Motivated Hospital Staff Improves Malaria Survival

African study shows significantly lower mortality rates in children who receive more attentive care

WEDNESDAY, Oct. 24 (HealthDay News) -- More children with malaria who are admitted to hospitals in developing countries will survive if hospital staff are given a financial incentive to follow guidelines for care, according to a report published online Oct. 22 in BMJ.

Sidu Biai, M.D., of the INDEPTH Network in Guinea-Bissau, Africa, and colleagues randomized 951 children with malaria (aged 3 months to 5 years) to either an intervention ward or a control ward in the national hospital of Guinea-Bissau in northwest Africa. All the children received a free drug kit for malaria and staff members assigned to both wards were trained in a standardized protocol for management of malaria. Nurses and doctors on the intervention ward were rigorously supervised to ensure they followed the protocol and received an extra stipend as an incentive to do so.

In the intervention group, 5 percent of patients died in the hospital, compared to 10 percent of patients in the control group. The length of stay was shorter in the intervention group than in the control group (seven versus eight days) and the rate of discharge from the hospital was 35 percent shorter in the intervention group. At follow-up visits 28 days after discharge, mortality was 7 percent in the intervention group and 11 percent in the control group.

"Our results imply that consideration should be given to supporting health staff salaries, possibly on the basis of performance targets," the authors conclude.

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