title: Impact of a malaria-control project in Benin that included the integrated management of childhood illness strategy.
abstract: OBJECTIVE
  To estimate the impact of the Integrated Management of Childhood Illness (IMCI) strategy on early-childhood mortality, we evaluated a malaria-control project in Benin that implemented IMCI and promoted insecticide-treated nets (ITNs).
  
  
  METHODS
  We conducted a before-and-after intervention study that included a nonrandomized comparison group. We used the preceding birth technique to measure early-childhood mortality (risk of dying before age 30 months), and we used health facility surveys and household surveys to measure process indicators.
  
  
  RESULTS
  Most process indicators improved in the area covered by the intervention. Notably, because ITNs were also promoted in the comparison area children's ITN use increased by about 20 percentage points in both areas. Regarding early-childhood mortality, the trend from baseline (1999-2001) to follow-up (2002-2004) for the intervention area (13.0% decrease; P < .001) was 14.1% (P < .001) lower than was the trend for the comparison area (1.3% increase; P = .46).
  
  
  CONCLUSIONS
  Mortality decreased in the intervention area after IMCI and ITN promotion. ITN use increased similarly in both study areas, so the mortality impact of ITNs in the 2 areas might have canceled each other out. Thus, the mortality reduction could have been primarily attributable to IMCI's effect on health care quality and care-seeking.
authors.affiliation: Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. axr9@cdc.gov
authors.forename: Alexander K
authors.initials: AK
authors.lastname: Rowe
authors.forename: Faustin
authors.initials: F
authors.lastname: Onikpo
authors.forename: Marcel
authors.initials: M
authors.lastname: Lama
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Osterholt
authors.forename: Michael S
authors.initials: MS
authors.lastname: Deming
mesh_terms: D001541:Benin / Q000453:epidemiology; D019090:Case Management; D002662:Child Health Services / Q000191:economics / Q000458:organization & administration*; D046688:Child Mortality; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057148:Insecticide-Treated Bednets; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D011787:Quality of Health Care