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CITATION: Presented at the International Conference on Improving Use of - page 40 / 51

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Improving Primary Care Pharmaceutical Use

Jintaganont

(1988)

Asia

PP&C

CHWs (& community)

8 village clusters (2 clusters from each of 4 districts, 1 E, 1 C)

Diarrhea

2-day small group training of CHWs followed by community sensitization meetings

% visited by CHW for ORT promotion

% mothers received ORS from CHW

% mothers w/ knowledge of ORS

ΔE = 2.5%63.1% = +60.6%

ΔC = 0.6%5.0% = +4.4%

ΔE = 7.1%.69.8% = +62.7%

ΔC = 1.8%6.5% = +4.7%

ΔE = 49.8%94.3% = +44.5%

ΔC = 45.4%64.2% = +18.8%

Khan

(1990)

Asia

PP&C

CHWs

38 villages (31 E1; 7 C which cross over in year 2 as E2)

ARI

ARI case mgmt program (recruit and train CHWs, biweekly CHW HH visits, home Tx, referral)

ARI <5 mortality rate (/1000)

ΔE1 = 8.64.0 = -53.5%

ΔC = 14.414.5 = +1.5%

ΔE2 = 14.56.5 = -55.2%

Lucero

(1994)

Asia

TS

CHWs MDs, parameds

8 municipalities (4 E; 4 C)

ARI

3 bi-annual ARI case mgmt training workshops, plus community ed through CHWs

All cause <5 mortality rate (/1000 person-yr)

ΔE = 18.59.5 = -48.6%

ΔC = 16.512.5 = -24.2%

McCord

(1978)

Asia

TS-C

(repeat meas.)

CHWs

13 villages with ~1400 children <3 yr

Diarrhea, ARI

Training of CHWs in workshop and on-site in STGs for ARI & diarrhea, then village conference

Diarrhea + ARI-specific <3 mortality rate (/1000)

Case fatality for diarrhea

Case fatality for ARI

Δ = 21.811.7 = -46.3%

Δ = 3.21.4 = -56.3%

Δ = 10522 = -79%

Miller

(1995)

Africa

TS-C

Community

civil registration data; national demographic surveys

Diarrhea

Egypt National CDD program (intensive implementation phase >82-=86: ORS supply, pre-service & in-service training, public education

Infant mortality (/1000 registered births)

Δpre (>77-=83) = -3.3/year

Δpost (>82-=87) = -4.1/year

Additional  reduction = 24.2%

Mtango

(1986)

Africa

RCT

CHWs, parameds

72 villages (36 EI; 36 C which cross over as E2)

ARI

ARI case mgmt program (train CHWs, HH visits each 6-8 wk, home Tx, referral, training for HC staff)

Pneumonia <5 mortality rate (/1000)

E1 post = 32.429.2

C/E2 post = 40.35.0 = -12.8%

-38-

Improving Primary Care Pharmaceutical UseApril, 1997

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