title: Perceived Quality of Care of Community Health Worker and Facility-Based Health Worker Management of Pneumonia in Children Under 5 Years in Western Kenya: A Cross-Sectional Multidimensional Study.
abstract: Integrated community case management (iCCM) programs that train lay community health workers (CHWs) in the diagnosis and treatment of diarrhea, malaria, and pneumonia have been increasingly adopted throughout sub-Saharan Africa to provide services in areas where accessibility to formal public sector health services is low. One important aspect of successful iCCM programs is the acceptability and utilization of services provided by CHWs. To understand community perceptions of the quality of care in an iCCM intervention in western Kenya, we used the Primary Care Assessment Survey to compare caregiver attitudes about the diagnosis and treatment of childhood pneumonia as provided by CHWs and facility-based health workers (FBHWs). Overall, caregivers rated CHWs more highly than FBHWs across a set of 10 domains that capture multiple dimensions of the care process. Caregivers perceived CHWs to provide higher quality care in terms of accessibility and patient relationship and equal quality care on clinical aspects. These results argue for the continued implementation and scale-up of iCCM programs as an acceptable intervention for increasing access to treatment of childhood pneumonia.
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California brian.shaw@ucsf.edu.
authors.forename: Brian I
authors.initials: BI
authors.lastname: Shaw
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Elijah
authors.initials: E
authors.lastname: Asadhi
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Kevin
authors.initials: K
authors.lastname: Owuor
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Peter
authors.initials: P
authors.lastname: Okoth
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abdi
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Craig R
authors.initials: CR
authors.lastname: Cohen
authors.affiliation: School of Medicine, University of California, San Francisco, San Francisco, California; Kenya Medical Research Institute, Nairobi, Kenya; United Nations International Children's Emergency Fund, New York, New York; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
authors.forename: Maricianah
authors.initials: M
authors.lastname: Onono
mesh_terms: D000328:Adult; D019090:Case Management / Q000458:organization & administration / Q000592:standards; D002675:Child, Preschool; D003151:Community Health Centers; D003153:Community Health Services; D003150:Community Health Workers; D005260:Female; D006268:Health Facilities; D006282:Health Personnel / Q000592:standards*; D006297:Health Services Accessibility; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010342:Patient Acceptance of Health Care; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000628:therapy*; D015397:Program Evaluation