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The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation
Journal
BMC Health Services Research
Volume
14
Pages / Article-Number
628
Keywords
Malaria, Exit interview, Direct observation, Patient recall, Adherence
Abstract
Background: This paper aims to assess the sensitivity and specificity of exit interviews as a measure of malaria case management practice as compared to direct observation.
Methods: The malaria case management of 1654 febrile patients attending 110 health facilities from across Papua New Guinea was directly observed by a trained research officer as part of a repeat cross sectional survey. Patient recall of 5 forms of clinical advice and 5 forms of clinical action were then assessed at service exit and statistical analyses on matched observation/exit interview data conducted.
Results: The sensitivity of exit interviews with respect to clinical advice ranged from 36.2% to 96.4% and specificity from 53.5% to 98.6%. With respect to clinical actions, sensitivity of the exit interviews ranged from 83.9% to 98.3% and specificity from 70.6% to 98.1%.
Conclusion: The exit interview appears to be a valid measure of objective malaria case management practices such as the completion of a diagnostic test or the provision of antimalarial medication, but may be a less valid measure of low frequency, subjective practices such as the provision of malaria prevention advice.
