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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The impact of self-assessment on provider performance in Mali
International Journal of Health Planning and Management, Volume 18, No. 1, Year 2003
Notification
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Description
Improving the quality of clinical care in developing country settings is a difficult task, both in public sector settings where supervision is infrequent and in private sector settings where supervision and certification are non-existent. This study tested a low-cost method, self-assessment, for improving the quality of care that providers offer in a peri-urban area in Mali. The study was a cross-sectional, case-control study on the impact of self-assessment on compliance with the quality of care standards. The two indicators of interest were the compliance with fever care standards and the compliance with structural quality standards. Both standards were derived from the Ministry of Health of Mali's standards for health care delivery. The study examined 36 providers, 12 of whom were part of the intervention and 24 of whom were part of the control group over a 3 month period from May to July 2001. Overall, the research team found a significant difference between the intervention and control groups in terms of overall compliance (p < 0.001) and in terms of assessment of fever (p < 0.005). The total costs for the intervention for 36 providers was less than US$250, which translated to approximately $6 per provider. The data appear to suggest that self-assessment, when used in a regular fashion, can have a significant effect on compliance with standards. However, it is clear that self-assessment is not a resource-neutral intervention. All of the individuals from the intervention pool interviewed cited the extra work that they had to do to comply with the intervention protocol as a burden. In particular, study participants put an emphasis on the 'long duration' of the study that 'discouraged' the study participants. Future research on self-assessment should include a larger sample of providers and should examine the impact of self-assessment over time. Copyright © 2003 John Wiley & Sons, Ltd.
Authors & Co-Authors
Kelley, Edward Talbott
United States, Rockville
Agency for Healthcare Research and Quality
Gamble Kelley, Allison
United States, Bethesda
Partners for Health Reform Plus/abt Associates
Simpara, Cheick H.T.
Mali, Bamako
Partners Health Reform Project Plus
Sidibé, Ousmane Omarou
Mali, Bamako
Partners Health Reform Project Plus
Makinen, Marty
United States, Bethesda
Partners for Health Reform Plus/abt Associates
Statistics
Citations: 16
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1002/hpm.688
ISSN:
07496753
Study Design
Randomised Control Trial
Cross Sectional Study
Case-Control Study
Study Locations
Mali