Abstract
The United States Agency for International Development (USAID)/Tanzania established the Tibu Homa project to: (1) increase availability and accessibility of fundamental facility-based curative and preventive child health services; (2) ensure sustainability of critical child health activities; and (3) increase linkages with the community to promote healthy behaviors and increase knowledge and use of child health services. Tibu Homa's components were training for healthcare workers on integrated management of childhood illnesses (IMCI), quality improvement, supply chain management, and supportive supervision and mentorship. MEASURE Evaluation was asked to conduct a performance evaluation to estimate the association between (1) the training modalities and (2) supportive components implemented by the Tibu Homa project with quality of care (QOC). The evaluation used a retrospective, mixed-methods approach drawing from a cross-sectional quantitative health facility survey, qualitative and costing data collection, secondary time series data, and project document review. The IMCI score was the primary outcome of the study. Evaluation results indicate the training modality was not associated with different levels of QOC as measured by the IMCI score. The QOC on this measure improved significantly over the course of the project regardless of training modality, but dropped by the time of follow-up. One year after the project ended, Tibu Homa facilities had higher QOC for all cases measured by the IMCI score, and higher rates of correct classification and treatment for pneumonia cases than did a group of comparison facilities. Both Tibu Homa and comparison facilities performed well on accurate classification and treatment of malaria cases. (Author abstract)