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Table 2 Adherence to program protocol by CHWs compared to gold standard

From: The fidelity of implementation of recommended care for children with malaria by community health workers in Nigeria

Domain% Adherencec
CHWGold standard (comparator)
A. General practice77.279.0
 i. Asked about fever88.687.1
 ii. Asked for child’s age100100
 iii. Temperature measurement takena5.912.5
 iv. Respiratory rate measurementb4.00.0
 v. Looked for danger signs (signs of severe malaria)42.950.0
B. Proficiency in the use of rapid diagnostic test kit91.190.6
 i. Checked for safety measure85.786.2
 ii. Labeled the cassettes used for each child97.185.7
 iii. Pricked the child’s finger correctly88.690.3
 iv. Accurate blood volume collected77.183.9
 v. Correct volume of buffer applied97.196.6
 vi. Blood and buffer placed in wells appropriately91.489.7
 vii. Waited specified time before reading the results94.396.3
 viii. Interpreted the results correctly97.196.4
C. Adherence to malaria treatment recommendation93.692.5
 i. Told caregiver the result of the RDT  
 ii. RDT positive—gave artemether-lumefantrine (ACT)74.370.0
 iii. or rectal artesunate (RA) as required100100
 iv. RDT negative—did not give ACT or RA100100
 v. Gave the correct dose of ACT or RA when applicable100100
D. Post-treatment initiation counseling of caregivers69.367.9
 i. Correct medication dosage97.197.1
 ii. Told caregiver how to use oral medications68.668.6
 iii. Ask to return within 48 h if the child’s health does not improve54.350.0
 iv. Told the caregiver to feed the child well57.155.9
Average Adherence82.882.5
  1. a51% missing, not included in mean score and % adherence for Domain A
  2. b29% missing, not included in mean score and % adherence for Domain A
  3. c% Adherence per domain = (sum of % of CHWs or comparators who executed each step in a domain/total number of steps in each domain)