title: Adopting integrated management of childhood illness module at local level in Bangladesh: implications for recurrent costs.
abstract: This study estimated the recurrent cost implications of adopting Integrated Management of Childhood Illness (IMCI) at the first-level healthcare facilities in Bangladesh. Data on illnesses of children who sought care either from community health workers (CHWs) or from paramedics over a four-month period were collected in a rural community. A total of 5,505 children sought care. About 75% of symptoms mentioned by mothers were directly related to illnesses that are targeted in the IMCI. Cough and fever represented 64% of all reported complaints. Referral of patients to higher facilities varied from 3% for the paramedics to 77% for the CHWs. Had the IMCI module been followed, proportion of children needing referral should have been around 8%. Significant differences were observed between IMCI-recommended drug treatment and current practice followed by the paramedics. Adoption of IMCI should save about US$ 7 million on drugs alone for the whole country. Proper implementation of IMCI will require employment of additional health workers that will cost about US$ 2.7 million. If the current level of healthcare use is assumed, introduction of IMCI in Bangladesh will save over US$ 4 million.
authors.affiliation: Tulane University, School of Public Health and Tropical Medicine, New Orleans, LA, USA. khan@tulane.edu
authors.forename: M Mahmud
authors.initials: MM
authors.lastname: Khan
authors.forename: Kuntal Kumar
authors.initials: KK
authors.lastname: Saha
authors.forename: Shakil
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D001459:Bangladesh; D002662:Child Health Services / Q000191:economics*; D002669:Child Welfare / Q000191:economics*; D002675:Child, Preschool; D017046:Cost Savings; D003365:Costs and Cost Analysis; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011306:Prescription Fees; D011446:Prospective Studies; D011795:Surveys and Questionnaires