Abstract
The Integrated Management of Childhood Illness is a strategy designed to address major causes of child mortality. The aim of this study was to assess the impact of the strategy on the quality of child health care provided at primary facilities. Child health quality of care and costs were compared in four states in Northeastern Brazil, in 2001. There were studied 48 health facilities considered to have had stable strategy implementation at least two years before the start of study, with 48 matched comparison facilities in the same states. A single measure of correct management of sick children was used to assess care provided to all sick children. Costs included all resources at the national, state, local and facility levels associated with child health care. Facilities providing strategy-based care had significantly better management of sick children at no additional cost to municipalities relative to the comparison municipalities. At strategy facilities 72% of children were correctly managed compared with 56% in comparison facilities (p=0.001). The cost per child managed correctly was US$13.20 versus US$21.05 in the strategy and comparison municipalities, respectively, after standardization for population size. The strategy improves the efficiency of primary facilities in Northeastern Brazil. It leads to better health outcomes at no extra cost.
Highlights
In September 2005, five years after signing the United Nations Millennium Declaration, heads of states reunited to review progress towards achieving the Millennium Development Goals (MDGs)
The strategy improves the efficiency of primary facilities in Northeastern Brazil
Three of the eight MDGs are exclusive to health, one of which is entirely focused on child survival, with the aim of eliminating two thirds of child mortality by 2015.14 Except for very few notable examples, progress towards the child survival MDG has generally been disappointing, especially in sub-Saharan Africa.[14]
Summary
In September 2005, five years after signing the United Nations Millennium Declaration, heads of states reunited to review progress towards achieving the Millennium Development Goals (MDGs). Three of the eight MDGs are exclusive to health, one of which is entirely focused on child survival, with the aim of eliminating two thirds of child mortality by 2015.14 Except for very few notable examples, progress towards the child survival MDG has generally been disappointing, especially in sub-Saharan Africa.[14] Many factors have contributed to this, but a common factor to all countries was lack of resources. In most settings there is a potential for achieving more with the available resources, by reducing waste and by changing the mix of activities being undertaken. Factors other than efficiency influence the mix of health activities chosen, including patient preferences and equity considerations. Without information on costs and health impact of alternative strategies to reduce child mortality, policymakers operate in an information vacuum and are unable to determine whether they are advancing as rapidly as possible towards their objectives
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
