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Am J Public Health. 2011 Dec;101(12):2333-41. doi: 10.2105/AJPH.2010.300068. Epub 2011 May 12.

Impact of a malaria-control project in Benin that included the integrated management of childhood illness strategy.

Author information

1
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. axr9@cdc.gov

Abstract

OBJECTIVES:

To estimate the impact of the Integrated Management of Childhood Illness (IMCI) strategy on early-childhood mortality, we evaluated a malaria-control project in Benin that implemented IMCI and promoted insecticide-treated nets (ITNs).

METHODS:

We conducted a before-and-after intervention study that included a nonrandomized comparison group. We used the preceding birth technique to measure early-childhood mortality (risk of dying before age 30 months), and we used health facility surveys and household surveys to measure process indicators.

RESULTS:

Most process indicators improved in the area covered by the intervention. Notably, because ITNs were also promoted in the comparison area children's ITN use increased by about 20 percentage points in both areas. Regarding early-childhood mortality, the trend from baseline (1999-2001) to follow-up (2002-2004) for the intervention area (13.0% decrease; P < .001) was 14.1% (P < .001) lower than was the trend for the comparison area (1.3% increase; P = .46).

CONCLUSIONS:

Mortality decreased in the intervention area after IMCI and ITN promotion. ITN use increased similarly in both study areas, so the mortality impact of ITNs in the 2 areas might have canceled each other out. Thus, the mortality reduction could have been primarily attributable to IMCI's effect on health care quality and care-seeking.

PMID:
21566036
PMCID:
PMC3222441
DOI:
10.2105/AJPH.2010.300068
[Indexed for MEDLINE]
Free PMC Article
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