International Journal for Quality in Health Care 5:67-74 (1993)
© 1993 International Society for Quality in Health Care
An Instrument to Assess Acute Respiratory Infection Case Management in Egypt
Department of International Health, Johns Hopkins University School of Hygiene and Public Health Baltimore, MD, USA
* Acute Respiratory Infections Unit, Child Survival Project, Ministry of Health Cairo, Egypt
Department of Pediatrics, Al Azhar University School of Medicine Cairo, Egypt
United Nations Children's Fund Cairo, Egypt
Purpose: To develop an instrument to measure the quality of acute respiratory infection (ARI) case management among Egyptian children. Methods: A baseline survey of all health facilities in a single district, using a multidata source instrument. Data sources included provides, caretakers, patient records and observation of patient care. Main Results: Physicians did not count the respiratory rate and check for subcostal retraction. Eighty-seven percent of children who did not require antibiotics received them. Of five children who required antibiotics, four (80%) were prescribed an oral regimen. Three of these should have been admitted to a hospital but were not. Antibiotics were available at the facilities an estimated 7.9 months per year. Oxygen for inpatient treatment was available in one of two hospitals. Conclusions: This instrument was useful for comprehensively evaluating facility capability to provide quality case management. Deficiencies were identified but were not unexpected in a baseline survey. The Egypt ARI program has the potential to have a substantial impact on how children with ARI are diagnosed and treated in health facilities.
Keywords: Acute respiratory infection, Egypt, case management
Received for publication May 25, 1992. Accepted for publication August 20, 1992.