作者: Dejan Zurovac , Mickey Ndhlovu , Nawa Sipilanyambe , Pascalina Chanda , Davidson H Hamer
关键词: Artemether/lumefantrine 、 Pediatric nursing 、 Medicine 、 Malaria 、 Health facility 、 Population 、 Program evaluation 、 Public health 、 Environmental health 、 Pediatrics 、 Artemether
摘要: Zambia was the first African country to change national antimalarial treatment policy artemisinin-based combination therapy – artemether-lumefantrine. An evaluation during early implementation phase revealed low readiness of health facilities and workers deliver artemether-lumefantrine, worryingly suboptimal practices. Improvements in case-management uncomplicated malaria two years after initial three are reported. Data collected facility surveys undertaken 2004 2006 at all outpatient departments government mission four Zambian districts were analysed. The cross-sectional, using a range quality care assessment methods. main outcome measures changes worker practices for children below five age presenting with as defined by guidelines. In 2004, 94 facilities, 103 944 consultations evaluated. 2006, 104 135 1125 evaluated same criteria selection. Health improved from 2006: availability artemether-lumefantrine 51% (48/94) 60% (62/104), presence dosage wall charts 20% (19/94) 75% (78/104), possession guidelines 58% (60/103) 92% (124/135), provision in-service training 25% (26/103) 41% (55/135). proportions treated also increased 1% (6/527) 27% (149/552) weighing 5 9 kg, 11% (42/394) 42% (231/547) 10 kg or more. both weight groups years, 22% (441/2020) not prescribed any drug. Although significant improvements have occurred over Zambia, provided point is yet optimal. Strengthening weak systems improving delivery effective interventions should remain high priority countries implementing new policies malaria.