Management of febrile illness in children less than 5 years of age at Limbe Health Center, Blantyre District in Malawi: a best practice implementation project

Abstract

BACKGROUND In Malawi, malaria, pneumonia and diarrhoea are leading causes of death in children < 5. Fever is a core symptom for each of these diseases. It is critical for child health that febrile illness management is best practice. OBJECTIVES This project aimed to assess current and promote evidence based best practice pediatric febrile management and thereby improve child health outcomes in Limbe Health Centre Malawi. METHODS The project used the Joanna Briggs Institute’s Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting change in health practice. A baseline audit was conducted followed by implementation of an education strategy targeted at clinicians to improve practice and follow-up audit. RESULTS At baseline there was no compliance in taking temperature at triage and administration of antipyretics as clinically indicated. There was low compliance (45%) in providing full assessment of a sick child and in the number of parents and carers given information on home management. Follow up audit produced better outcomes. 90% of the children had temperature taken at triage, 90% were fully assessed, 100% received antipyretics as clinically indicated and 100% of caregivers received information on home management. CONCLUSION This evidence implementation project provides another example of how evidence based audit and feedback may be used to improve practice and health outcomes, even in a low resource setting. To ensure that the shift towards evidence based practice in management of febrile illness in children is maintained further audits and feedback cycles will be needed.