Results of a multi-country exploratory survey of approaches and methods for IMCI case management training
Ameena E Goga1, Lulu M Muhe, Kevin Forsyth
1Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, South Africa. Ameena.Goga@mrc.ac.za
Insights
Shorter Integrated Management of Childhood Illness case management training (ICMT) courses are acceptable globally, despite reduced clinical practice. These adapted training programs are crucial for expanding child survival initiatives.
Area of Science:
- Global Health
- Pediatric Medicine
- Health Systems Strengthening
Background:
- The Integrated Management of Childhood Illness Strategy (IMCI) is vital for improving child survival.
- Current recommendations advocate for an 11-day in-service IMCI case management training (ICMT) with specific participant-to-facilitator ratios and clinical practice duration.
- This study explored country experiences and the acceptability of shortening ICMT duration.
Purpose of the Study:
- To document country experiences with Integrated Management of Childhood Illness case management training (ICMT).
- To determine the acceptability of shortening the duration of ICMT.
- To assess adaptations in ICMT content and methodology in response to implementation pressures.
Main Methods:
- A multi-country exploratory questionnaire survey was conducted in 27 purposively-selected countries.
- Questionnaires were distributed to national IMCI focal persons, course directors/facilitators, and IMCI trainees.
- Quantitative and qualitative data were collected to analyze country practices and perceptions.
Main Results:
- Twenty-four countries participated, with most offering shorter ICMT courses (3-10 days).
- Shorter courses featured reduced clinical practice (<30% time), fewer exercises, and less individual feedback.
- Key strengths identified were varied training methodologies and the integrated approach, with chart booklets and clinical practice deemed critical.
Conclusions:
- Standardized, shorter ICMT courses incorporating participatory methods and adequate clinical practice could be globally acceptable.
- Adapting training duration is crucial for increasing access to quality child healthcare and meeting child survival goals (MDG4).
- Regularly updating content and focusing on skills-building are recommended for effective ICMT.
Background:
The Integrated Management of Childhood Illness Strategy (IMCI) is effective in improving management of sick children, and thus child survival. It is currently recommended that in-service IMCI case management training (ICMT) occur over 11-days; that the participant: facilitator ratio should be
Methods:
Questionnaires (QA) were sent to national IMCI focal persons in 27 purposively-selected countries. To probe further, questionnaires (QB and QC respectively) were also sent to course-directors or facilitators and IMCI trainees, selected using snowball sampling after applying pre-defined criteria, in these countries. Questionnaires gathered quantitative and qualitative data.
Results:
Thirty-three QA, 163 QB, 272 QC and two summaries were returned from 24 countries. All countries continued to adapt course content to local disease burden. All countries offer shorter ICMT courses, ranging from 3-10 days (commonest being 5-8 days). The shorter ICMT courses offer fewer exercises, more homework, less individual feedback and reduced clinical practice (<30% time). Whereas changes to course content were usually evidence-based, changes to training methodology and course duration evolved as pressure to expand implementation mounted. Participants varied in their self-reported skill and perception about each course. However, the varied methodology and integrated approach to management of illnesses were commonly cited as strengths of ICMT, and the chart booklet and clinical practice sessions were identified as critical components of ICMT. Four themes emerged from the qualitative work, viz. the current 11-day course is too expensive and should be shortened; advocacy around IMCI should increase; content should be regularly updated, new content areas should be introduced cautiously and more attention should be paid to skills-building rather than knowledge accumulation.
Conclusion:
Whilst the 11-day ICMT course is still recommended, as efforts intensify to increase access to quality care and meet MDG4, standardized shorter ICMT courses, that include participatory methodologies and adequate clinical practice, could be acceptable globally.
More Related Videos
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic illness...
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:24Kaplan-Meier Approach