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首页> 外文期刊>Health policy and planning >Impact of IMCI health worker training on routinely collected child health indicators in Northeast Brazil.
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Impact of IMCI health worker training on routinely collected child health indicators in Northeast Brazil.

机译：IMCI卫生工作者培训对巴西东北部例行收集的儿童健康指标的影响。

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The Integrated Management of Childhood Illness (IMCI) is a global strategy including improvements in case management at health facilities, strengthening health systems support and improving key family and community practices relevant to child health. In Brazil, IMCI was introduced in 1997, being largely restricted to training health workers in case management. IMCI training of doctors and nurses took place in many municipalities, but implementation of the other two components of IMCI was very limited. We analyze the impact of IMCI health worker training on infant mortality in three states in north-eastern Brazil, by comparing three groups of municipalities over the period 1999 to 2002: 23 with training coverage of 50% or greater, 216 with lower training coverage, and 204 without any IMCI training. Two sources of mortality data are used: vital registration of deaths and births, and the community health workers' (CHW) demographic surveillance system. The latter resulted in a larger number of deaths beingreported and in more stable mortality rates over time than the former. Infant mortality rates (IMR) declined rapidly according to both sources of information, during the study period. After adjustment for confounding factors, there was no association between IMCI training coverage and infant mortality measured through either information system. According to the CHW data, the adjusted annual changes were of -7.2 deaths per 1,000 births in the high IMCI training coverage group, -4.6 in the low IMCI training coverage and -5.0 in the no IMCI group (p=0.46). According to vital statistics, the corresponding average annual changes were -5.0, -4.2 and -2.8 deaths per 1,000 births (p=0.16). The negative findings from the Brazil evaluation suggest that IMCI clinical training, in the absence of the other two components of IMCI, and in an area with infant mortality under 50 per 1,000, is unlikely to lead to a measurable impact on mortality.
机译：儿童疾病综合管理（IMCI）是一项全球战略，其中包括改善卫生设施的病例管理，加强卫生系统的支持以及改善与儿童健康有关的重要家庭和社区实践。在巴西，IMCI于1997年引入，在很大程度上仅限于培训卫生工作者的病例管理。在许多城市，对IMCI的医生和护士进行了培训，但是IMCI其他两个组成部分的实施非常有限。我们比较了巴西东北部三个州的IMCI卫生工作者培训对婴儿死亡率的影响，方法是将1999年至2002年的三组市政当局进行比较：23个培训覆盖率达到或超过50％; 216个培训覆盖率更低; 204没有经过IMCI培训。使用了两种死亡率数据来源：死亡和出生的重要记录，以及社区卫生工作者的人口统计学监测系统。与前者相比，后者导致了更多的死亡报告，并且随着时间的推移死亡率也更加稳定。在研究期间，根据两种信息来源，婴儿死亡率（IMR）迅速下降。调整混杂因素后，IMCI培训覆盖率与通过任一信息系统测得的婴儿死亡率之间均无关联。根据CHW数据，调整后的年度变化在高IMCI培训覆盖率组中为-7.2每1000例死亡，在低IMCI培训覆盖率组中为-4.6，在无IMCI培训覆盖率组中为-5.0（p = 0.46）。根据生命统计，相应的年平均变化为每千名婴儿中-5.0，-4.2和-2.8死亡（p = 0.16）。巴西评估的负面结果表明，在没有IMCI其他两个组成部分的情况下，以及在婴儿死亡率低于千分之50的地区，IMCI临床培训不太可能对死亡率产生可衡量的影响。

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