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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

CHW

Gold standard (comparator)

A. General practice

77.2

79.0

 i. Asked about fever

88.6

87.1

 ii. Asked for child’s age

100

100

 iii. Temperature measurement takena

5.9

12.5

 iv. Respiratory rate measurementb

4.0

0.0

 v. Looked for danger signs (signs of severe malaria)

42.9

50.0

B. Proficiency in the use of rapid diagnostic test kit

91.1

90.6

 i. Checked for safety measure

85.7

86.2

 ii. Labeled the cassettes used for each child

97.1

85.7

 iii. Pricked the child’s finger correctly

88.6

90.3

 iv. Accurate blood volume collected

77.1

83.9

 v. Correct volume of buffer applied

97.1

96.6

 vi. Blood and buffer placed in wells appropriately

91.4

89.7

 vii. Waited specified time before reading the results

94.3

96.3

 viii. Interpreted the results correctly

97.1

96.4

C. Adherence to malaria treatment recommendation

93.6

92.5

 i. Told caregiver the result of the RDT

  

 ii. RDT positive—gave artemether-lumefantrine (ACT)

74.3

70.0

 iii. or rectal artesunate (RA) as required

100

100

 iv. RDT negative—did not give ACT or RA

100

100

 v. Gave the correct dose of ACT or RA when applicable

100

100

D. Post-treatment initiation counseling of caregivers

69.3

67.9

 i. Correct medication dosage

97.1

97.1

 ii. Told caregiver how to use oral medications

68.6

68.6

 iii. Ask to return within 48 h if the child’s health does not improve

54.3

50.0

 iv. Told the caregiver to feed the child well

57.1

55.9

Average Adherence

82.8

82.5

  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)