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IMCI Tanzania
An estimated 10 million children die each year from preventable or treatable causes. Most could be saved by the correct application of simple standards of care such as the Integrated Management of Childhood Illness (IMCI) protocols for classifying and treating common causes of death including pneumonia, diarrhoea, malaria, measles, and malnutrition. However, despite a worldwide effort, the use of IMCI protocols remains limited due to the expense of training, the lack of sufficient supportive supervision, and the tendency to follow protocols less rigorously over time. Further, the difficulty of updating protocols has contributed to the use of treatments for malaria and other diseases long past the point where they are no longer effective. (see our work on malaria) Vastly more effort has gone into developing standardized treatments than developing innovative and effective methods to deploy them.
 D-tree International has been working in the area of child health to improve the flexibility and use of IMCI protocols through the development of an electronic version of IMCI (eIMCI) for use on cell phones and other mobile devices. We have piloted e-IMCI in rural Tanzania where our initial results indicate that clinicians more closely adhere to the IMCI protocol when using e-IMCI than without it and were enthusiastic about its use with patients. The software we have developed runs on a mobile phone and guides health workers step-by-step through the full IMCI assessment, classification and treatment plan. The software was designed for ease of use and the training of clinicians took less than 1 hour in all cases. This work was supported by generous grants from the World Health Organization, the Rockefeller Foundation and the US National Institutes of Health.
We have recently completed a large scale study to validate the initial findings that e-IMCI leads to improved adherence to the IMCI protocols compared to the conventional use of IMCI. We are currently running another study to show that e-IMCI can be used to improve the communication between health worker and child caretaker about how to treat the child and watch for danger signs. Another third piece of the evaluation is looking at the cost and cost-effectiveness of e-IMCI compared to the conventional paper based IMCI. These studies have been conducted in Tanzania in collaboration with the Ifakara Health Research and Development Centre between 2008 and present.
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