5198.0: Wednesday, November 15, 2000 - 2:30 PM

Abstract #12871

Cost-effectiveness of standard vs. computer-based training in the integrated management of childhood illness (IMCI) algorithm in Uganda

Paula Tavrow, PhD1, A Kekitiinwa, MD2, A Maganda2, A Sebina-Zziwa2, G Ndeezi1, and S Blumenfeld, MD1. (1) Operations Research, Quality Assurance Project, 7200 Wisconsin Avenue, Suite 600, Bethesda, MD 20814-4811, 301 941-8452, ptavrow@urc-chs.com, (2) Makerere University, Uganda

The Quality Assurance Project (QAP) and Makerere University in Uganda conducted an operations research study to test the cost-effectiveness of computer-based training (CBT) versus standard training in IMCI. Standard IMCI training, developed by WHO, is an 11-day course in that requires 6 facilitators for 20 participants. The course costs about $500 per participant. The costs are a burden on countries interested in introducing IMCI on a national scale. Moreover, studies have shown a decline in knowledge and technical performance after the training, even though participants had a high level of skill and knowledge at the completion of training. QAP designed a CBT in IMCI as a potentially cost-effective alternative to the classroom component of standard training.

Three rounds of training were set up in which Ugandan health providers were randomized into either the standard or the IMCI course. Knowledge (20-question multiple choice written examination) and performance measures (observation done by expert clinicians) were developed to be used at the end of training, two weeks after training, and 3 months after training.

Findings from the study indicate that there is no difference in participants' knowledge or skills by type of course and there is no difference in participants' retention over time. All cadres of health workers, many of whom had no previous experience with computers, were able to use the computers effectively to learn the material. They also enjoyed spending time on the computers. Using the CBT course leads to a savings of approximately 25-28% (not including the hardware costs).

Learning Objectives: 1.Understand main components of and issues concerning IMCI in-service training in a developing country 2.Recognize the relative advantages of computer-assisted training in IMCI

Keywords: Training, Child Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Quality Assurance Project (QAP)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment

The 128th Annual Meeting of APHA