IDL-BNC @ IDRC >
IDRC / CRDI >
IDRC Research Results / Résultats de recherches du CRDI >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10625/49660

Title: Strengthening health human resources and improving clinical outcomes through an integrated guideline and educational outreach in resource-poor settings: a cluster-randomized trial
Authors: Schull, Michael J
Banda, Hastings
Kathyola, Damson
Fairall, Lara
Martiniuk, Alexandra
Issue Date: 2010
Citation: Schull, M. J., Banda, H., Kathyola, D., Fairall, L., Martiniuk, A., Burciul, B., … Bateman, E. (2010). Strengthening health human resources and improving clinical outcomes through an integrated guideline and educational outreach in resource-poor settings: a cluster-randomized trial. Trials, 11 (118). doi:10.1186/1745-6215-11-118
Abstract: Background: In low-income countries, only about a third of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) patients eligible for anti-retroviral treatment currently receive it. Providing decentralized treatment close to where patients live is crucial to a faster scale up, however, a key obstacle is limited health system capacity due to a shortage of trained health-care workers and challenges of integrating HIV/ AIDS care with other primary care services (e.g. tuberculosis, malaria, respiratory conditions). This study will test an adapted primary care health care worker training and guideline intervention, Practical Approach to Lung Health and HIV/AIDS Malawi (PALM PLUS), on staff retention and satisfaction, and quality of patient care. Methods/Design: A cluster-randomized trial design is being used to compare usual care with a standardized clinical guideline and training intervention, PALM PLUS. The intervention targets middle-cadre health care workers (nurses, clinical officers, medical assistants) in 30 rural primary care health centres in a single district in Malawi. PALM PLUS is an integrated, symptom-based and user-friendly guideline consistent with Malawian national treatment protocols. Training is standardized and based on an educational outreach approach. Trainers will be front-line peer healthcare workers trained to provide outreach training and support to their fellow front-line healthcare workers during focused (1-2 hours), intermittent, interactive sessions on-site in health centers. Primary outcomes are health care worker retention and satisfaction. Secondary outcomes are clinical outcomes measured at the health centre level for HIV/AIDS, tuberculosis, prevention-of-mother-to-child-transmission of HIV and other primary care conditions. Effect sizes and 95% confidence intervals for outcomes will be presented. Assessment of outcomes will occur at 1 year post- implementation. Discussion: The PALM PLUS trial aims to address a key problem: strengthening middle-cadre health care workers to support the broader scale up of HIV/AIDS services and their integration into primary care. The trial will test whether the PALM PLUS intervention improves staff satisfaction and retention, as well as the quality of patient care, when compared to usual practice.
URI: http://hdl.handle.net/10625/49660
Project Number: 105955
Project Title: Linking Health Information Systems for Effective Decision Making (East Africa)
Appears in Collections:2010-2019 / Années 2010-2019
IDRC Research Results / Résultats de recherches du CRDI
Research Results (GHRI) / Résultats de recherches (IRSM)
Africa Health Systems Initiative - Research Partnerships / composante recherche - initiative systèmes de santé en Afrique
Health Systems Research / recherche sur les systèmes de santé

Files in This Item:

File Description SizeFormat
IDL-49660.pdf
224.61 kBAdobe PDF

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

 

Valid XHTML 1.0! DSpace Software Copyright © 2002-2010  Duraspace - Feedback