OBJECTIVE: Training health workers to use Integrated Management of Childhood Illness (IMCI) guidelines can improve care for ill children in outpatient settings in developing countries. However, even after IMCI training, important performance gaps exist. One potential reason is that the effect of training can rapidly wane. Our aim was to determine if the performance of IMCI-trained health workers deteriorated over 3 years. METHODS: We studied two departments in Benin. First, we performed a record review of 32 IMCI-trained health workers during the first year of IMCI implementation (2001-2002). Second, we analysed data from cross-sectional health facility surveys from 2001 to 2004 that represented the entire study area. Primary outcomes were the proportion of children under 5 years old with potentially life-threatening illnesses who received either recommended or adequate treatment, and among all children, an index of overall guideline adherence. Secondary outcomes reflected the treatment of individual diseases. Outcomes were calculated monthly, and time trends were evaluated with regression modelling. RESULTS: The record review included 9393 consultations, and the surveys included 411 consultations performed by 105 health workers. For both data sources, performance trends were essentially flat for nearly all outcomes. Absolute levels of performance revealed substantial performance gaps. CONCLUSIONS: We found no evidence that performance declined over 3 years after IMCI training. However, important performance gaps found immediately after IMCI training persisted and should be addressed.
OBJECTIVE: Training health workers to use Integrated Management of Childhood Illness (IMCI) guidelines can improve care for ill children in outpatient settings in developing countries. However, even after IMCI training, important performance gaps exist. One potential reason is that the effect of training can rapidly wane. Our aim was to determine if the performance of IMCI-trained health workers deteriorated over 3 years. METHODS: We studied two departments in Benin. First, we performed a record review of 32 IMCI-trained health workers during the first year of IMCI implementation (2001-2002). Second, we analysed data from cross-sectional health facility surveys from 2001 to 2004 that represented the entire study area. Primary outcomes were the proportion of children under 5 years old with potentially life-threatening illnesses who received either recommended or adequate treatment, and among all children, an index of overall guideline adherence. Secondary outcomes reflected the treatment of individual diseases. Outcomes were calculated monthly, and time trends were evaluated with regression modelling. RESULTS: The record review included 9393 consultations, and the surveys included 411 consultations performed by 105 health workers. For both data sources, performance trends were essentially flat for nearly all outcomes. Absolute levels of performance revealed substantial performance gaps. CONCLUSIONS: We found no evidence that performance declined over 3 years after IMCI training. However, important performance gaps found immediately after IMCI training persisted and should be addressed.
Authors: Laura C Steinhardt; Faustin Onikpo; Julien Kouamé; Emily Piercefield; Marcel Lama; Michael S Deming; Alexander K Rowe Journal: BMC Health Serv Res Date: 2015-07-21 Impact factor: 2.655
Authors: Sarah M Burnett; Martin K Mbonye; Sarah Naikoba; Stella Zawedde-Muyanja; Stephen N Kinoti; Allan Ronald; Timothy Rubashembusya; Kelly S Willis; Robert Colebunders; Yukari C Manabe; Marcia R Weaver Journal: PLoS One Date: 2015-09-09 Impact factor: 3.240
Authors: Mary Docherty; Kate Shaw; Lucy Goulding; Hannah Parke; Erica Eassom; Farnoosh Ali; Graham Thornicroft Journal: Int J Ment Health Syst Date: 2017-01-05
Authors: Ashwin Vasan; David C Mabey; Simran Chaudhri; Helen-Ann Brown Epstein; Stephen D Lawn Journal: Health Policy Plan Date: 2017-04-01 Impact factor: 3.344