Strategies for scaling-up the number of health care workers trained in integrated management of childhood illness (IMCI) and other child-survival interventions could be just as effective with shorter periods of preservice training. These are the conclusions of an Article in this week's Alma Ata Special Issue of The Lancet, authored by Dr Luis Huicho, Universidad Nacional Mayor de San Marcos, Universidad Peruana Cayetano Heredia and Institute of Child Health, Lima, Peru, and colleagues.
The research team looked at data from Bangladesh, Brazil, Uganda and Tanzania to determine whether longer preservice training (>4 years Brazil, >3 years other countries) was more effective than shorter duration training. Indicators examined were assessment, classification, and management of sick children according to IMCI guidelines. Each child was examined twice, by the IMCI health-worker being assessed and by a gold-standard supervisor. In Brazil and Uganda, more children were managed correctly by workers with shorter training; in Tanzania, workers with longer training did better in assessment, but not in the management, of sick children; while in Bangladesh, there was no difference.
The researchers conclude: "IMCI training is associated with much the same quality of child care across different health worker categories, irrespective of the duration and level of preservice training. Strategies for scaling up IMCI and other child-survival interventions might rely on health workers with shorter duration of preservice training deployed in underserved areas."
Dr Luis Huicho, Universidad Nacional Mayor de San Marcos, Universidad Peruana Cayetano Heredia and Institute of Child Health, Lima, Peru T) +51-1-993481121 E) lhuicho@gmail.com
Full paper: http://press.thelancet.com/AAchildcare.pdf
Journal
The Lancet