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Health Policy and Planning 2005 20(Suppl. 1):i58-i68; doi:10.1093/heapol/czi051
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© The Author 2005, Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved.

Supplement Article

Improving facility-based care for sick children in Uganda: training is not enough

George W Pariyo1, Eleanor Gouws2, Jennifer Bryce3, Gilbert Burnham4 and The Uganda IMCI Impact Study Team*

1 Department of Health Policy Planning and Management, Makerere University Institute of Public Health, Kampala, Uganda, 2 Division of Child and Adolescent Health, World Health Organization, Geneva, Switzerland, 3 WHO Consultant, 2081 Danby Road, Ithaca, NY, USA and 4 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

Correspondence: Eleanor Gouws, UNAIDS, 20 Avenue Appia, 1211 Geneva, Switzerland. Tel: +41-22–791 4237; Fax: +41-22–791 4746; E-mail: gouwse{at}unaids.org

This study assessed the effects of scaling-up Integrated Management of Childhood Illness (IMCI) on the quality of care received by sick children in 10 districts in Uganda. Health workers trained in IMCI were found to deliver significantly better care than health workers who had not yet been trained, but absolute levels of service quality remained low. Achieving training coverage alone is not sufficient as a strategy to improve and sustain care quality. Other factors including training quality, effective supervision, availability of essential drugs, vaccines and equipment, and the policy context are also important and must be included in child survival policies and plans.

Key Words: IMCI, child health, quality care, health facility, Uganda

Additional members of the Uganda IMCI Impact Study team:

Black RE, Galiwango E, Wabwire-Mangen F, Ntalo R, Alobo N, Ibanda S, Kisalu A, Nabiwemba E, Okia M.


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