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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Improving quality and efficiency of facility-based child health care through Integrated Management of Childhood Illness in Tanzania
Health Policy and Planning, Volume 20, No. SUPPL. 1, Year 2005
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Description
Objectives: To assess the effect of Integrated Management of Childhood Illness (IMCI) relative to routine care on the quality and efficiency of providing care for sick children in first-level health facilities in Tanzania, and to disseminate the results for use in health sector decision-making. Design: Non-randomized controlled trial to compare child health care quality and economic costs in two intervention (>90% of health care workers trained in IMCI) and two comparison districts in rural Tanzania. Participants: For quality measures, all sick children presenting for care at random samples of first-level health facilities; for costs, all national, district, facility and household costs associated with child health care, taking a societal perspective. Results: IMCI training is associated with significantly better child health care in facilities at no additional cost to districts. The cost per child visit managed correctly was lower in IMCI than in routine care settings: $4.02 versus $25.70, respectively, in 1999 US dollars and after standardization for variations in population size. Conclusion: IMCI improved the quality and efficiency of child health care relative to routine child health care in the study districts. Previous study results indicated that the introduction of IMCI in these Tanzanian districts was associated with mortality levels that were 13% lower than in comparison districts. We can therefore conclude that IMCI is also more cost-effective than routine care for improving child health outcomes. The dissemination strategy for these results led to adoption of IMCI for nationwide implementation within 12 months of study completion. © The Author 2005. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved.
Authors & Co-Authors
Bryce, Jennifer W.
Unknown Affiliation
Gouws, Eleanor
Unknown Affiliation
Adam, Taghreed
Unknown Affiliation
Black, Robert E.
Unknown Affiliation
Schellenberg, Joanna Armstrong
Unknown Affiliation
Manzi, Fatuma
Unknown Affiliation
Victora, Cesar Gomes
Unknown Affiliation
Habicht, Jean Pierre L.
Unknown Affiliation
Statistics
Citations: 104
Authors: 8
Affiliations: 11
Identifiers
Doi:
10.1093/heapol/czi053
e-ISSN:
14602237
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Randomised Control Trial
Cross Sectional Study
Quasi Experimental Study
Study Approach
Quantitative
Study Locations
Tanzania