Effectiveness of health services
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Case-fatality ratio among inpatients
Some health problems can be mostly resolved during an inpatient stay or emergency visit. For example, patient follow-up sheets should be completed for each child admitted for rehydration. Extracting data from these sheets should allow calculation of the case-fatality ratio for children admitted with dehydration.
Assessing the accuracy of health workers' diagnoses is especially important with some diseases which are difficult to diagnose only from signs and symptoms, but which require prompt, effective treatment. For example, malaria requires administration of appropriate drugs early in the course of disease. A simple malaria smear survey, where smear specimens are examined under a microscope from a series of patients diagnosed with malaria, can tell how accurate are clinical diagnoses of malaria.
Health worker treatment quality
Supervision of health workers should include periodic checks of how well they follow the standard treatment protocols recommended by the health coordinators. This may include interviews of health workers, periodic verbal or written testing, and observation.