Integrated management of childhood illness: field test of the WHO/UNICEF training course in Arusha, United Republic of Tanzania

The 11-day training course on Integrated management of childhood illness was field tested with three types of first-level facility health workers: medical assistants, rural medical aides, and MCH (maternal and child health) aides. The objective of the field test was to determine whether the materials were effective in preparing participants to manage correctly sick children and to suggest improvements in the course materials and teaching procedures. The course combined classroom work and daily inpatient and outpatient clinical sessions. Each participant individually examined 9-10 inpatients and managed more than 30 sick children as outpatients. Individual feedback from facilitators during clinical practice and module work, combined with data collection documenting the adequacy of the assessment, classification, treatment and counselling carried out by the participants, allowed an assessment of the participants' mastery of key clinical skills. Although some participants had difficulty in reading the modules in English, all three groups overall were able to assess, classify, and treat most sick children by the end of the course, and most of them were able to provide adequate counselling. Specific improvements were suggested and subsequently incorporated into the guidelines and training materials.