Diarrhea, Malaria, Malnutrition, Measles, Pneumonia
Conditions
Keywords
Benin, child health, developing country, health services research, health worker performance, Integrated Management of Childhood Illness
Brief summary
The objective of this study was to determine the effectiveness and cost-effectiveness of a package of interventions to support health workers in Benin (in West Africa) who had been trained to use Integrated Management of Childhood Illness guidelines (i.e., guidelines intended to improve the treatment of childhood illnesses).
Detailed description
Integrated Management of Childhood Illness (IMCI) is a child health strategy in developing countries with a goal of improving the treatment of illnesses at first-level health facilities through the use of clinical practice guidelines. The World Health Organization (WHO) recommends implementing the guidelines with an 11-day training course. There is a concern that health workers might not master all aspects of the guidelines and that health worker performance may deteriorate over time. In 1999, Benin (in West Africa) was planning to implement IMCI. In response to concerns about how well health workers would follow IMCI guidelines, interventions were designed to support health workers after IMCI training: 1) regular supervision of health workers; 2) supervision of supervisors; 3) job aids; and 4) non-financial incentives for health workers. These interventions were intended to be used together. The objective of this study was to determine the effectiveness and cost-effectiveness of the package of interventions to support IMCI-trained health workers in Benin.
Interventions
BEHAVIORALHealth worker supports (supervision, job aids, incentives)
Sponsors
Ministry of Health, Benin
Centers for Disease Control and Prevention
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Weeks to 59 Months
Healthy volunteers
No
Inclusion criteria
* Inclusion criteria for health facilities were: 1) public and licensed private health facilities providing outpatient services, and 2) the level of care was appropriate for use of Integrated Management of Childhood Illness (IMCI) guidelines. * Inclusion criteria for consultations were children 1 week - 59 months old seen for any illness during regular working hours (typically 8am-6pm) on weekdays.
Exclusion criteria
* Health facilities in which the level of care was not appropriate for use of Integrated Management of Childhood Illness (IMCI) guidelines(i.e., one referral hospital and one sub-specialty hospital).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of children with potentially life-threatening illnesses who received recommended treatment, according to Integrated Management of Childhood Illness guidelines. | 3 years |
| Proportion of children with potentially life-threatening illnesses who received recommended treatment, according to Integrated Management of Childhood Illness guidelines, or adequate treatment. | 3 years |
| Mean proportion of needed case management tasks that were performed during consultations. | 3 years |
Secondary
| Measure | Time frame |
|---|---|
| Proportion of children with pneumonia who received recommended treatment, according to Integrated Management of Childhood Illness guidelines. | 3 years |
| Proportion of children with malaria who received recommended treatment, according to Integrated Management of Childhood Illness guidelines. | 3 years |
Countries
Benin
Outcome results
None listed