Evaluating the capacity of CMDs to correctly assess, classify, and treat febrile illness using HBMF-PLUS

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1 Evaluating the capacity of CMDs to correctly assess, classify, and treat febrile illness using HBMF-PLUS Checklist for use by Paediatrician to evaluate the capacity of CMDs to correctly assess, classify and treat febrile illness using HBMF-Plus GEERAL IFORMATIO otes for Evaluator: Complete pages & on General information on CMD once for each CMD Date:... dd/... mm/... yy Paediatrician ID: CMD s socio-demographic characteristics CMD ID... Q. Age (in years) Q. Sex: [ ] M [ ] F Q. What is the highest level of school you have completed? (tick the appropriate box) [ ] one [ ] Primary school [ ] Form two [ ] Form four [ ] Form four plus post-basic training [ ] Professional training [ ] Other, specify. Q. What is your marital status? [ ] Married [ ] Single [ ] Separated/divorced [ ] Widowed [ ] Other Q. Occupation of CMD: [ ] Teacher [ ] Business [ ] Farmer [ ] Other, Specify CMD work experience Q. When were you st trained as a CMD? Date : /./. Q. How many years experience do you have as a CMD?.years Q. How long have you worked as a CMD in this community?...months...years Q9. How long have you lived in this community?...months...years () My whole life (99) I don t live in this community Q. Are there other communities in which you have worked as a CMD? [ ] es, specify where and for how long... [ ] o

2 Q. What kinds of other in-service training have you received in your work as a CMD? Check all that apply Received training If es, was this training in the last two years? ES o Past years () utritional rehabilitation () ITs () Infant and young child feeding () Essential family practices / C-IMCI () ewborn Care () Malaria treatment (with Homapak) () Malaria treatment with Coartem () Antenatal care () Safe motherhood (9) Family Planning () HIV/AIDs () TB () Other,specify. () Other, specify... () Other, specify.. Over years ago

3 otes for Evaluator: Each CMD should be evaluated assessing, classifying and treating children that do not need referral by the CMD. However, evaluations of children requiring referral must be included as well as, but only completed up to question A. CMD ID... Q. Child s ame ( st name and initial of Surname)... Q. Sex: [ ] M [ ] F Q. Age.. Months Q. Sex (Caretaker): [ ] M [ ] F Q. Age (caretaker)... years Q. Caretaker type: [ ] Biological Mother [ ] Father [ ] Other..... ASSESSMET otes for Evaluator: RECORD WHAT OU HEAR OR SEE; DO OT ASK QUESTIOS. Does the CMD seek written informed consent from the caregiver? A Does the CMD ensure the ICF is signed/thumb-printed by A the caregiver? If yes, provide a copy of the ICF along with this checklist. Does the CMD ask for the age of the child? Does the CMD record the age of the child? A Does the CMD ask the location of the child s home? A Does the CMD record the location of the child s home? A A Does the CMD ask if the child has fever (reported or now)? If fever, did the CMD ask for how long? A A9 Does the CMD ask if the child has cough? If cough, did the CMD ask for how long? A Does the CMD ask if the child has a cold? If cold, did the CMD ask for how long? Does the CMD ask whether the child has convulsions? Does the CMD ask if the child has difficulty drinking or feeding? If yes, does the CMD ask if the child is OT able to drink or feed ATHIG? A A Does the CMD ask whether the child is vomiting? If vomiting, did the CMD ask if the child is vomiting EVERTHIG? Does the CMD look for signs of dehydration in the child? Does the CMD look for signs of severe anaemia in the A

4 9 child? A Does the CMD look for chest in-drawing in the child? A Does the CMD ask or look for prostration in the child? A Does the CMD ask if the child has altered mental state? A Does the CMD ask if child has received any treatment in the last days? A Does the CMD make the correct decision between keeping and treating the child and referral? A (If child requires referral): does the CMD provide the appropriate advice on how to complete referral? A Does the CMD provide the child with a completed referral note? A Does the caretaker accept referral for the child? A Does the CMD give any treatment to the child prior to referral? If yes, record the treatment given... A 9 Temperature Reading: Does the CMD take the temperature of the child? Does the CMD correctly (turn the thermometer on, take axillary temperature, beep goes off before reading) take the temperature of the child? CMD record the temperature reading of the child on the chart? What is the temperature reading?.. c (Check Case Record Form for CMD s entry) Does the CMD repeat the temperature measurement of the child? What is the repeat temperature reading of the CMD?.. c (Check Case record form for CMD s entry?) ou now need to take your own two () independent readings of the child s temperature. What are your readings?.. c.. c Counting Respiratory Rate: Does the CMD remember to count the respiratory rate before taking off blood from the child? Does the CMD ensure the patient is settled (seated in a comfortable place away from the sun, or lying down) before beginning the count?

5 9 Does the CMD follow instructions (looks at child s lower part of the chest, starts the timer by pressing centre circle, and starts counting at the beep, stops counting after beeps indicating a minute) on how to take the count? Does the CMD record this rate in the child s chart? How many times does the CMD count the respiratory rate of the child?... What were the two rates determined by the CMD to be within breathes of each other?...;... Did the CMD make the correct choice of the final rate (last one within breathes of a previous rate) to use? What was that final rate of the CMD?... How did the CMD classify this rate? ou now need to take your independent count of the respiratory rate of the child. What did you take as your final rate?... How do you classify this rate? If the CMD s final rate is not consistent with yours, any reasons for this? normal g, normal g, fast g fast g In this section, only note the RDT result recorded by the CMD What was the RDT test result recorded by the CMD? Positive egativ e Invali d CLASSIFICATIO C. Does the CMD give one or more classifications for the child? [ ] es [ ] o Skip to Treatment section below ote: if the classification is not clear to the observer during the encounter, he/she is permitted to ask the CMD after the encounter is complete. Record CMD classification here below: Record your independent classification below: C One or more danger signs One or more danger signs C ot able to drink or feed ot able to drink or feed anything C Vomits everything Vomiting everything C Dehydration Dehydration

6 C Severe Anaemia Severe Anaemia C Chest in-drawing Chest in-drawing C Convulsions Convulsions C9 Prostration Prostration C Very sleepy or unconscious Very sleepy or unconscious C Altered mental state Altered mental state C What diagnosis did the CMD make? i. [ ] child has malaria ii. [ ] child has pneumonia iii. [ ] child has both malaria and pneumonia iv. [ ] child has neither malaria nor pneumonia v. [ ] other, specify C Diagnosis by Evaluator: i. [ ] child has malaria ii. [ ] child has pneumonia iii. [ ] child has both malaria and pneumonia iv. [ ] child has neither malaria nor pneumonia v. [ ] other, specify TREATMET Record CMD Treatment here below: T T T Did the CMD prescribe medication for the child? If yes, what treatment was prescribed Record your independent treatment below: Correc Did you prescribe medication for the t child? Regim If yes, what treatment was en? prescribed Coartem / Coartem Amoxyl / Amoxyl Paracetamol / Paracetamol othing / othing If no to T, what advice was given to the caregiver? COMMUICATIO CM- Does the CMD explain how to administer treatment? Does the CMD demonstrate how to administer the treatment? If no to T, what advice was given to the caregiver? AL Amoxyl Paracetamol A A A Does the CMD ask an open-ended question to verify the caretaker s comprehension of how to administer the treatment? A A A Does the CMD give or ask the mother to give the first dose of A A A

7 the treatment right away? A A A CM. Does the CMD advice on home care? [ ] es [ ] o Skip to question #CM CM. Circle all advice given by the CMD: Advised caregiver to give more fluids and continue feeding es o Advised to go to health facility/return if the child cannot drink or feed es o Advised to go to health facility/return if child becomes sicker es o Advised caretaker on use of IT es o Other, specify. es o Other, specify. es o Other, specify. es o FOLLOW-UP O DA : otes for Evaluator: ask the CMD and Caregiver to mimic day after initial contact F. Does the CMD ask caregiver how the child is doing? [ ] es [ ] o F. Does the CMD take the temperature reading of the child? [ ] es [ ] o F. Does the CMD record the temperature reading of the child on the chart? [ ] es [ ] o F. What does the CMD do if the child is still unwell? [ ] Refer [ ] Changes Treatment [ ] Gives additional treatment (same) [ ] asks caregiver to observe child for another day [ ] Other, specify...

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