Improving the quality of medical consultation for children in rural clinics
Main beneficiary countries:Burkina Faso - Mali
Terre des hommes, Lausanne
Largest Swiss Children's Aid Organization, Terre des hommes Lausanne improves the health and protection of some two million children and their families every year in 30 countries.
Sector: Organizational: Communities, public authorities, NGOs, associations, foundations, etc.
Country of origin: Switzerland
Healthcare themes targeted
Stage of development:
Area where initiative is utilised
Initiative start date
Initiative end date
Financing method
Economic model(s)
Nearly 1 in 10 children dies before the age of five in Burkina Faso, mostly from preventable and/or treatable conditions such as malaria, pneumonia, diarrhea and malnutrition. Indeed, despite having life-saving commodities for these diseases (antibiotics, oral rehydration salts, zinc, antimalarials, etc.), the low quality of care results in many children not receiving the treatment they need. In order to improve the diagnosis and treatment of sick children, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) developed the Integrated Management of Childhood Illness (IMCI) strategy, which provides an evidence-based protocol to guide healthcare workers through the management of sick children under five. However, despite significant investments by governments and donors, the correct use of IMCI is still very low. In the case of Burkina Faso, for example, a report by the Ministry of Health showed that only 10% of healthcare workers used the IMCI paper forms, resulting in only 15.4% of children correctly diagnosed. Healthcare workers find the current paper-based job aid to support IMCI implementation cumbersome and time consuming. As a result, healthcare workers end up simplifying the protocol (or not using it at all) and fail to correctly manage and treat sick children. This situation is exacerbated by the low levels of skilled health workers (most are not medical doctors, nor nurses), the physical isolation of health facilities (most of them in rural areas with poor road access and electric supply), poor supervision, poor quality of patient records and the subsequent absence of accountability, performance management and continuous medical education. The low adherence of healthcare workers to IMCI drives low quality of childcare and undermines the reduction of child mortality through healthcare services.
IeDA does not only improve the recording of data but also the quality of the medical consultation and the prescription, and does so in the peripheral health centers the least equipped but the most frequented of the health system. In addition to offering a digitized patient record and an a diagnosis aid, IeDA has the specificity to make possible to close the information loop by enabling district management teams to identify the profile of consultations conducted in each health center and by each agent, spot outliers and conduct targeted supervisions on centers the most likely to commit misdiagnosis or enter wrong information. Thus IeDA offer the opportunity to the health worker of an individualized and remote support, over time.
IeDA was developed in 2013 with the Ministry of Health of Burkina Faso to significantly improve the performance of primary healthcare workers in using national guidelines for the management of sick children. IeDA provides a complete solution for delivering quality care to under-fives, supporting healthcare workers through a digital job aid (on a tablet device), providing performance data to facility and district managers for management purposes, supporting coaching and quality improvement at the facility level and allowing continuous training of healthcare workers. In addition, IeDA is integrated with DHIS2, the health management information system deployed in Burkina Faso by the Ministry of Health (MoH), and sends regular data to that system. IeDA improved quality of care at the primary healthcare facility, as well as supervision and decision making at district and central levels through the four components described below:
To date, IeDA has been deployed in 640 clinics (including 40 in Mali) and supported nearly 3,000 healthcare workers to deliver over 1.5 million consultations to children under five. The approach is used in over 80% of consultations performed in the 640 facilities, and interim results from the evaluation study (by the London School of Hygiene and Tropical Medicine) show an improvement of healthcare workers’ performance, high acceptability by healthcare workers and district managers.
Health professional training - Telemedicine (remote diagnosis and consultations) - Information, education and communication for behaviour change (IEC) - Patient monitoring and medical data
2000000 Number of beneficiaries since launch
200000 Number of users per Month
Yes
Yes
No
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evaluated independently
Industrial: Startups, enterprises, etc.
Academic entities: Universities, research laboratories, etc.
Academic entities: Universities, research laboratories, etc.
Academic entities: Universities, research laboratories, etc.
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