Article Text
Abstract
Objectives To evaluate a primary child eye care training module for use in the WHO/UNICEF Integrated Management of Newborn and Childhood Illness (IMNCI) programme by primary healthcare workers.
Design Pre-training and post-training study.
Setting Primary healthcare facilities in a semirural district, central Tanzania.
Participants 54 primary healthcare workers selected by the Ministry of Health were trained during routine IMNCI training. All these healthcare workers were assessed pre-intervention and post-intervention. A subgroup of 40 were also assessed 6 months after the completion of training.
Intervention Training in an IMNCI eye module, developed for child primary healthcare workers with the Tanzania Ministry of Health and eye care experts.
Main outcome measures Knowledge, skills and attitudes were assessed using multiple choice questions, case studies and a self-assessment of skills using a Likert scale before and immediately after training, and 6 months later. A total score was derived. At 6 months, attitudes were assessed in semistructured interviews.
Results 69% PHWs trained were nurses. The baseline (before training) score was 29.9 (95% CI 27.5 to 32.4) and increased by 11.2 points (95% CI 8.3 to 14) immediately after training, and by 12.4 points (95% CI 9.2 to 15.6) at 6 months post the training. Therefore, the post-training scores increased and there was no evident difference in scores from immediately after training to 6 months later. Self-assessed confidence in skills decreased from 9/18 (95% CI 9 to 10) to 6/18 (95% CI 6 to 7). At 6 months, the module was reported as easy to understand and use, with challenges including difficulties in examining children’s eyes and poor referral systems.
Conclusions The module increased knowledge of child eye health in primary healthcare workers, which was maintained, and was acceptable. The module has since been included into the national IMNCI health policy in Tanzania.
- comm child health
- health services research
- ophthalmology
- screening
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Footnotes
Twitter @aeeshamalik
Contributors ANJM, MM and CG conceptualised and designed the study. ANM and MM led the collection of data. All authors analysed the data. MJK undertook the statistical analysis of the data. ANM wrote the first draft and revised the manuscript with all authors contributing to revisions.
Funding This work was supported by the British Council for Prevention of Blindness (BCPB) grant number 14836 and CBM grant number 3324-MYP.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was obtained from LSHTM Ethics Committee (Ref: 13484), MUHAS Ethics committee (Ref: 2017-12-21/AEC/Vol.XII/84) and the Tanzania National Institute for Medical Research (Ref: NIMR/HQ/R.8a/Vol.IX/2622). Permission to conduct the study was given by the Regional and District Executive Secretaries. All PHWs gave written informed consent to participate.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Further deidentified participant data are available by email to: aeesha.malik@lshtm.ac.uk.