Testing a Digital Tool for Healthcare Workers to Reduce Child Mortality

Integrated Management of Childhood Illness (IMCI) is a standardized, evidence-based, diagnostic support system approach to pediatric care, which has been shown to reduce childhood (under-5) mortality in some settings. Designed by the World Health Organization and UNICEF, IMCI strengthens prevention and management of common childhood illnesses by improving health worker skills, health systems, and family and community health practices. In India, adherence to the National Health Mission's version of IMCI, Integrated Management of Neonatal and Childhood Illness (IMNCI) has been a challenge. Terre des hommes (Tdh) developed the Integrated e-Diagnostic Approach (IeDA), a digitalized IMCI job aid that has been shown to improve healthcare worker performance and protocol adherence. The IeDA software is updated as best practices change, helping to standardize care and support evidence-based clinical decisions in real time. At the end of a patient consultation, IeDA gives healthcare providers an analysis of signs, symptoms, and test results and suggests a diagnosis, which the provider can then use to propose treatment. Terre des hommes has been using IeDA in the state of Jharkhand since 2020. With support from the DIV Fund, Terre des hommes is conducting a randomized controlled trial (RCT) of IeDA in India in collaboration with the Johns Hopkins Bloomberg School of Public Health and Doctors for You. The RCT will: (1) evaluate the impact of IeDA on the percentage of children under five who are correctly diagnosed and treated; (2) assess the fidelity of IeDA implementation across healthcare facilities; and (3) analyze costs of implementing IeDA to inform future decision making around scaling IeDA in India and beyond.