TableĀ 1

Basic characteristics of four hospital surveys conducted over the period 2002 to 2012 and definitions of patient level indicators

20025200611200912201213
Number of hospitals1481722
Hospital selectionPurposefulPurposefulPurposefulPurposeful
Total cases examined64121359521298
Case selection processConvenience sample of children on ward during survey period with acute non-surgical illnessesRandom sample of paediatric inpatient records over six months period prior to survey with acute non-surgical illnessesConvenience sample of paediatric inpatient records from most recent discharges with malaria, pneumonia and diarrhoeaConvenience sample of paediatric inpatient records from most recent discharges with acute non-surgical illnesses
Indicator calculations for children with an admission diagnosis of an acute, non-surgical illness
Use of malaria testingProportion with an admission diagnosis of malaria for whom a malaria test (blood slide examination or rapid test) is ordered to substantiate diagnosis
Use of HIV testing (at least rapid testing)Proportion for whom an HIV test is requested (typically a first rapid test). Routine HIV testing for all admissions has been recommended in Kenya as part of formerly diagnostic testing and counselling and latterly provider initiated testing and counselling
Use of haemoglobin measurementProportion with clinically documented pallor for whom a measured haemoglobin is requested as a standalone test or as part of a full blood count using any available laboratory method
Use of blood glucose measurementProportion of admissions for whom a blood glucose measurement is requested/documented either as a rapid bedside test or as a formal laboratory test using any available laboratory method
Use of lumbar puncture to identify meningitisProportion of all admissions for whom a lumbar puncture is requested/documented by the admitting clinical team to rule out/rule in meningitis
Indicator calculations among children with specific admission diagnoses
Use of a quinine loading doseProportion with an admission diagnosis of malaria for whom a quinine prescription began with a loading dose to initiate therapy
Use of once daily gentamicinProportion of children prescribed gentamicin in whom therapy was based on the recommended once daily regimen
Use of a specific fluid plan for children with severe dehydrationProportion of children given iv fluids for severe dehydration in whom the nature, volume and duration of initial fluids prescribed matched national and international recommendations