Résumé :
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[BDSP. Notice produite par INIST-CNRS F9IR0x0Y. Diffusion soumise à autorisation]. Background In developing countries, health workers often do not follow clinical practice guidelines. However, few studies have examined why different types of errors occur. Methods We analysed a sample of consultations of children with non-severe malaria (defined as fever without signs of severe illness) from a health facility survey conducted in Ouémé Département, Benin. Treatment was defined as correct (recommended antimalarial), a minor error (non-recommended antimalarial), or a major error (no antimalarial). Results In all, 85 health workers and 289 children were studied. In a multivariate logistic regression analysis, the following factors were significantly associated with major errors : treatment by a physician (adjusted odds ratio [aOR]=13.57,95% CI : 1.45-126.75), child's age=1 supervision visit in the past 6 months (aOR=0.33,95% CI : 0.14-0.77), fever treatment wall chart in the consultation room (aOR=0.29,95% CI : 0.12-0.73), and number of non-fever chief complaints (aOR=0.67 per complaint, 95% CI : 0.48-0.93). In-service training in malaria treatment was not significantly associated with either error type. Conclusions Many factors may influence health worker performance, and factors such as preservice training may influence performance in unexpected ways. Identifying different errors and analysing them separately can help reveal potential causes that may be masked by combining errors into a single category.
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