Table 4 Citations by participants related to dimension 3
Dimension 3: medical content of the algorithm | |
|---|---|
Language or miscomprehension | |
“There are no difficult questions, but sometimes mothers have difficulties to understand. (…) You have to repeat to all of them and explain [what the question in REC is really requesting]. (…) For example, when the mother says: my child has diarrhoea; you have to ask her if there is blood in the stool. But some don’t know what this means, you have to insist: ‘when the child passes stool, exactly how do they look?’” Birth attendant, female | |
Missing pathologies | |
“We know that the diagnosis [in REC] comes from IMCI, but we see other pathologies that are not included in IMCI. If there is a possibility integrate other pathologies [into REC], it could help us to treat them. For example, when a child comes in with dermatitis, it is not included in IMCI, but it is still a consultation that you have to manage using REC” HO, male | “[In REC] there is no candidiasis, dysentery, wounds, burns, or conjunctivitis but we see a lot of them, it is very common (…) [It would be good] if we could add these to REC, as they are very frequent” RN, female |
Absence of final diagnosis | |
“We sometimes get children with fever who have a negative malaria RDT. You have to find the cause of the fever but the child has no diarrhoea, no cough… You don’t know which treatment to give because REC suggests none… (…) There is no diagnosis. (…) And I would like to be able to tell the mother: ‘this is what your child is suffering from.’” Birth attendant, female | |
Occasional lack of guidance in treatment | |
“If the fever is not elevated, REC offers no treatment at the end [of the consultation]. But the mother insists that the child had a fever and she came to you to present this issue. With [REC], one finds that the child has nothing, and you don’t know what to do…” HO Male | |
The “sick young infant aged up to 2 months” part of the algorithm | |
“Concerning new-borns, as soon as a new-born is febrile, when their temperature is higher than 37.5, REC tells you: severe bacterial infection and automatically advises you to refer the child. However, we sometimes assess [these patients] as cases we can and prefer to manage [ourselves, in the HF].” FGD | “What I find less good it is the part for children under 2 months. I feel there are cases we can manage at the health facility, but when you tick some signs on the device, REC tells you to refer…” Birth attendant, female |
HIV evaluation | |
“Here, in our context it is rare to see a child with an HIV test result, generally the mothers do it in the pre-natal consultations, but it is often not noted in the child’s health logbook. Therefore, it makes [this section of REC] a bit difficult. There are questions that are difficult to answer without proof and I find this part ambiguous.” RN male | |