Community-Integrated Management of Childhood Illness (IMCI) Programme Evaluation

Summary

The proposed four-year randomized study will attempt to test the hypothesis that community-based child health interventions in conjunction with facility-based IMCI will improve child care practices, nutritional status and child survival. The objectives of this research are:

1. To measure the effectiveness of the community-based interventions in improving selected child care practices in the community.
2. To measure the effectiveness of the community-based interventions in improving child nutritional status and in reducing child morbidity and mortality.
3. To document the process of implementation of community-based interventions at scale to promote selected key family and community practices related to child health.
4. To undertake cost-effectiveness analysis of the interventions.

Integrated Management of Childhood Illness (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF to reduce childhood mortality and morbidity and to contribute to improved growth and development of children under-5 years of age Experience suggests that a purely facility based strategy will not reach the significant portion of the population that does not have access to or choose not to use a health facility. Links between the service providers and families at household levels is essential in order to ensure that families have the knowledge, skills and ability to provide appropriate preventative and curative care to their children. However, globally, actual evidence of effectiveness of community-based IMCI interventions implemented at scale is meager.

C-IMCI in Bangladesh will be implemented by GoB in partnership with NGOs and also through active participation of different community groups, civil societies, and the private sector.

Both GoB and UNICEF/Bangladesh have agreed that an evaluation of the C-IMCI implementation by GoB, as proposed here, would be very opportune and useful in providing the evidence and analysis of lessons that will guide further scale-up in the country.

A cluster-randomized design will be used for this evaluation. Fourteen Upazilas where facility-based IMCI is already in place will be selected, and 7 upazillas will be randomly allocated to C-IMCI intervention and 7 to comparison. Community-based IMCI in the intervention upazillas will be implemented by GoB through the district health system while in the comparison upazillas existing services will continue, including facility-based IMCI.

Conditions

• Childhood Illness

Interventions

OTHER

Community-based interventions to promote maternal and child health

Promotion of antenatal and postnatal care and safe delivery Essential Newborn care Community case management, and feeding for children.

Sponsors & Collaborators

• Directorate General for Health Services, Ministry of Health, Bangladesh

  collaborator UNKNOWN

• Johns Hopkins Bloomberg School of Public Health

  collaborator OTHER

• World Health Organization

  collaborator OTHER

• UNICEF

  collaborator OTHER

• International Centre for Diarrhoeal Disease Research, Bangladesh

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Max Age

49 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2009-07-31

Primary Completion

2013-12-31

Completion

2013-12-31

Countries

• Bangladesh

Study Locations