{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:32:06Z","timestamp":1788845526501,"version":"build-2803163510"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill & Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1132551"],"award-info":[{"award-number":["OPP1132551"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0239361","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T17:33:13Z","timestamp":1601055193000},"page":"e0239361","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":18,"title":["Quality of clinical assessment and management of sick children by Health Extension Workers in four regions of Ethiopia: A cross-sectional survey"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5465-6345","authenticated-orcid":true,"given":"Dawit Wolde","family":"Daka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluemebet Abera","family":"Wordofa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirkuzie","family":"Woldie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars \u00c5ke","family":"Persson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Della","family":"Berhanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"pone.0239361.ref001","article-title":"Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Inter-agency Group for Child Mortality Estimation","author":"D You","year":"2015","journal-title":"Lancet"},{"issue":"3","key":"pone.0239361.ref002","doi-asserted-by":"crossref","first-page":"e1002757","DOI":"10.1371\/journal.pmed.1002757","article-title":"Age distribution, trends, and forecasts of under-5 mortality in 31 sub-Saharan African countries: A modeling study","volume":"16","author":"W Zuo","year":"2019","journal-title":"PLOS Med"},{"key":"pone.0239361.ref003","author":"United Nations Children\u2019s Fund","year":"2019","journal-title":"Levels and Trends in Child Mortality. Estimates developed by the UN Inter-agency Group for Child Mortality Estimation"},{"issue":"11","key":"pone.0239361.ref004","doi-asserted-by":"crossref","first-page":"e1142","DOI":"10.1016\/S2214-109X(17)30331-5","article-title":"How Ethiopia achieved Millennium Development Goal 4 through multisectoral interventions: a Countdown to 2015 case study","volume":"5","author":"J Ruducha","year":"2017","journal-title":"Lancet Glob Heal"},{"key":"pone.0239361.ref005","volume-title":"Ethiopia Mini Demographic and Health Survey 2019: Key Indicators","author":"Ethiopian Public Health Institute (EPHI) [Ethiopia] and ICF","year":"2019"},{"issue":"5","key":"pone.0239361.ref006","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1093\/heapol\/czv115","article-title":"Access to integrated community case management of childhood illnesses services in rural Ethiopia: a qualitative study of the perspectives and experiences of caregivers","volume":"31","author":"B Shaw","year":"2016","journal-title":"Health Policy Plan"},{"issue":"3","key":"pone.0239361.ref007","doi-asserted-by":"crossref","first-page":"596","DOI":"10.4269\/ajtmh.15-0586","article-title":"Effects of the integrated Community Case Management of Childhood Illness Strategy on Child Mortality in Ethiopia: A Cluster Randomized Trial","volume":"94","author":"A Amouzou","year":"2016","journal-title":"Am J Trop Med Hyg"},{"issue":"1","key":"pone.0239361.ref008","doi-asserted-by":"crossref","first-page":"i21","DOI":"10.1093\/heapol\/czx054","article-title":"Community-Based Interventions for Newborns in Ethiopia (COMBINE): Cost-effectiveness analysis","volume":"32","author":"B Mathewos","year":"2017","journal-title":"Health Policy Plan"},{"key":"pone.0239361.ref009","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s12992-019-0470-1","article-title":"Community health extension program of Ethiopia, 2003\u20132018: successes and challenges toward universal coverage for primary healthcare services","volume":"15","author":"Y Assefa","year":"2019","journal-title":"Global Health"},{"issue":"1","key":"pone.0239361.ref010","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4314\/ahs.v18i1.24","article-title":"Approaches and strategies used in the training and supervision of Health Extension Workers (HEWs) delivering integrated community case management (iCCM) of childhood illness in Ethiopia: a qualitative rapid appraisal","volume":"18","author":"D Nsibande","year":"2018","journal-title":"Afr Health Sci"},{"issue":"9","key":"pone.0239361.ref011","doi-asserted-by":"crossref","first-page":"e1001696","DOI":"10.1371\/journal.pmed.1001696","article-title":"Monitoring and Evaluating Progress towards Universal Health Coverage in Ethiopia","volume":"11","author":"A Alebachew","year":"2014","journal-title":"PLOS Med"},{"key":"pone.0239361.ref012","first-page":"120","article-title":"Community case management improves use of treatment for childhood diarrhea, malaria and pneumonia in a remote district in Ethiopia\u2019s Oromiya Region","volume":"23","author":"T Degefie","year":"2009","journal-title":"Ethiop J Heal Dev"},{"issue":"2","key":"pone.0239361.ref013","doi-asserted-by":"crossref","first-page":"020404","DOI":"10.7189\/jogh.06.020404","article-title":"Assessment of the impact of quality improvement interventions on the quality of sick child care provided by Health Extension Workers in Ethiopia","volume":"6","author":"NP Miller","year":"2016","journal-title":"J Glob Health"},{"key":"pone.0239361.ref014","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1093\/heapol\/czs095","article-title":"Quality of sick child care delivered by Health Surveillance Assistants in Malawi","volume":"28","author":"KE Gilroy","year":"2013","journal-title":"Health Policy Plan"},{"issue":"3","key":"pone.0239361.ref015","first-page":"15","article-title":"National scale-up of integrated community case management in rural Ethiopia: Implementation and early lessons learned","volume":"52","author":"H Legesse","year":"2014","journal-title":"Ethiop Med J"},{"key":"pone.0239361.ref016","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1146\/annurev-publhealth-032013-182354","article-title":"Community Health Workers in Low, Middle and High-Income Countries: An Overview of Their History, Recent Evolution, and Current Effectiveness","volume":"35","author":"HB Perry","year":"2014","journal-title":"Annu Rev Public Heal"},{"issue":"11","key":"pone.0239361.ref017","doi-asserted-by":"crossref","first-page":"2100","DOI":"10.1111\/apa.14888","article-title":"Health Extension Workers\u2019 diagnostic accuracy for common childhood illnesses in four regions of Ethiopia: a cross-sectional study","volume":"108","author":"T Getachew","year":"2019","journal-title":"Acta Paediatr"},{"issue":"3","key":"pone.0239361.ref018","article-title":"Factors influencing the low utilization of curative child health services in Shebedino district, Sidama zone, Ethiopia","volume":"52","author":"W Tefera","year":"2014","journal-title":"Ethiop Med J"},{"issue":"3","key":"pone.0239361.ref019","doi-asserted-by":"crossref","first-page":"636","DOI":"10.4269\/ajtmh.14-0660","article-title":"Determinants of Utilization of Health Extension Workers in the Context of Scale-Up of Integrated Community Case Management of Childhood Illnesses in Ethiopia","volume":"93","author":"B Shaw","year":"2015","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0239361.ref020","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1186\/s12913-020-05151-3","article-title":"Protocol for the evaluation of a complex intervention aiming at increased utilization of primary child health services in Ethiopia: A before and after study in intervention and comparison areas","volume":"20","author":"D Berhanu","year":"2010","journal-title":"BMC Health Serv Res"},{"key":"pone.0239361.ref021","unstructured":"World Health Organization. Health Facility Survey: Tool to evaluate the quality of care delivered to sick children attending outpatients facilities (using the Integrated Management of Childhood Illness clinical guidelines as best practices). 2003. Report No.: 9241545860. Available from: https:\/\/apps.who.int\/iris\/handle\/10665\/42643"},{"key":"pone.0239361.ref022","author":"Ministry of Health of Ethiopia","year":"2014","journal-title":"The Integrated Community Case Management (iCCM) Chart Booklet Ethiopia"},{"issue":"2","key":"pone.0239361.ref023","doi-asserted-by":"crossref","first-page":"424","DOI":"10.4269\/ajtmh.13-0751","article-title":"Integrated Community Case Management of Childhood Illness in Ethiopia: Implementation Strength and Quality of Care","volume":"91","author":"NP Miller","year":"2014","journal-title":"Am J Trop Med Hyg"},{"issue":"12","key":"pone.0239361.ref024","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.15171\/ijhpm.2018.63","article-title":"Quality of Sick Child-Care Delivered by Community Health Workers in Tanzania","volume":"7","author":"C Baynes","year":"2018","journal-title":"Int J Heal Policy Manag"},{"issue":"1","key":"pone.0239361.ref025","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/S2214-109X(18)30408-X","article-title":"Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis","volume":"7","author":"DA McAllister","year":"2019","journal-title":"Lancet Glob Heal"},{"key":"pone.0239361.ref026","first-page":"1","article-title":"Insufficient referral practices of sick children in Ethiopia shown in a cross\u2010sectional survey","volume":"40","author":"H Beyene","year":"2020","journal-title":"Acta Paediatr"},{"key":"pone.0239361.ref027","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1471-2431-12-46","article-title":"Compliance with referral of sick children: A survey in five districts of Afghanistan","volume":"12","author":"W Newbrander","year":"2012","journal-title":"BMC Pediatr"},{"key":"pone.0239361.ref028","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1186\/s12913-019-4076-3","article-title":"Strengthening referral systems in community health programs: a qualitative study in two rural districts of Maputo Province, Mozambique","volume":"19","author":"C Give","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"pone.0239361.ref029","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1186\/s12936-016-1609-7","article-title":"Community health workers adherence to referral guidelines: evidence from studies introducing RDTs in two malaria transmission settings in Uganda","volume":"15","author":"S Lal","year":"2016","journal-title":"Malar J"},{"key":"pone.0239361.ref030","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1093\/inthealth\/ihs008","article-title":"Assessment of the adherence of community health workers to dosing and referral guidelines for the management of fever in children under 5 years: a study in Dangme West District, Ghana","volume":"5","author":"MA Chinbuah","year":"2013","journal-title":"Int ernational Heal"},{"issue":"9","key":"pone.0239361.ref031","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1377\/hlthaff.2016.0261","article-title":"Training and supervision did not meaningfully improve quality of care for pregnant women or sick children in sub-Saharan Africa","volume":"35","author":"HH Leslie","year":"2016","journal-title":"Health Aff"},{"key":"pone.0239361.ref032","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1136\/archdischild-2013-305863","article-title":"Mentoring and quality improvement strengthen integrated management of childhood illness implementation in rural Rwanda","volume":"100","author":"H Magge","year":"2015","journal-title":"Arch Dis Child"},{"key":"pone.0239361.ref033","doi-asserted-by":"crossref","first-page":"989","DOI":"10.2147\/JMDH.S228951","article-title":"How effective are mentoring programs for improving health worker competence and institutional performance in africa? A systematic review of quantitative evidence","volume":"12","author":"GT Feyissa","year":"2019","journal-title":"J Multidiscip Healthc"},{"issue":"1","key":"pone.0239361.ref034","doi-asserted-by":"crossref","first-page":"33194","DOI":"10.3402\/gha.v9.33194","article-title":"The performance of community health workers in the management of multiple childhood infectious diseases in Lira, northern Uganda\u2014A mixed methods cross-sectional study","volume":"9","author":"P Wanduru","year":"2016","journal-title":"Glob Health Action"},{"key":"pone.0239361.ref035","first-page":"65","article-title":"Effectiveness of supportive supervision on the consistency of integrated community cases management skills of the health extension workers in 113 districts of Ethiopia","volume":"52","author":"A Ameha","year":"2014","journal-title":"Ethiop Med J"},{"key":"pone.0239361.ref036","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1186\/1475-2875-13-367","article-title":"Performance of community health workers managing malaria, pneumonia and diarrhoea under the community case management programme in central Uganda: a cross sectional study","volume":"13","author":"J Bagonza","year":"2014","journal-title":"Malar J"},{"key":"pone.0239361.ref037","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1186\/1475-2875-11-282","article-title":"Performance of community health workers under integrated community case management of childhood illnesses in eastern Uganda","volume":"11","author":"JN Kalyango","year":"2012","journal-title":"Malar J"},{"key":"pone.0239361.ref038","doi-asserted-by":"crossref","first-page":"e12719","DOI":"10.1111\/mcn.12719","article-title":"Can community health workers manage uncomplicated severe acute malnutrition? A review of operational experiences in delivering severe acute malnutrition treatment through community health platforms","volume":"15","author":"N L\u00f3pez-Ejeda","year":"2019","journal-title":"Matern Child Nutr"},{"key":"pone.0239361.ref039","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12913-015-0910-4","article-title":"Predictors of health worker performance after Integrated Management of Childhood Illness training in Benin: A cohort study Health systems and services in low and middle income settings","volume":"15","author":"LC Steinhardt","year":"2015","journal-title":"BMC Health Serv Res"},{"issue":"4","key":"pone.0239361.ref040","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5334\/ijic.3971","article-title":"Coaching community health volunteers in integrated community case management improves the care of sick children under-5: Experience from Bondo, Kenya","volume":"18","author":"M Shiroya-Wandabwa","year":"2018","journal-title":"Int J Integr Care"},{"issue":"471","key":"pone.0239361.ref041","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/apa.14282","article-title":"Improving community health worker performance through supportive supervision: a randomised controlled implementation trial in Pakistan","volume":"107","author":"W Aftab","year":"2018","journal-title":"Acta Paediatr Int J Paediatr"},{"key":"pone.0239361.ref042","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1186\/s12913-016-1699-5","article-title":"Health workers\u2019 perspectives, knowledge and skills regarding community case management of childhood diarrhoea and pneumonia: A qualitative inquiry for an implementation research project \u201cnigraan\u201d in District Badin, Sindh, Pakistan","volume":"16","author":"F Rabbani","year":"2016","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0239361.ref043","first-page":"1","article-title":"Performance of community health workers: Situating their intermediary position within complex adaptive health systems","volume":"15","author":"MC Kok","year":"2017","journal-title":"Hum Resour Health"},{"issue":"5","key":"pone.0239361.ref044","doi-asserted-by":"crossref","first-page":"e0156438","DOI":"10.1371\/journal.pone.0156438","article-title":"The Ethiopian health extension program and variation in health systems performance: What matters?","volume":"11","author":"N Fetene","year":"2016","journal-title":"PLoS One"},{"key":"pone.0239361.ref045","first-page":"320","article-title":"Ethiopia \u2018 s health extension workers use of work time on duty: time and motion study","volume":"32","author":"H Tilahun","year":"2017","journal-title":"Health Policy Plan"},{"issue":"1","key":"pone.0239361.ref046","doi-asserted-by":"crossref","first-page":"53","DOI":"10.21586\/ross0000004","article-title":"Handling the Hawthorne effect:The challenges surrounding a participant observer","volume":"1","author":"D Oswald","year":"2014","journal-title":"Rev Soc Stud"},{"issue":"3","key":"pone.0239361.ref047","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jclinepi.2013.08.015","article-title":"Systematic review of the Hawthorne effect: New concepts are needed to study research participation effects","volume":"67","author":"J Mccambridge","year":"2014","journal-title":"J Clin Epidemiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0239361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T17:34:24Z","timestamp":1601055264000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0239361"}},"subtitle":[],"editor":[{"given":"Elizeus","family":"Rutebemberwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,9,25]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0239361","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,25]]}}}