OR (95% CI) for the effect of time (month of follow-up) on individual indicators’ performance change
| Type of task | Indicator | OR (95% CI) (performance change per month) | Correlation between random slopes and random intercepts |
| Simple documentation indicators | |||
| Passive feedback | Central cyanosis | 1.05 (1.00 to 1.09) | −0.89 |
| Pallor | 1.03 (1.01 to 1.06) | −0.88 | |
| Indrawing | 1.09 (1.01, to 1.18) | −0.93 | |
| Grunting | 1.09 (1.03 to 1.18) | −0.93 | |
| Acidotic breathing | 1.11 (1.03 to 1.19) | −0.91 | |
| No feedback | Jaundice | 1.06 (1.02 to 1.10) | −0.91 |
| Wheeze | 1.06 (1.01 to 1.13) | −0.92 | |
| Lymph nodes >1 cm | 1.12 (1.03 to 1.20) | −0.90 | |
| Wrist/rib signs for rickets | 1.20 (1.06 to 1.27) | −0.92 | |
| Thrush | 1.13 (1.04 to 1.24) | −0.95 | |
| Crackles | 1.07 (1.02 to 1.12) | −0.90 | |
| Stridor | 1.13 (1.04 to 1.24) | −0.96 | |
| Difficult documentation indicators | |||
| Active feedback | MUAC/WHZ | 1.15 (1.08 to 1.23) | −0.80 |
| Respiratory rate | 1.04 (1.01 to 1.09) | −0.79 | |
| Passive feedback | AVPU | 1.06 (1.01 to 1.10) | −0.93 |
| Capillary refill | 1.11 (1.05 to 1.16) | −0.88 | |
| Skin pinch | 1.09 (1.04 to 1.16) | −0.94 | |
| Ability to drink | 1.09 (1.03 to 1.17) | −0.95 | |
| No feedback | Pulse rate | 1.02 (0.96 to 1.08) | −0.78 |
| Temperature | 1.03 (0.99 to 1.08) | −0.88 | |
| Cognitive work indicators | |||
| Group A: indicators requiring cognitive work to plan investigations or classify disease severity in line with guidelines | |||
| Active feedback | HIV status known | 1.19 (1.13 to 1.26) | −0.96 |
| LP result available | 0.99 (0.96 to 1.03) | −0.75 | |
| MPS results recorded | 1.01 (0.98 to 1.03) | 0.13 | |
| Passive feedback | Hb for pallor | 1.04 (1.01 to 1.10) | −0.45 |
| Glucose for danger signs | 1.02 (1.01 to1.12) | −0.74 | |
| No feedback | Non-classified malaria | 0.91 (0.83 to 0.99) | −0.34 |
| Non-classified pneumonia | 0.95 (0.92 to 0.98) | −0.67 | |
| Non-classified dehydration | 1.02 (0.99 to 1.04) | −0.55 | |
| Non-classified diarrhoea | 0.94 (0.86 to 1.03) | −0.65 | |
| Group B: indicators involving cognitive work to prescribe drugs in line with recommended guidelines | |||
| Active feedback | Artesunate for malaria | 1.17 (1.01 to 1.37) | −0.89 |
| Zinc for diarrhoea | 1.01 (0.98 to 1.07) | −0.02 | |
| Correct gentamicin dose | 1.02 (0.99 to 1.04) | −0.79 | |
| No feedback | Ceftriaxone for meningitis | 1.01 (0.97 to 1.05) | −0.61 |
| Elevated penicillin dose for meningitis | 1.00 (0.98 to 1.04) | −0.69 | |
AVPU, alert, verbal response, pain response, unresponsive; Hb, haemoglobin; LP, lumbar puncture; MPS, malaria parasite slide; MUAC/WHZ, mid-upper arm circumference/weight for height z-score.