73M. Mahmud Khan, et al • Implementing IMCI in a Developing Country Original Article Implementing IMCI in a Developing Country: Estimating the Need for Additional Health Workers

This study estimates the personnel cost implications of implementing the newly proposed Integrated Manage-ment of Childhood Illness (IMCI) algorithm in the first level health care facilities in rural Bangladesh. Policy makers need to know the additional resource requirements for IMCI before its actual implementation so that appropriate levels and combinations of personnel and drugs can be allocated. The additional personnel requirement of implement-ing IMCI was estimated by noting the time spent by the Community Health Workers (CHWs) in rural Bangladesh in obtaining all the required information for IMCI classification of health conditions. The average time needed to collect information for the IMCI approach, including the physical checkup of sick children, was found to be about 16.3 minutes. The average time requirements were more or less similar for all the different IMCI illness categories considered. If the IMCI relevant information was not collected, healthcare personnel spend about 8 minutes to manage a sick child. Therefore, IMCI strategy represents a significant increase in the time input of health workers. Using the additional time input requirement of IMCI, Bangladesh needs to employ somewhere between 2,700 and 4,100 health workers in rural areas. Currently, full-time equivalents involved in child health activities in Bangladesh are no more than 2,500. The additional cost of employing these health workers will be around 2.6 to 4.0 million US dollars, about one to 1.5 percent of total health sector budget of the Government of Bangladesh