Consultancy (On-The-Job Training (OJT) for Health Workers Using the Integrated Management of Childhood Illnesses (IMCI) Approach in Lagos State) at Save The Children

Background

• The core intervention of Integrated Management of Childhood Illness (IMCI) is the integrated management of the commonest causes of mortalities among children- Malaria, diarrhea, measles, pneumonia and malnutrition. In health facilities, IMCI strategy promotes identification of childhood illnesses in the outpatient settings and provides appropriate treatment and referrals when necessary. The strategy also helps to improve the quality of care of sick children at the referral level by proving an effective link between the care provided at the community and the management approach in the facility.
• Meanwhile, it is worthy of note that IMCI reduces wastage of resources and avoids duplication of efforts that may occur in different vertical disease programming. Thus, the essential blocks of IMCI will include the skills of the health workers, health system strengthening and improvement in family and community practices.
• Health worker training is a key component of integrated management of childhood illnesses (IMCI). However, the coverage of IMCI training still remains low in many countries including Nigeria. The baseline study carried out prior to the effective commencement of the HCB project in the three HCB project states also showcased this affirmation. As was presented in the baseline report, among 208 health facilities assessed, only 41% have heard of IMCI as an intervention while only half have had the training. For us to achieve an appreciable level of IMCI coverage, more front line health workers have to be reached with IMCI trainings.
• The barriers to IMCI training coverage are not limited to the duration of the training which most times take away health workers away for their primary duties for close to six days. However, other barriers are the cost of engaging the many facilitators and its residential nature. Although, the government of the day has shown willingness and commitment towards IMCI, many of the efforts still come from the donors and NGOs which does not encourage sustainability.
• Meanwhile, we need to explore other methods of propagating IMCI trainings. Alternative, but lower cost methods of IMCI training need to be promoted to reach trained and untrained frontline health workers in both private and public sector. Hence, the aim of this  training which is to improve the skills of frontline health workers on case management of specific disease components of IMCI through On the Job training(OJT) approach.

Objectives:

• To enhance the skills of the frontline  health workers in tackling common childhood illnesses at facility  level using the IMCI guidelines
• To strengthen follow up visits, reinforce learning and address skill gaps using an on the job approach.

Purpose of the Assignment:

• The purpose of this consultancy is to conduct a rapid spot assessment of the health workers in identified facilities that are underserved and hard to reach. Based on the findings of the assessment, consultant(s) would conduct an on the job training for the health workers using the IMCI guidelines in Lagos state.

Approach for the OJT Activity:

• The consultancy period will be for 50 days.
• Initial assessment of health workers ability to properly manage a child with childhood illnesses – malaria, pneumonia, diarrhea. This will be by onsite observation of health workers in the child welfare clinics using a skills checklist.
• After the clinic session, the consultant will review the skills checklist findings with the health workers and agree on the findings.
• The consultant using the IMCI chart booklet trains the health workers on how to appropriately assess, classify and treat a child presenting in the facility with malaria, diarrhea and pneumonia. Also the health workers will be trained on how to counsel the caregivers on appropriate home management for the illnesses and when to return.
• The consultant will pay four (4) visits to the same health facility to ensure that the health workers have been fully trained on the necessary skills required to properly manage a child presenting with all Malaria, Pneumonia, Diarrhoea and be able to check for malnutrition and initiate treatment, give vaccines that are due or missed
• Consultant then leaves behind a chart booklet for the use of the health workers
• Consultant will also conduct a follow up visit (within six weeks of training completion) to assess the knowledge and skills change amongst the health workers in that facility
• During the follow up visit, the consultant will observe the health workers again using the skills checklist and feedback provided to the health workers.
• During the conduct of the OJT, a training quality checklist will be applied by Save the Children MNCH Advisors who will then pay visits to the facilities where health workers are undergoing the OJT training to monitor the quality of the training conducted.
• Consultant(s) will keep the attendance of all health workers mentored or trained in the health facilities in a format that will be determined by Save the Children.
• The consultant(s) will keep an activity timesheet which will be shared with the MNCH Advisor after each of activity.
• Training reports are at the end of the satisfactory training will then be developed by the consultants and shared with SCI office.

Expected Outputs:

• All health workers trained have skills in tackling common childhood illnesses at community and facility level
• Monthly report of activities
• A comprehensive report of the training activity upon completion.
• Attendance list of all health workers reached with OJT, indicating the following - Names, Name of health facility, Cadre, Gender, phone number, email address, others.

Qualifications

• Health professional
• IMCI certified trainer.