Table 3.
Clinical skills test. The number of PHCWs with provided the correct answer for the diagnosis, management and timing (urgency) of four clinical conditions.
| Total N/107 (%) |
Terai n/46 (%) |
Hills n/40 (%) |
Mountains n/21 (%) |
p-value | |
|---|---|---|---|---|---|
| Corneal ulcer | |||||
| Diagnosis | 29 (27.1) | 18 (39.1) | 8 (20.0) | 3 (14.4) | 0.05 |
| Management | 63 (58.9) | 26 (56.5) | 26 (65.0) | 11 (52.4) | 0.58 |
| Timing | 74 (69.2) | 28 (60.9) | 33 (82.5) | 13 (61.9) | 0.07 |
| Median score (IQR) | 2 (1–2) | 2 (0–3) | 2 (1–2) | 1 (0–2) | |
| Mean score (SD) | 1.55 (0.10) | 1.57 (0.17) | 1.68 (0.15) | 1.29 (0.24) | |
| Conjunctivitis | |||||
| Diagnosis | 89 (83.2) | 42 (91.3) | 31 (77.5) | 16 (76.2) | 0.15 |
| Management | 94 (87.9) | 42 (91.3) | 35 (87.5) | 17 (81.0) | 0.48 |
| Timing | 71 (66.4) | 30 (65.2) | 28 (70.0) | 13 (61.9) | 0.80 |
| Median score (IQR) | 3 (2–3) | 3 (2–3) | 3 (2–3) | 3 (2–3) | |
| Mean score (SD) | 2.37 (0.09) | 2.48 (0.12) | 2.35 (0.15) | 2.19 (0.26) | |
| Cataract | |||||
| Diagnosis | 81 (75.7) | 37 (80.4) | 29 (72.5) | 15 (71.4) | 0.61 |
| Management | 74 (69.2) | 34 (73.9) | 26 (65.0) | 14 (66.7) | 0.65 |
| Timing | 45 (42.0) | 28 (60.9) | 12 (30.0) | 5 (23.8) | 0.01 |
| Median score (IQR) | 2 (1–3) | 3 (2–3) | 2 (0.5–2.5) | 2 (0–2) | |
| Mean score (SD) | 1.87 (0.11) | 2.15 (0.16) | 1.68 (0.18) | 1.62 (0.25) | |
| Ophthalmia neonatorum | |||||
| Diagnosis | 58 (54.2) | 29 (63.0) | 20 (50.0) | 9 (42.9) | 0.24 |
| Management | 56 (52.3) | 24 (52.2) | 20 (50.0) | 12 (57.1) | 0.87 |
| Timing | 66 (61.7) | 27 (58.7) | 28 (70.0) | 11 (52.4) | 0.35 |
| Median score (IQR) | 2 (1–3) | 2 (1–3) | 2 (1–3) | 2 (1–2) | |
| Mean score (SD) | 1.68 (0.10) | 1.74 (0.16) | 1.70 (0.16) | 1.52 (0.21) | |
| Total Score | |||||
| Median score (IQR) | 8 (6–9) | 8 (6–10) | 7.5 (6–9) | 7 (6–8) | |
| Mean score (SD) | 7.48 (2.46) | 7.93 (2.29) | 7.40 (2.41) | 6.62 (2.77) | 0.60* |
| Visual acuity training | |||||
| Yes | 15 (14.0) | 9 (19.6) | 4 (10.0) | 2 (9.5) | 0.36 |
| No | 92 (85.9) | 37 (80.4) | 36 (90.0) | 19 (90.5) | |
| Median VA score (IQR) | 3 (2–4) | 3 (3–4) | 2.5 (0.5–4) | 3.5 (3–4) | |
| Mean VA score (SD) | 2.88 (0.35) | 3.00 (0.44) | 2.25 (1.03) | 3.33 (0.33) |
The maximum score for each condition was 3 and the maximum total score was 12. The maximum visual acuity score was 4; this only included those that had been trained. The p-value is for a comparison of the three districts. *p-value calculated by ANOVA.