Evaluation of distance learning IMCI training program: the case of Tanzania

Lulu M Muhe,Asia Hussein,Felixambrose Bundala,Mary Azayo,Nemes Iriya,Theopista John,Maryam Juma Bakari

doi:10.1186/s12913-018-3336-y

Abstract

BackgroundThe standard 11-days IMCI (Integrated Management of Childhood Illness) training course (standard IMCI) has faced barriers such as high cost to scale up. Distance learning IMCI training program was developed as an alternative to the standard IMCI course. This article presents the evaluation results of the implementation of distance learning IMCI training program in Tanzania.MethodsFrom December 2012 to end of June 2015, a total of 4806 health care providers (HCP) were trained on distance learning IMCI from 1427 health facilities {HF) in 68 districts in Tanzania. Clinical assessments were done at the end of each course and on follow up visits of health facilities 4 to 6 weeks after training. The results of those assessments are used to compare performance of health care providers trained in distance learning IMCI with those trained in the standard IMCI course. Statistical analysis is done by comparing proportions of those with appropriate performances using four WHO priority performance indicators as well as cost of conducting the courses. In addition, the perspectives of health care providers, IMCI course facilitators, policy makers and partners were gathered using either focussed group discussions or structured questionnaires.ResultsDistance learning IMCI allowed clusters of training courses to take place in parallel, allowing rapid expansion of IMCI coverage. Health care providers trained in distance learning IMCI performed equally well as those trained in the standard IMCI course in assessing Main Symptoms, treating sick children and counselling caretakers appropriately. They performed better in assessing Danger Signs. Distance learning IMCI gave a 70% reduction in cost of conducting the training courses.ConclusionDistance learning IMCI is an alternative to scaling up IMCI as it provides an effective option with significant cost reduction in conducting training courses.

Highlights

The standard 11-days IMCI (Integrated Management of Childhood Illness) training course has faced barriers such as high cost to scale up
health care providers (HCP) from the same clinic were able to attend the training on different days, ensuring that the clinic remained staffed while all providers had a chance to receive training on different days of the same week
The comparison group we used i.e. HCP who got trained in the standard IMCI within 1–2 years period were relatively small numbers and this has probably resulted in the wide confidence intervals we showed in the results section

Summary

Introduction

The standard 11-days IMCI (Integrated Management of Childhood Illness) training course (standard IMCI) has faced barriers such as high cost to scale up. Distance learning IMCI training program was developed as an alternative to the standard IMCI course. This article presents the evaluation results of the implementation of distance learning IMCI training program in Tanzania. In the area of health, training evaluation is a systematic collection of data evaluating the performance of health care providers (HCP) in assessing and treating patients. In this article we describe the evaluation of a distance learning program on child health, IMCI is a holistic training package focussing on the main killers of under-five children. It was developed in the 1990’s by the World Health Organization (WHO). IMCI is part of the national child strategy in 90 of the 97 low and middle income countries and is the primary strategy for child health according to WHO [5]

Methods

Results

Discussion

Conclusion