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Revista chilena de pediatría

versión impresa ISSN 0370-4106


ZAMORA G, Adalid D.; CORDERO V., Dilberth  y  MEJIA S., Martha. Evaluation of the strategy "Integrated Management of Childhood Illiness"(IMCI) In Health Services, Bolivia 1999. Rev. chil. pediatr. [online]. 2002, vol.73, n.2, pp.184-191. ISSN 0370-4106.

The implementation of the IMCI strategy in Bolivia started at the end of the year 1996; in this process trained and visits of monitoring were carried out to health workers of three districts, considered as initials. The present article presents the results of the application of an assessment methodology to measure the impact of the training and monitoring of IMCI, recommended by the World Health Organization (WHO), which becomes the first world test. The objectives this IMCI evaluation were: know the quality of care to the child under 5, availability of drugs, and equipment for integrated care in first level health services of three districts. Identify the barriers that impede the integrated care. Validate the proposed methodology by WHO. The evaluation was done in April 1999, in three rural districts (Altiplano Sur in La Paz, Valles Cruceños and Chiquitania Centro in Santa Cruz). The teams of evaluators observed the case management, carry out and exit interview to the mother, re-examined the child and reviewed the equipment and provision of drugs. 36 health services were included selected randomly, there was observed 54 health workers that looked 102 children. The results showed that the clinical abilities have improved clearly, in comparison with the baseline of the year 1997. There was a reduction in the unnecesasary use of antibiotics. The weaknesses were related to the identification and behavior toward the classification of "anemia" and with counseling aspects, to the mother. Problems were identified with the availability of drugs and in-service vaccination. After the analysis of the collected data "workshops to workers proposed recommendations aimed to improving the application of IMCI in its services. Finally recommendations on the methodology of evaluation were made

Palabras clave : IMCI; integrated child care; health facilities assessment.

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