1. IMCI Gap Design Software development
Improving the quality of IMCI services using e-health technology in Bangladesh: Developing the e-IMCI software through a participatory approach involving frontline health workers and health managers
Author: Ahmed Ehsanur Rahman and Shams El Arifeen
Introduction
Gaps and Challenges
IMCI
Global strategy developed WHO and UNICEF in 1990s
Lack of adherence of guidelines
Designed to address major causes of childhood deaths
Inadequate and inappropriate documentation
Step-by-step in history taking, clinical assessment, classification and treatment
Inadequate monitoring and supervision system
Objective
Develop e-IMCI software by digitizing IMCI guidelines through a participatory approach involving frontline health workers and health managers
Method and Design
Gap
Health Facility Assessment
Qualitative Exploration
Step1
Step-2
Step-3
Step-4
Manager: 5
IMCI supervisor: 10
IMCI service provider:28
12 facilities
417 IMCI service contacts: observation, re-examination
Identification
In-depth Interview
Consultative Workshop
Workshop-1: Policy Makers and Manager
Workshop-2: IMCI service providers
Share paper based system gaps
Identify expectations from e-IMCI and discuss design and options of e-IMCI
Design
Computer Programmer: 3
IMCI trained doctors: 3
Anthropologist: 1
e-IMCI demo testing: 100 rounds per classification
Software development
Android program
Team Composition
Validity Testing
Field testing
4 first level facility
6 IMCI service provider
1 month
432 sick children
Software finalization
Final version of the e-IMCI software was updated after addressing the key gaps and operational
e-IMCI is acceptable to the IMCI service providers, supervisors and managers
e-IMCI introduction in routine system in feasible
1-2 weeks of intensive support is required for new technology adoption
Additional support required for logistics and maintenance of tablets
Next step
e-IMCI is the process of national scale-up as a part of RHIS service automation
Results and Conclusion