Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.
Strengthening referral of sick children from the private health sector and its impact on referral uptake in Uganda: a cluster randomized controlled trial protocol.
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DOI：
10.1186/s12913-016-1885-5
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发表时间：
2016-11-11
影响因子：
2.8
通讯作者：
Mbonye A
中科院分区：
文献类型：
--
作者：
Buregyeya E;Rutebemberwa E;LaRussa P;Mbonye A
乌干达5岁以下儿童死亡率很高，目前估计为每1 000名活产66人。向私营部门寻求治疗的患病儿童转诊不佳是促成因素之一。拟议的干预措施旨在改善向私人设施（注册药店/私人诊所）寻求护理的儿童的转诊和接受转诊建议。在乌干达中部的穆科诺区，将采用整群随机设计来测试干预措施。一组抽样研究将实施干预措施。干预措施将包括三个组成部分：一）提高社区的认识：村卫生小组将讨论转诊的重要性，并鼓励家庭省钱;二）培训和监督私营部门的服务提供者诊断、治疗和转诊患病儿童;三）公共和私营服务提供者之间定期举行会议（由地区卫生小组召集），讨论转诊制度。本研究将纳入20个群集，按1：1的比例随机分配。每个集群至少有319名患病儿童，从所有集群招募的患病儿童总数将为8910人;调整10%的后续损失和私人网点的可能退出。直接的可持续影响将是对患病儿童的适当治疗。由于私营部门提供的服务范围将扩大，干预措施可能会对私营部门的做法产生影响。拟议的研究也可能对家庭产生影响，因为：一）他们可能会意识到及时转诊对儿童疾病管理的重要性，二）与降低发病率有关的成本节省将被家庭用于获得其他社会服务。私营部门和公共部门之间的联系将为提供其他公共卫生干预措施和改善两个部门的工作关系创造一个潜在的渠道。此外，私营部门服务质量的提高将提高提供者的信心，并有望增加私营部门的客户。 NCT 02450630注册日期：2015年5月9日
Uganda’s under-five mortality is high, currently estimated at 66/1000 live births. Poor referral of sick children that seek care from the private sector is one of the contributory factors. The proposed intervention aims to improve referral and uptake of referral advice for children that seek care from private facilities (registered drug shops/private clinics). A cluster randomized design will be applied to test the intervention in Mukono District, central Uganda. A sample of study clusters will implement the intervention. The intervention will consist of three components: i) raising awareness in the community: village health teams will discuss the importance of referral and encourage households to save money, ii) training and supervision of providers in the private sector to diagnose, treat and refer sick children, iii) regular meetings between the public and private providers (convened by the district health team) to discuss the referral system. Twenty clusters will be included in the study, randomized in the ratio of 1:1. A minimum of 319 sick children per cluster and the total number of sick children to be recruited from all clusters will be 8910; adjusting for a 10 % loss to follow up and possible withdrawal of private outlets. The immediate sustainable impact will be appropriate treatment of sick children. The intervention is likely to impact on private sector practices since the scope of the services they provide will have expanded. The proposed study is also likely to have an impact on families as; i) they may appreciate the importance of timely referral on child illness management, ii) the cost savings related to reduced morbidity will be used by household to access other social services. The linkage between the private and public sectors will create a potential avenue for delivery of other public health interventions and improved working relations in the two sectors. Further, improved quality of services in the private sector will improve provider confidence and hopefully more clientelle to the private practices. NCT02450630 Registration date: May/9th/2015
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影响因子：
168.9
作者：
Lozano, Rafael;Naghavi, Mohsen;Murray, Christopher J. L.
通讯作者：
Murray, Christopher J. L.
DOI：
10.4269/ajtmh.2012.11-0791
发表时间：
2012-11-01
影响因子：
3.3
作者：
Awor, Phyllis;Wamani, Henry;Peterson, Stefan
通讯作者：
Peterson, Stefan
影响因子：
3.3
作者：
Cheung, Yin Bun;Jeffries, David;Milligan, Paul
通讯作者：
Milligan, Paul
影响因子：
3
作者：
Rutebemberwa, Elizeus;Pariyo, George;Kallander, Karin
通讯作者：
Kallander, Karin
影响因子：
168.9
作者：
Peterson, S;Nsungwa-Sabiiti, J;Mukasa, G
通讯作者：
Mukasa, G