Box 63.1Impact of IMCI on Mortality and Nutrition in Tanzania

Tanzania is the only MCE site where the evaluation has been completed. Its design included a comparison of mortality in four districts—two with and two without IMCI—over the two-year period starting in mid 2000. Demographic surveillance systems were used to compare under-five mortality rates in areas of the IMCI and control districts. Adjustments for age (zero to one and one to four years) and rainfall were made using Poisson regression models. During the IMCI phase-in period (July 1999 to June 2000), under-five mortality levels were almost identical in IMCI and comparison districts, at about 27 deaths per 1,000 child-years or approximately 120 deaths per 1,000 children between birth and the age of less than five years. The quality of health care provided in the IMCI districts was substantially higher than in the control districts (see box 63.2). Over the following two years, mortality levels became 13 percent lower in IMCI districts than in the comparison areas, corresponding to a rate difference of 3.8 fewer deaths per 1,000 children per year. Stunting rates also became significantly lower in the IMCI districts. Contextual factors, such as mosquito net use, all favored the comparison districts.

Source: Armstrong Schellenberg and others 2004.

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Box 63.2

Improving the Use of Antimicrobials through IMCI Case-Management: Findings from the MCE. Antimicrobial drugs, including antibiotics and antimalari-als, are an essential child survival intervention. Prompt and correct provision of drugs to children under (more...)

From: Chapter 63, Integrated Management of the Sick Child

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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