BACKGROUND
The Integrated Management of Childhood Illness (IMCI) faces challenges like high training costs and limited literacy among community health workers (CHWs), resulting in low adherence. Electronic IMCI (eIMCI) platforms with training modules may address these limitations but require further evaluation.
OBJECTIVE
This study aims to evaluate an eIMCI platform for training support and disease management in rural China.
METHODS
A cluster randomized controlled trial was conducted in western China. 24 CHWs and 72 children aged 2-5 years treated by them (3 per CHW) were randomized into intervention and control groups. The intervention group received online training and used the eIMCI platform for disease management. The control group received traditional in-person training and paper-based IMCI. The primary outcome was the proportion of children correctly diagnosed/classified by the CHWs as deemed by a pediatric specialist. Poisson regression with Generalized Linear Models estimated the relative risk (RR) between groups, adjusting for CHW clustering, CHW variables (age, sex, education), and patient variables (age, sex, disease number).
RESULTS
13 CHWs treated 39 children in the intervention group, and 11 CHWs treated 33 children in the control group. Correct classification was significantly higher in the intervention versus control group (64.1% vs 39.4%, P=.036). Multivariable regression confirmed this improvement (RR=2.10, 95% CI: 1.45-3.06; P<.001). Correct treatment increased non-significantly (38.5% vs 27.3%, P=.316). Online training reduced time and costs by ~80% but with a minor decline in post-training scores.
CONCLUSIONS
With substantially lower training burden, the eIMCI platform demonstrated potential to improve IMCI in rural China.
CLINICALTRIAL
Chinese Clinical Trial Registry: ChiCTR2100042533 (https://www.chictr.org.cn/showproj.html?proj=119995)