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Using problem-solving teams to improve compliance with IMCI guidelines in Kenya.

Tavrow P | Malianga L | Kariuki M
Organization: Quality Assurance Project/URC

Region and Country: Africa, Sub Saharan, Kenya


The Quality Assurance Project (QAP) tested whether facility-based teams, trained and coached to develop and implement improvements in providers' IMCI performance, achieved improvements in case management after one year. IMCI, the Integrated Management of Childhood Illness, is an algorithm that informs healthcare providers how to treat sick children under five. In this study, 21 facility-based improvement teams in two districts of Kenya received several days' training from coach-supervisors who themselves had received three weeks of training. IMCI case management performance by IMCI-trained providers was measured by direct observation in 14 control facilities (no improvement teams) and in the 21 facilities with teams. These measurements were taken both before the team training and about one year later. The nature of the improvement efforts made by the teams during the year was also assessed. The pooled proportion of critical IMCI case management tasks performed to standard increased 55% in the facilities with teams compared to an increase of only 14% in the control facilities, a significant difference. (author's)