1 |
14.9, 23.2 |
0.361 |
| -Dry season |
137 |
9.1 |
6.9, 11.3 |
113 |
10.0 |
7.6, 12.4 |
0.592 |
| Village clinic located in room not attached or not next to home |
55 |
54.6 |
38.8, 69.4 |
85 |
80.0 |
70.3, 87.1 |
0.007 |
| Days in past 7 days operate village clinic (mean) |
134 |
3.5 |
2.7, 4.4 |
113 |
3.5 |
2.5, 4.5 |
0.930 |
| Hours in past 7 days operate village clinic (mean) |
134 |
30.6 |
21.6, 39.6 |
113 |
32.3 |
8.2, 56.3 |
0.896 |
| Primary iCCM protocol used* | |||||||
| -Sick child recording form |
26 |
16.8 |
9.6, 27.8 |
72 |
46.9 |
20.6, 75.0 |
0.039 |
| -Village clinic register |
69 |
60.1 |
39.8, 77.4 |
113 |
100.0 |
100.0, 100.0 |
<0.001 |
| -iCCM mobile application |
109 |
79.1 |
63.4, 89.2 |
0 |
0.0 |
0.0, 0.0 |
<0.001 |
| Items currently included in drug box† |
137 |
9.2 |
8.7, 9.6 |
113 |
8.9 |
8.5, 9.3 |
0.349 |
| Items stockout that lasted 7 days or moreǂ |
137 |
1.7 |
1.1, 2.2 |
113 |
2.0 |
1.4, 2.7 |
0.358 |
|
Training, supervision, and mentoring | |||||||
| Most recent iCCM training: | |||||||
| -Initial |
53 |
34.0 |
16.8, 56.9 |
18 |
11.7 |
5.5, 23.1 |
0.034 |
| -Refresher |
84 |
66.0 |
43.1, 83.2 |
95 |
88.3 |
76.9, 94.5 |
|
| Months since most recent iCCM training (median, interquartile range) |
137 |
4.4 |
2.4, 18.4 |
113 |
2.4 |
2.4, 15.4 |
0.508 |
| Tools trained on in most recent iCCM training (mean)§ |
137 |
2.9 |
2.9, 3.0 |
113 |
2.9 |
2.9, 3.0 |
0.981 |
| Days report to health facility in past month (mean) |
137 |
5.8 |
4.8, 6.8 |
113 |
7.1 |
5.5, 8.6 |
0.170 |
| Supervisory visits in past 3 months (mean) |
137 |
1.2 |
1.0, 1.3 |
113 |
1.0 |
0.8, 1.3 |
0.330 |
| Most recent supervisory visit by senior HSA (%) |
93 |
69.5 |
47.4, 85.2 |
57 |
60.1 |
41.0, 76.5 |
0.494 |
| Tasks conducted during most recent supervisory visit (mean) |
137 |
5.6 |
5.2, 6.1 |
113 |
4.7 |
3.6, 5.8 |
0.138 |
| Mentor visits in past 3 months (mean) |
136 |
0.8 |
0.6, 1.1 |
113 |
0.7 |
0.3, 1.0 |
0.433 |
| Tasks conducted during most recent mentor visit (mean)¶ | 137 | 3.0 | 2.2, 3.8 | 113 | 2.0 | 1.0, 3.1 | 0.160 |
iCCM – integrated community case management, HSA – health surveillance assistant
*Categories are not mutually exclusive because HSA may use multiple guides.
†Drug box should include 11 items: LA (1 × 6 and 2 × 6 blister packets), rapid diagnostic test, rectal artesunate, amoxicillin/cotrimoxazole, oral rehydration solution, zinc, paracetamol, eye antibiotic, timer, and gloves. ‡Nine items included for stockout: LA (1 × 6 and 2 × 6 blister packets), rapid diagnostic test, rectal artesunate, amoxicillin, oral rehydration solution, zinc, paracetamol, and eye antibiotic.
§The tools include sick child recording form, village clinic register, and referral slip.
Seven possible tasks are included: reviewing village clinic register, checking supplies and equipment levels, using a supervision checklist, administering a case scenario, observing management of a sick child, meeting with village committee members, and giving feedback on iCCM activities.
¶Four possible tasks are included: using a mentoring checklist, observing management of a sick child, demonstrating how to care for a sick child or identify danger signs, and giving feedback on case management skills.