Table 5 Adaptations and/or modifications of community-based management of PSBI implementation strategies during the COVID-19 pandemic in Ethiopia, 2021
Strategy | Adaption/ modification | Timing of modification (pre, during, end) | Planned/ ad hoc | Who decided/ participated | Reason for modification | Modifications | Evidence of effect |
|---|---|---|---|---|---|---|---|
Community-based management of PSBI training (Dembecha) | Organized offsite training for HEWs and their supervisors | During implementation (December 2021) | Planned | Implementation team | To improve appropriateness of the strategy (greater # of HEWs not trained on basic PSBI treatment and restrictions on gatherings due to COVID-19 lifted) | Form (mode of delivery) and content | Improved competency in pre-post training evaluation score |
Supportive supervision (Dembecha) | Intensified support system | During implementation (November–December 2021) | Planned | Implementation team | To address the contextual challenge of a shift in resources and attention following the SOE and business shutdown | Change in the form (intensified the support system) | More frequent support improved the performance of HEWs [40] |
Supplies (Dembecha) | Redistributed gentamicin 20Â mg/ml | During implementation (July 2021) | Planned | Implementation team | To address a shortage of supplies | New strategy | The supply of drugs was a critical component of PSBI treatment implementation |
iCCM module incorporated into eCHIS (Lume) | Digitized PSBI treatment protocol | During implementation (August 2021) | Ad hoc | MOH | To test the digital PSBI treatment protocol | New strategy | Electronic clinical decision algorithms improved the management of sick children in primary care [41] The eCHIS app potentially facilitated the identification and registration of newborns and SYIs, referral, and clinical decision |