title: Clinical examination of pregnant women by paramedical and medical personnel: an assessment of consistency of findings in a field study.
abstract: BACKGROUND
  As a part of a project to improve the maternal and child health services in 4 primary health centres (PHCs) in Bellary and Raichur districts of Karnataka, we assessed the consistency in recording symptoms, signs and some clinical observations of pregnant women by three examiners-the junior health assistant, medical officer of the PHC and a private medical practitioner.
  
  
  METHODS
  One hundred seventy-four pregnant women were examined independently by the three examiners on the same day for 4 symptoms reported by the women themselves, 4 signs assessed by the examining person and 9 simple clinical observations. Agreement rates in each examiner pair for each parameter were assessed.
  
  
  RESULTS
  We found poor rates of agreement in assesment of various parameters by each observer pair. The disagreement rates were lower between the two doctors compared with those between the junior health assistant and each doctor.
  
  
  CONCLUSIONS
  The agreement rates between various healthcare personnel in assessing pregnant women are low. There is a need for measures to correct this situation.
authors.affiliation: International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, Maharashtra, India. ksrini_02@yahoo.com
authors.forename: K
authors.initials: K
authors.lastname: Srinivasan
authors.forename: C P
authors.initials: CP
authors.lastname: Prakasam
authors.forename: T
authors.initials: T
authors.lastname: Rajaretnam
authors.forename: Purujit
authors.initials: P
authors.lastname: Praharaj
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D007194:India; D007224:Infant Care / Q000592:standards; D007231:Infant, Newborn; D008485:Medical Audit; D008880:Midwifery / Q000592:standards*; D009731:Nursing Audit; D010348:Patient Care Team / Q000145:classification / Q000592:standards; D010808:Physical Examination / Q000592:standards*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D011295:Prenatal Care / Q000592:standards*; D011320:Primary Health Care / Q000592:standards; D011446:Prospective Studies; D015203:Reproducibility of Results; D019035:Rural Health Services / Q000592:standards*; D000078329:Workforce