Private practitioners are a major source of care for childhood illnesses in developing countries, but the care they provide is often of poor quality. This study tested the effectiveness of two new methods for improving the quality of private practitioner care of sick children: the verbal case review (VCR) and INFECTOM. The VCR is a method for evaluating private providers' quality of care based on mothers' reports and INFECTOM is a package of interventions for improving private providers' quality of care. The study was conducted in 110 villages of Bihar State, India, by three local non-governmental organizations (NGOs). First, the VCR was used for interviews with mothers of approximately 600 children sick with diarrhoea, ARI or fever in the past 2 weeks. The VCR identified practitioners consulted for the treatment of the sick children and recorded providers' case management practices as reported by the mothers. Based on the results of the VCR, the INFECTOM intervention was carried out. This consisted of INformation sessions for the providers regarding standard case management guidelines for ARI, diarrhoea and fever, FEedback to providers on their performance based on the results of the VCR, ConTracting with practitioners to gain their commitment to practice specific guidelines, and Ongoing Monitoring of practitioners' practices with feedback of the results to the practitioners and the community. Seven months after the interventions were initiated, another cross-sectional VCR survey of approximately 300 sick children was carried out to evaluate the impact of the activities on practitioners' case management practices. The results of the study show statistically significant improvements in private practitioners' history taking, examination and counselling practices for ARI, diarrhoea and fever. It was concluded that the VCR and INFECTOM were feasible for implementation by community-based NGOs, and were effective in improving the technical quality of care provided by private health practitioners in rural India.
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http://dx.doi.org/10.1093/heapol/15.4.400 | DOI Listing |
JAMA Pediatr
January 2025
Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Importance: Detection of congenital cytomegalovirus (cCMV) infection has previously relied on targeted screening programs or clinical recognition; however, these approaches miss most cCMV-infected newborns and fail to identify those infants who are asymptomatic at birth but at risk for late-onset sensorineural hearing loss.
Objective: To determine the feasibility of using routinely collected newborn dried blood spots (DBS) in a population-based cCMV screen to identify infants at risk for hearing loss and describe outcomes of infants screened.
Design, Setting, And Participants: This diagnostic study of a population-based screening program in Ontario, Canada, took place from July 29, 2019, to July 31, 2023.
Pediatr Radiol
January 2025
Hospital for Sick Children, University of Toronto, 175 Elizabeth Street, Toronto, Ontario, M5G2G3, Canada.
Pediatr Blood Cancer
January 2025
The Hospital for Sick Children, University of Toronto, Toronto, Canada.
Introduction: Medulloblastoma (MB) is the most common malignant childhood brain tumor. Molecular subgrouping of MB has become a major determinant of management in high-income countries. Subgrouping is still very limited in low- and middle-income countries (LMICs), and its relevance to management with the incorporation of risk stratification (low risk, standard risk, high risk, and very high risk) has yet to be evaluated in this setting.
View Article and Find Full Text PDFBMC Genomics
January 2025
Department of Ophthalmology & Vision Science, School of Medicine, University of California Davis, Sacramento, CA, USA.
Purpose: Corneal dysmorphologies (CDs) are typically classified as either regressive degenerative corneal dystrophies (CDtrs) or defective growth and differentiation-driven corneal dysplasias (CDyps). Both eye disorders have multifactorial etiologies. While previous work has elucidated many aspects of CDs, such as presenting symptoms, epidemiology, and pathophysiology, the genetic mechanisms remain incompletely understood.
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