View clinical trials related to Childhood Illness.
Filter by:The proposed four-year randomized study will attempt to test the hypothesis that community-based child health interventions in conjunction with facility-based IMCI will improve child care practices, nutritional status and child survival. The objectives of this research are: 1. To measure the effectiveness of the community-based interventions in improving selected child care practices in the community. 2. To measure the effectiveness of the community-based interventions in improving child nutritional status and in reducing child morbidity and mortality. 3. To document the process of implementation of community-based interventions at scale to promote selected key family and community practices related to child health. 4. To undertake cost-effectiveness analysis of the interventions. Integrated Management of Childhood Illness (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF to reduce childhood mortality and morbidity and to contribute to improved growth and development of children under-5 years of age Experience suggests that a purely facility based strategy will not reach the significant portion of the population that does not have access to or choose not to use a health facility. Links between the service providers and families at household levels is essential in order to ensure that families have the knowledge, skills and ability to provide appropriate preventative and curative care to their children. However, globally, actual evidence of effectiveness of community-based IMCI interventions implemented at scale is meager. C-IMCI in Bangladesh will be implemented by GoB in partnership with NGOs and also through active participation of different community groups, civil societies, and the private sector. Both GoB and UNICEF/Bangladesh have agreed that an evaluation of the C-IMCI implementation by GoB, as proposed here, would be very opportune and useful in providing the evidence and analysis of lessons that will guide further scale-up in the country. A cluster-randomized design will be used for this evaluation. Fourteen Upazilas where facility-based IMCI is already in place will be selected, and 7 upazillas will be randomly allocated to C-IMCI intervention and 7 to comparison. Community-based IMCI in the intervention upazillas will be implemented by GoB through the district health system while in the comparison upazillas existing services will continue, including facility-based IMCI.
The long-term consequences of poverty on child health, including cognitive development, are one of the world's great tragedies. In the Philippines, diarrhea, acute lower respiratory infections, and the attendant problems of malnutrition, are the leading causes of childhood illness. The Philippine government plans to launch a broad national Health Sector Reform Agenda (HSRA) that will address the problems of poverty and illness in children. The introduction of these reforms provides an exceptional opportunity to conduct a social experiment. Four institutions, already involved in the design and implementation of the HSRA, plus leading experts in international health, government, and health measurement will collaborate on this project to collect longitudinal data and measure the impact of HSRA reforms on child health outcomes in a population. We will measure the health impacts of two experimental interventions: (1) expansion of health insurance coverage, and (2) capitation of providers. Our research will measure the impact of health reforms on the physical and cognitive health outcomes of children age 0-4. We will use a block design of 21 sites throughout the Philippines: seven for each of the two interventions, and seven matched controls. We will measure the quality of clinical practice using vignettes and will measure health outcomes using objective clinical tests. We will also use an advanced sampling strategy and panel data to link clinical practice with population health outcomes. This unparalleled research opportunity will yield significant insights about specific, unanswered questions of tremendous importance: Does health care serve as a social intervention that ameliorates the effects of morbidity and malnutrition on cognitive development? How effective are government policies at creating incentives to improve the quality of clinical practice? Do financial and organizational policies actually lead to better health and developmental outcomes? The results from this study will provide insights into the linkages between increased access, high quality care, and health outcomes in children.