Evaluation of the effectiveness of Electronic IMCI compared to standard of care in PHC clinics in KZN


IMCI is a strategy developed by WHO and UNICEF to improve the quality of care given to sick children under 5-years of age attending primary health care clinics, and to address high rates of morbidity and mortality among children. The strategy uses an evidence based algorithm combined with training and mentoring to provide a structured approach for management of sick children. The IMCI strategy has been adopted in many countries worldwide including South Africa. IMCI improves quality of care for sick children but IMCI evaluations identified barriers to IMCI implementation including expensive training, poor literacy among health care workers, lack of political support, fragmented health systems, lack of skilled facilitators and poor supervision. In SA, the ministerial committee for child health (CoMMiC) has raised concerns that, despite considerable investment in training, IMCI has not been widely adopted as standard practice at primary level facilities, is not implemented consistently, and lacks scope to address some common child illnesses. The emerging use of new technologies and digital tools provide promising solutions to improve health outcomes in a number of different programmes. In SA, an electronic version of IMCI (eIMCI) has been developed for use on desktop computers in the consulting room. Usied of eIMCI has been piloted in one district in KZN. This project aims to undertake a randomised controlled trial to evaluate of the effectiveness of electronic-IMCI (e-IMCI) implementation compared to standard of care in primary health care clinics in KwaZulu-Natal, South Africa.


  • Regular meetings with department of health stakeholders in the province and in the district continue
  • Ethical approval obtained.
  • The eIMCI steering committee continue to meet electronically
  • Three reference groups in Ugu district complete
  • Computers are available in all 15 participating eIMCI clinics – new computers installed in 4 clinics, tower replaced in 1 clinic, printers installed in all 15 eIMCI clinics
  • Two pilot eIMCI trainings conducted in Umgungundlovu district in November 2019
  • Three training sessions undertaken in January and February 2020 – training activities ceased due to Covid-19 lockdown
  • Ongoing mentoring and IT support continued throughout the lockdown period
  • Training recommenced in October 2020 with two training sessions
  • Mentoring and IT support of new participants commenced
  • Data collection was due to commence in January 2021 but due to second wave of Covid-19 and subsequent South African lockdown, was postponed and only started at the end of February 2021. Data collection was completed in June 2021.