Integrated Management of Childhood Illness (IMCI) in Bangladesh: early findings from a cluster-randomised study

Background We report the preliminary findings from a continuing cluster randomised evaluation of the Integrated Management of Childhood Illness (IMCI) strategy in Bangladesh. Methods 20 first-level outpatient facilities in the Matlab sub-district and their catchment areas were randomised to either IMCI or standard care. Surveys were done in households and in health facilities at baseline and were repeated about 2 years after implementation. Data on use of health facilities were recorded. IMCI implementation included health worker training, health systems support, and community level activities guided by formative research. Findings 94% of health workers in the intervention facilities were trained in IMCI. Health systems supports were generally available, but implementation of the community activities was slow. The mean index of correct…