Integrated Management of Childhood Illness in Kumasi, Ghana

Wiedmeier JE (1), Whipple NS (4), Brown A (2), Hill KM (2), Holmann M (2), Vandenberghe R (2), Gray-Cooper OM (1), Dickerson T (4), Ansong D (3), Alder SC (1)

University of Utah, Department of Family and Preventive Medicine, Division of Public Health, Salt Lake City, UT/US(1); University of Utah, School of Medicine, Salt Lake City, UT/US (2); Kwame Nkrumah University of Science and Technology, Kumasi, Ghana (3)

Background: Child (0-5), infant mortality rates (per 1,000 live births), although declining, as of 2011 are still high (77.6). This is likely due to lack of health workers, overload of health services at the medical assistant level, patients waiting too long to seek care due to lack of access and distance to care.

IMCI in the Community: Caring For The Sick Child In The Community, a WHO/UNICEF program, serves as a tool to support basic health services for children provided by community health workers in the context of the Integrated Management of Childhood Illness (IMCI) strategy.  The strategy is based on several premises including that it targets the conditions that cause the most childhood deaths in developing countries, relies on evidence-based child survival interventions, brings curative health care to children in those communities that are hardest to reach, utilizes trained, supervised community members, linked to facility-based services, to deliver interventions, and is consistent with practices recommended by international health agencies.  Interventions include oral rehydration therapy and zinc for diarrhea, antibiotics for pneumonia, and antimalarials for malaria.

Training Methods: Learning materials: Caring for the Sick Child in the Community teaching packets and photo books distributed to all members attending the class; Role play: Practiced how to make the child’s caregiver feel comfortable in order for open discussion of the child’s condition to take place; Video: demonstrated case presentations for various childhood illnesses; PowerPoint:  aided in main points and visual representation of important topics; Demonstration: how to use a MUAC strap, how to mix ORC/zinc solutions, and how to perform a rapid diagnostic test for malaria; Using the recording form to identify problem: accurate information gathered on the recording form about the child help to identify the child’s illness and proper care; Quizzes: assessment of teaching methods and effectiveness

Results: Post-training quizzes were administered to program trainees. Results demonstrated retention of material taught. Trainees expressed excitement to perpetuate this training to community health workers, and they have begun to schedule these training sessions.

Conclusion: Our training shows that community health workers can gain knowledge through a structured training program.  Future studies include examining if this training translates into improved community care of sick children.

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