Information and Communication Technology to Enhance the Implementation of the Integrated Management of Childhood Illness: A Systematic Review and Meta-Analysis

Andrea Bernasconi*, Marco Landi, Clarence S. Yah, Marianne A.B. van der Sande

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Objective: To evaluate the impact of Information and Communication Technology (ICT) on the implementation of Integrated Management of Childhood Illness (IMCI) and integrated Community Case Management (iCCM) through a systematic review and meta-analysis (PROSPERO registration number: CRD42024517375). Methods: We searched MEDLINE, EMBASE, Cochrane Library, and gray literature from January 2010 to February 2024, focusing on IMCI/iCCM-related terms (Integrated Management of Childhood Illness, IMCI, integrated Community Case Management, iCCM) and excluding non-ICT interventions. A meta-analysis synthesized the effect of ICT on clinical assessment, disease classification, therapy, and antibiotic prescription through odds ratio (OR; 95% CI) employing a random effects model for significant heterogeneity (I2>50%) and conducting subgroup analyses. Results: Of 1005 initial studies, 44 were included, covering 8 interventions for IMCI, 7 for iCCM, and 2 for training. All digital interventions except 1 outperformed traditional paper-based methods. Pooling effect sizes from 16 studies found 5.7 OR for more complete clinical assessments (95% CI, 1.7-19.1; I2, 95%); 2.0 for improved disease classification accuracy (95% CI, 0.9-4.4; I2, 93%); 1.4 for more appropriate therapy (95% CI, 0.8-2.2; I2, 93%); and 0.2 for reduced antibiotic use (95% CI, 0.06-0.55; I2 99%). Conclusion: This review is the first to comprehensively quantify the effect of ICT on the implementation of IMCI/iCCM programs, confirming both the benefits and limitations of these technologies. The customization of digital tools for IMCI/iCCM can serve as a model for other health programs. As ICT increasingly supports the achievement of sustainable development goals, the effective digital interventions identified in this review can pave the way for future innovations.

Original languageEnglish
Article numberdoi.org/10.1016/j.mcpdig.2024.06.005
Pages (from-to)438-452
Number of pages15
JournalMayo Clinic Proceedings: Digital Health
Volume2
Issue number3
DOIs
Publication statusPublished - Sept 2024

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