title: Effect of performance review and clinical mentoring meetings (PRCMM) on recording of community case management by health extension workers in Ethiopia.
abstract: BACKGROUND
  The Performance Review and Clinical Mentoring Meeting (PRCMM) is an approach to improve and sustain Health Extension Worker (HEW) skills and performance in integrated Community Case Management (iCCM).
  
  
  OBJECTIVE
  To compare HEW performance in recording case management before and after they participated in PRCMM.
  
  
  METHODS
  We conducted a historical cohort analysis of iCCM case records between September 2010 and December 2012 from 622 randomly selected health posts representing 31 intervention woredas (districts) of Amhara, Oromia and Southern Nations Nationalities and Peoples' Regions. We used longitudinal regression analysis comparing the trend in the consistency of the classification with the assessment, treatment and follow-up date as well as caseload in the periods before and after PRCMM, with 5511 and 7901 case records, respectively.
  
  
  RESULTS
  Overall consistency improved after PRCMM for all common classifications as follows: pneumonia (54.1% [95% CI: 47.7%-60.5%] vs. 78.2% [73.9%-82.5%]), malaria (50.8% [42.9%-58.7%] vs. 78.9% [73.4%- 84.4%]), and diarrhea (33.7% [27.9%-39.5%] vs. 70.0% [64.7%-75.3%]). This improvement was consistently observed comparing the six months before and the six months after PRCMM in all the common classifications except for malaria where the improvement observed during the first three post-PRCMM months disappeared during the fifth and sixth months. Caseload increased significantly after PRCMM (6.6 [95% CI: 5.9-7.3] vs. 9.2 [8.5-9.9] cases/health post/month).
  
  
  CONCLUSIONS
  PRCMM seemed to improve iCCM performance of HEWs and should be integrated within the PHC system and given about every six months, at least at first, to sustain improvement.
authors.forename: Birkety
authors.initials: B
authors.lastname: Mengistu
authors.forename: Ali Mehyar
authors.initials: AM
authors.lastname: Karim
authors.forename: Andargachew
authors.initials: A
authors.lastname: Eniyew
authors.forename: Abraham
authors.initials: A
authors.lastname: Yitabrek
authors.forename: Antenane
authors.initials: A
authors.lastname: Eniyew
authors.forename: Sentayehu
authors.initials: S
authors.lastname: Tsegaye
authors.forename: Fekadu
authors.initials: F
authors.lastname: Muluye
authors.forename: Hailu
authors.initials: H
authors.lastname: Tesfaye
authors.forename: Berhanu
authors.initials: B
authors.lastname: Demeke
authors.forename: David R
authors.initials: DR
authors.lastname: Marsh
mesh_terms: D019090:Case Management; D002662:Child Health Services; D002675:Child, Preschool; D002983:Clinical Competence; D003153:Community Health Services; D003150:Community Health Workers / Q000193:education*; D004282:Documentation / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008611:Mentors