Management of dehydration in under-five children with acute gastroenteritis by nurses and midwives in selected health centres in Lusaka, Zambia

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2018-07-02
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Dehydration is a major cause of child mortality in sub-Saharan Africa. In Zambia child mortality rate from diarrhoea is 68 deaths per 1,000 live births despite implementation of child survival interventions. A descriptive quantitative study with triangulation of data collection methods and guided by Donabedian’s Quality of Health Care Framework was conducted to assess management of dehydration in under-five children with Acute Gastroenteritis (AGE) in selected health centres in Zambia. The specific objectives were; to assess availability of resources (structure) in the management of dehydration in under-five children with Acute Gastroenteritis; to examine the process of management of dehydration in under-five children with Acute Gastroenteritis; to evaluate caretaker satisfaction (outcome) with care given during the management of dehydration due Acute Gastroenteritis; and to analyse associations between healthcare provider characteristics, caretaker satisfaction and case management. Simple random sampling method was used to recruit 155 nurses who answered a self-administered questionnaire and 58 who were observed; and 58 caretakers who participated in exit interviews. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 24.0. Chi-square tests were used to determine significant relationships between healthcare provider characteristics, caretaker satisfaction and case management. Quality of management of dehydration due to AGE in under-five children was inadequate. Structurally, nurses and midwives had inadequate knowledge on dehydration management. Only 25.8% had knowledge that age is used to determine duration of rehydration. On process measure, only approximately 40% of the cases were well managed. Significantly in-service training improved case management (CI 95%, p=0.000). Caretaker satisfaction was significantly associated with interaction with nurses and midwives (CI 95%, p=0.000).
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