Quality assessment of malaria case management in public primary health care clinics in Namibia : development of an instrument to be used by the district primary health care supervisors in clinics

• Main Author: Haidula, Leena
• Other Authors: Coetzee, N
• Format: Dissertation
• Language: English
• Published: University of Cape Town 2014
• Subjects: Public Health
• Online Access: http://hdl.handle.net/11427/8603

Bibliography: leaves 37-38. === Malaria is a major public health problem in Namibia and this problem warrants special attention in terms of monitoring the trends and formulating controls and prevention strategies at all levels of the health care system and the community. Malaria accounts for more than 40 % of the diagnosed outpatients cases in the health facilities. Malaria is the leading cause of ill health and deaths among both children and adults, particularly in the northern regions of Namibia where about 60% of the population lives. This disease is seasonal with the potential for epidemic proportions, which are related to exceptionally heavy rainfall. There is increasing evidence that malaria cases are poorly managed and the staffs is poorly supervised, especially at clinic levels where all malaria cases are clinically diagnosed A number of health workers have been trained in various aspects of malaria control including case management; there is a need to evaluate their performance in order to sustain high quality care. Their performance must be evaluated regularly and feedback given so that practices could be adjusted and improved. What is required is a validated, acceptable, applicable and useful instrument that can be used routinely for assessment clinic based quality care performance. The Ministry of Health and Social Services developed a national guideline for malaria case management used at different facilities and levels in the country. There is no affordable and applicable continuous assessment instrument of the quality of health care that can be used by primary health care supervisors to assess the quality of malaria case management at health care clinics. The aim of this study is to develop and pilot a performance based quality assessment instrument for routine quality assessment of malaria case management to be used by district supervisors in public health care clinics in Namibia. The instrument developed was found to be useful by the district supervisors and the clinic staff interviewed during the assessment period. Poor referral systems, lack of training on malaria case management and poor supervision were the major problems identified in this pilot study. These problems have been discussed with the clinic staffs and the district supervisors concerned for appropriate action. The developed instrument has enabled me to obtain a rapid and general overview of the clinic performances related to quality services provided to malaria patients. The information obtained evidenced the usefulness of this instrument. This pilot study has established the baseline information for quality assessment of malaria case management for the primary health care clinics assessed. However, it has been noted that continuous assessment of health services performances is very important if the quality of malaria case management is to be achieved.