Instructions: Interview all providers at the facility who provide curative care services. At a minimum interview the person in-charge and a nurse.
INTERVIEWER: INTRODUCE YOURSELF TO THE PROVIDER./ CONSENT
I am a student of the school of Public Health of the University of Ghana, Legon. In doing my MPH dissertation, I am collecting information on treatment of uncomplicated malaria with respect to the new anti malaria policy in the district. This information will be useful to the facility and DHMT in planning your health service delivery.
All information from this survey is confidential and participation in answering questions for this survey is voluntary. You can refuse to answer any question or all the questions. I am asking for your help to ensure that the information collected is accurate. If you need any further information please feel free to contact the people on this information sheet.
Do you have any questions for me? Can we begin now?
100
SIGNATURE OF INTERVIEWER INDICATES PARTICIPANT AGREEMENT TO PARTICIPATE AND THAT THE TIME IS CONVENIENT
FACILITY IDENTIFICATION
Name of Region: CENTRAL Name of District: _ASSIN NORTH
Name of the facility_________________________________
Type of Health Facility : (1= Hospital; 2 = Health Centre;; 3= CHPs 4= Clinic; 5= Maternity home;
6= Other _________________________________) Operating Authority:
1= Government; 2 = Quasi-government 3 = Non-governmental organization 4= Mission/Religious 5 = Private for profit
6 = Other _______________________) 3 REGION CODE DISTRICT CODE FACILITY CODE FACILITY TYPE OPERATING AUTHORITY 1 5 Date: ____________________________________________ DAY / MONTH / YEAR
Provider Information
Provider category*: (1=Doctor; 2=Medical Assistant; 3=Nurse; 4= Midwife; 5= Community Health Officer; ;
6=other (specify___________ Sex of Provider: (1=male; 2=female)
Provider Code (start numbering the interviews at each facility with one and continue until you have interviewed all the providers who treat for malaria at the facility)
PROVIDER CATEGORY SEX OF PROVIDER PROVIDER CODE
NO. QUESTIONS CODING CLASSIFICATION GO TO Provider Training and Experience
101 Do you personally provide care for clients with malaria? YES...1
NO ...2 ÎEND 102 In what year did you start working in this facility? YEAR 103 What is your current technical qualification? Medical Officer...10
Medical Asst...20
Nurse...30
Midwife ...40
Community Health Nurse ...50
Other____________________ ...96
104 What year did you graduate with this qualification? YEAR ...
NOW I WOULD LIKE TO ASK YOU SOME QUESTIONS ABOUT THE SERVICES YOU PROVIDE HERE IN RELATION TO MALARIA NO. QUESTIONS CODING CLASSIFICATION GO TO 201 Do you know of the new antimalarial drug therapy, Artesunate-Amodiaquin introduced by the Ministry of Health? YES………1
NO……….2
202 Did you receive any training specifically with the introduction of this policy? YES………1 NO……….2
202a In what year did you receive the training? 2004………..1
2005………..2
2006………..3
2007………..4
Other (specify)………..
203 What did you learn about the new malaria policy? (circle all that apply) p. CHQ is no longer effective…1 q. Parasite is resistance to CHQ……….2
r. Combination more effective...3
s. Easier to take combination...4
u. Other ……… 5
204 Do you agree to the need for a change? YES………1
NO……….…….2
205 Do you have a copy of the national malaria policy? (ask to see a copy) ,. Yes seen ……….1
Yes, reported to have…… 2
No……… 3
Don’t know………..8
206 Do you have a copy of the new standard treatment guideline? (ask to see a copy) Yes, seen………1 Yes, reported to have………2
No……….……… …...3
Don’t know…….…………...8
207 Where is the copy/copies usually kept? (circle all that apply) Each consulting room……1 One consulting room……..2
Medical Assist’s consulting room………..3
Med Sup’s office…………..4
Administrator’s office……..5
Doctors’ resting room…….6
Officer-in-charge’s room…7 a. Other………..8
o. (specify)………..
208 Do you prescribe the Artesunate-Amodiaquin combination to patients? YES………1 NO……….…….2 Î210 209 How often do you prescribe this combination? a. Always………..1
b. Very often………….2 c. Sometimes………...3 d Seldomly…………..4 e. not at all………5 Î210 Î210 Î210 Î210 210 Why will you sometimes prescribe the other antimalarials? (CIRCLE ALL THAT APPLY) p. fear of adverse reaction……1
q. personal experience………..2
r. experience of a patient…….3
s. lack of confidence…………..4
t. experience of a colleague…5 u. patients refusal/preference..6
v. stock out at dispensary…….7
w. other………8
o. (specify) ……….
211 Under what conditions do you prescribe other anti- malaria other than Artesunate/Amodiaquin? p. Patient’s preference...……….1 q. Dispensary stock out…..…...2
r. Patient’s condition…………..3
s. NHIS status of patient…..….4
t. Treatment failure with combination………..5
u. Other……….6
o. (specify)……….
212 What other anti malarial do you prescribe other than Artesunate/Amoadiaquin? p. Amodiaquine only...1 q. Artesunate only...2
r. Alaxin………3
s. Chloroquine...4
t. S/P...5
213 What factors influence the choice of anti malaria you
prescribe? p. State of the patient………....1 q. Preference of patient……...2
r. Age of patient……….………..3
s. Personal conviction………….4
t. Standard treatment guideline.5 u. Other treatment protocols…..6
v. NHIS requirement………7
w. Other……….8
o. (specify)……….. ………..
MALARIA MENTIONED NOT MENTIONED 1 2 1 2 1 2 1 2 1 2 1 2 1 2 301 What factors influence your dosage of drugs? (don’t probe, tick as mentioned) a. age b. weight c. cost of treatment d. side effects e. standard treatment guidelines f. available protocols / charts g. other o. (specify) ……….
302 Do you routinely write down your diagnosis Yes……….……….1
No………2
303 Do you ask the patient to come back for review Yes………..1
No………..……..2
MENTIONED(1) NOT MENTIONED(2) 1 2 1 2 1 2 1 2 1 2 304 What do you counsel your patient on?(Don’t probe) a. the disease b. prevention c. how to correctly take drugs d. diets taken with medication e. other o. (specify)………..
305 When people are given the drug, do they come back still feeling sick or with complaints. (adverse effects)? Yes……….……….1 No……….2 Î308 MENTIONED(1) NOT MENTIONED(2) 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 306 What side effects of artesunate-amodiaquin do clients complain of? (DON’T PROBE) a. dizziness/drowsiness/weakness b. palpitation c. vomiting d. restlessness e. protruded tongue f. worsening of symptoms g. fits/confusion/coma h. others o. (specify)………..
YES(1) NO(2)
1 2 1 2 1 2 1 2 307 How do you take care of reported adverse reactions?
a) fill adverse drug reaction form b) record in a book
c) manage the adverse reaction and discharge when well
d) refer patients to hospital e) other
o) (specify)………
Divided/whole Tablets What dose of anti-malarial do you prescribe? Correct Not Correct correct Not correct Don’t Know Dosage A. Artesunate 4mg/kg body weight bid for 3 days 1 2 3 4 8 B. Amodiaquine 10mg/kg body weight bid for 3 days 1 2 3 4 8 C. S/P 1500mg/75mg start (adult) 1 2 3 4 8 308 D. Quinine 10mg/kg (Max 600mg) 8 hourly for 7 days. 1 2 3 4 8 E. Chloroquin 800mg dly for 2 days, then 400mg on 3rd day. 1 2 3 4 8 F. Other 1 2 3 4 8 O. Specify……….
309 How will you rate the effectiveness of the new policy? very effective……….1
effective………..2
effective but for the side effects………….3
not effective………4
a. other………8
b. specify………..
310 If given the chance to decide the fate of this new policy, what will that be? Continue……….1 Modify……….2
take it out………3
go back to chloroquine……….4
a. other ………..………5
o. specify………