# The Impact of integrated management of childhood illness training on knowledge levels of healthcare workers in Botswana

## TL;DR

This study examined whether IMCI training improved healthcare workers' knowledge in Botswana but found no significant difference between trained and untrained workers.

## Contribution

The study provides new empirical evidence on the effectiveness of IMCI training in Botswana, suggesting it may not significantly improve knowledge levels.

## Key findings

- IMCI-trained healthcare workers showed similar knowledge levels to non-trained workers.
- A majority of untrained workers had poor knowledge performance (69.4%).
- The study found no statistically significant difference in knowledge levels between trained and untrained groups (p = 0.092).

## Abstract

The Integrated Management of Childhood Illness (IMCI) strategy was developed to improve outcomes through integration of preventive and curative interventions in countries with high mortality. This study aimed to assess the impact of IMCI training on the knowledge levels of healthcare workers (HCWs) in Botswana, comparing the trained with the non-trained. This was a cross-sectional study from a national IMCI survey across all 27-health districts of Botswana in September 2023. Within each district, random sampling was used to select 10 healthcare facilities (HCFs) to be included in the survey. HCFs were ordered by their size to ensure that all types were represented. The demographics, training and qualifications of the HCWs were documented. Stata 13.1 software was used for analysis, and data was summarized with frequencies and percentages. Pearson’s chi square test was used to compare the performances of IMCI trained versus non-IMCI trained HCWs. A p-value of <0.05 was considered statistically significant. A total of 964 HCWs participated in the survey. The most frequent cadre was General Nurse with 385 (40.7%) participants. Participants trained in IMCI were 471 (49.2%) and those who consult sick children were 615 (65.1%). Those who were IMCI trained had good (80–100%) and moderate (60–79%) knowledge levels at 51 (14.1%) and 91 (25.2%) participants respectively than those who had no IMCI training at 25 (9.9%) for good and 52 (20.6%) for moderate performances. HCWs who were not IMCI trained had poor performance (0-59%) at 175 (69.4%) participants while the IMCI trained had poor performance at 219 (60.7%). The performances showed no statistically significant difference (p = 0.092), reflective of similar knowledge levels. Overall, the performance of IMCI trained HCWs was not significantly different from those not IMCI trained, translating to that IMCI training does not have effect on knowledge levels of HCWs in management of childhood illness. This, however, should be interpreted with caution since it could be due to the stated study limitations. A future IMCI study on knowledge, attitudes and practices (KAP) or a longitudinal study would be more beneficial.