Intérêt de la prise en charge intégrée des maladies de l'enfant dans les soins ambulatoires aux enfants de moins de 5 ans vus en unités de soins périphériques à Lomé (Togo)

Dzayissé, Y. Atakouma; Tsolenyanu, Enyonam; Gbadoé, Adama Dodji; Boukari, Rachida; Lawson-Evi, K.; Agbèré, AD; Tatagan-Agbi, A.; Assimadi, J. K.

doi:10.1016/j.arcped.2006.09.012

Cited by 3 publications

(3 citation statements)

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“…Characteristics of the included 46 studies are presented in Table S1 [6], [8], [15], [16], [28], [29], [44], [45], [46], [47], [48], [49], [50], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], [65], [66], [67], [68], [69], [70], [71], [72], [73], [74], [75], [76], [77], [78], [79], [80], [81], [82], [83], [84]. For the meta-analysis, four studies were cluster-RCTs [8], [66], [81], [82], seven studies were pre-post studies [28], [44], [48], [50], [63], [74], [83], and 15 studies were cross-sectional studies [29], [45], [46], [47], [49], [52]…”

Section: Resultsmentioning

confidence: 99%

“…For the meta-analysis, four studies were cluster-RCTs [8], [66], [81], [82], seven studies were pre-post studies [28], [44], [48], [50], [63], [74], [83], and 15 studies were cross-sectional studies [29], [45], [46], [47], [49], [52], [57], [60], [61], [64], [67], [69], [70], [73], [75]. The majority of studies were conducted in Africa [28], [44], [45], [46], [47], [48], [49], [50], [57], [60], [61], [63], [66], [70], [73], [74], [84], followed by Asia [8], [29], [64], [69], [75], [82], [83], and South America [52], [67], [81]. In total, there were 14,582 clinical encounters conducted by health workers (i.e., medical students, medical officers, doctors, health workers, nurses, aides, and lady health visitors) from 1,939 different health facilities.…”

Section: Resultsmentioning

confidence: 99%

“…IMCI training ranged from 20 hours to 14 days in duration. Seven studies examined all five performances of interest, including classifying illness, providing vaccinations, prescribing medications, instructing caregivers on administering medications, counseling on nutrition [48], [49], [52], [57], [69], [70], [73]; five studies only examined treatment [47], [60], [64], [74], [83]; two studies only examined a short-course nutrition counseling module [81], [82]; one study only examined caregiver instruction [66]; and 11 studies examined a combination of the four components of health worker performance [8], [28], [29], [44], [45], [46], [50], [61], [63], [67], [75].…”

Section: Resultsmentioning

confidence: 99%

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Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis

et al. 2013

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BackgroundAn estimated 6.9 million children die annually in low and middle-income countries because of treatable illneses including pneumonia, diarrhea, and malaria. To reduce morbidity and mortality, the Integrated Management of Childhood Illness strategy was developed, which included a component to strengthen the skills of health workers in identifying and managing these conditions. A systematic review and meta-analysis were conducted to determine whether IMCI training actually improves performance.MethodsDatabase searches of CIHAHL, CENTRAL, EMBASE, Global Health, Medline, Ovid Healthstar, and PubMed were performed from 1990 to February 2013, and supplemented with grey literature searches and reviews of bibliographies. Studies were included if they compared the performance of IMCI and non-IMCI health workers in illness classification, prescription of medications, vaccinations, and counseling on nutrition and admistration of oral therapies. Dersminion-Laird random effect models were used to summarize the effect estimates.ResultsThe systematic review and meta-analysis included 46 and 26 studies, respectively. Four cluster-randomized controlled trials, seven pre-post studies, and 15 cross-sectional studies were included. Findings were heterogeneous across performance domains with evidence of effect modification by health worker performance at baseline. Overall, IMCI-trained workers were more likely to correctly classify illnesses (RR = 1.93, 95% CI: 1.66–2.24). Studies of workers with lower baseline performance showed greater improvements in prescribing medications (RR = 3.08, 95% CI: 2.04–4.66), vaccinating children (RR = 3.45, 95% CI: 1.49–8.01), and counseling families on adequate nutrition (RR = 10.12, 95% CI: 6.03–16.99) and administering oral therapies (RR = 3.76, 95% CI: 2.30–6.13). Trends toward greater training benefits were observed in studies that were conducted in lower resource settings and reported greater supervision.ConclusionFindings suggest that IMCI training improves health worker performance. However, these estimates need to be interpreted cautiously given the observational nature of the studies and presence of heterogeneity.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis

et al. 2013

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Integrated management of childhood illness (IMCI) strategy for children under five

Gera

Shah

Garner

et al. 2016

Cochrane Database of Systematic Reviews

141

124

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Background More than 7.5 million children younger than age five living in low- and middle-income countries die every year. The World Health Organization (WHO) developed the integrated management of childhood illness (IMCI) strategy to reduce mortality and morbidity and to improve quality of care by improving the delivery of a variety of curative and preventive medical and behavioral interventions at health facilities, at home, and in the community. Objectives To evaluate the effects of programs that implement the IMCI strategy in terms of death, nutritional status, quality of care, coverage with IMCI deliverables, and satisfaction of beneficiaries. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), including the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE; EMBASE, Ovid; the Cumulative Index to Nursing and Allied Health Literature (CINAHL), EbscoHost; the Latin American Caribbean Health Sciences Literature (LILACS), Virtual Health Library (VHL); the WHO Library & Information Networks for Knowledge Database (WHOLIS); the Science Citation Index and Social Sciences Citation Index, Institute for Scientific Information (ISI) Web of Science; Population Information Online (POPLINE); the WHO International Clinical Trials Registry Platform (WHO ICTRP); and the Global Health, Ovid and Health Management, ProQuest database. We performed searches until 30 June 2015 and supplemented these by searching revised bibliographies and by contacting experts to identify ongoing and unpublished studies. Selection criteria We sought to include randomised controlled trials (RCTs) and controlled before-after (CBA) studies with at least two intervention and two control sites evaluating the generic IMCI strategy or its adaptation in children younger than age five, and including at minimum efforts to improve health care worker skills for case management. We excluded studies in which IMCI was accompanied by other interventions including conditional cash transfers, food supplementation, and employment. The comparison group received usual health services without provision of IMCI. Data collection and analysis Two review authors independently screened searches, selected trials, and extracted, analysed and tabulated data. We used inverse variance for cluster trials and an intracluster co-efficient of 0.01 when adjustment had not been made in the primary study. We used the GRADE (Grades of Recommendation, Assessment, Development and Evaluation Working Group) approach to assess the certainty of evidence. Main results Two cluster-randomised trials (India and Bangladesh) and two controlled before-after studies (Tanzania and India) met our inclusion criteria. Strategies included training of health care staff, management strengthening of health care systems (all four studies), and home visitin...

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Does shortening the training on Integrated Management of Childhood Illness guidelines reduce its effectiveness? A systematic review

Rowe

Holloway

et al. 2011

Health Policy and Planning

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Intérêt de la prise en charge intégrée des maladies de l'enfant dans les soins ambulatoires aux enfants de moins de 5 ans vus en unités de soins périphériques à Lomé (Togo)

Cited by 3 publications

References 2 publications

Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis

Does Integrated Management of Childhood Illness (IMCI) Training Improve the Skills of Health Workers? A Systematic Review and Meta-Analysis

Integrated management of childhood illness (IMCI) strategy for children under five

Does shortening the training on Integrated Management of Childhood Illness guidelines reduce its effectiveness? A systematic review

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