Study of Post-Training Supports for Health Workers in Benin

Centers for Disease Control and Prevention1,577 enrolled

Overview

The objective of this study was to determine the effectiveness and cost-effectiveness of a package of interventions to support health workers in Benin (in West Africa) who had been trained to use Integrated Management of Childhood Illness guidelines (i.e., guidelines intended to improve the treatment of childhood illnesses).

Integrated Management of Childhood Illness (IMCI) is a child health strategy in developing countries with a goal of improving the treatment of illnesses at first-level health facilities through the use of clinical practice guidelines. The World Health Organization (WHO) recommends implementing the guidelines with an 11-day training course. There is a concern that health workers might not master all aspects of the guidelines and that health worker performance may deteriorate over time. In 1999, Benin (in West Africa) was planning to implement IMCI. In response to concerns about how well health workers would follow IMCI guidelines, interventions were designed to support health workers after IMCI training: 1) regular supervision of health workers; 2) supervision of supervisors; 3) job aids; and 4) non-financial incentives for health workers. These interventions were intended to be used together. The objective of this study was to determine the effectiveness and cost-effectiveness of the package of interventions to support IMCI-trained health workers in Benin.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

1,577

Conditions

Malaria Pneumonia Diarrhea Measles Malnutrition

Interventions

Health worker supports (supervision, job aids, incentives)BEHAVIORAL

Eligibility

Sex: ALLMin age: 1 WeekMax age: 59 Months

Medical Language ↔ Plain English

Inclusion Criteria: * Inclusion criteria for health facilities were: 1) public and licensed private health facilities providing outpatient services, and 2) the level of care was appropriate for use of Integrated Management of Childhood Illness (IMCI) guidelines. * Inclusion criteria for consultations were children 1 week - 59 months old seen for any illness during regular working hours (typically 8am-6pm) on weekdays. Exclusion Criteria: * Health facilities in which the level of care was not appropriate for use of Integrated Management of Childhood Illness (IMCI) guidelines(i.e., one referral hospital and one sub-specialty hospital).

Locations (1)

All eligible health facilities

Entire Department of Oueme and Plateau, Oueme and Plateau, Benin

Outcomes

Primary Outcomes

Proportion of children with potentially life-threatening illnesses who received recommended treatment, according to Integrated Management of Childhood Illness guidelines.

Time frame: 3 years

Proportion of children with potentially life-threatening illnesses who received recommended treatment, according to Integrated Management of Childhood Illness guidelines, or adequate treatment.

Time frame: 3 years

Mean proportion of needed case management tasks that were performed during consultations.

Time frame: 3 years

Secondary Outcomes

Proportion of children with pneumonia who received recommended treatment, according to Integrated Management of Childhood Illness guidelines.

Time frame: 3 years

Proportion of children with malaria who received recommended treatment, according to Integrated Management of Childhood Illness guidelines.

Time frame: 3 years

Data from ClinicalTrials.gov

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