Costing of the integrated management of childhood illnesses in Bangladesh : a study based on Matlab data

The use of IMCI guidelines would replace the "reported symptoms" methodology now in use. The study was carried out by community health workers and paramedics at health care sub-centers in the Matlab district under the direction of the International Center for Diarrheal Disease Research, Bangladesh. It compares current illness patterns, referral rates, personnel time, drug prescribing practices and costs, and patient care seeking behavior with what would have occurred using IMCI. It estimates that, in theory, nationwide use of IMCI would save the country $6.8 million in drug costs per year. (In reality, since Bangladesh suffers an acute drug shortage, meeting all drug needs would increase drug expenditures, but that is not due to IMCI.) Because of the additional time spent required under IMCI to examine and treat children and to counsel their parents/guardians on follow-up care, implementation of IMCI would more than double the current number of health workers. The cost of this additional workforce is estimated to be $2.6 million per year. (Author abstract, modified)