ICATT
(IMCI-Computerize Adaptation Training Tools)
Implementation in Indonesia
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ICATT implementation process
Adaptation
(1)
Trial
Socialization
Adaptation
(2)
ToT
Training
(in-service)
Operational Research
ICATT’s activities
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Organization at National, provinces and district
TOT ICATT (6-8 participant/district)
ICATT Training (10 PH’s, @ 2 participant,
doctor and nurse)
Internal evaluation meeting: januari 2010
Dissemination stake holder meeting January
2010
Guidelines and curriculum were developed in
collaboration with Centre of Health Education
and Training – MoH.
1. Adaptation
Adaptation (2)
• ICATT  IMCI training using computer
• Started in 2009
• Adaptation in:
– Language
– Video
• IMCI video translated into Bahasa Indonesia
• Video addition
– Component: + Implementation of IMCI in PHC
component
– Guidelines and curriculum
2. Trial
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In collaboration with Gadjah Mada University
In 2 districts: Boyolali and Banyumas
In-service setting
Self-learning method:
– Trainee learnt ICATT at home or Health Centre
– Monitoring by tutor: once a week (by phone)
• Participant get; IMCI chart booklet, recording
forms and ICATT on DVD or USB.
• The Criteria for Training ICATT
1. Many HCs have computers
2. Not far from UGM or Jakarta
3. Committed to implement IMCI
4. There is a need to train staff in IMCI (staff never
been trained or needing refresher training)
5. Access to at least 1 computer with correct
specifications: spare space of 2.5 Gb, color screen,
audio , DVD drive or USB . Head set could be
supplied.
6. Commitment to have computer time of 3-5 hours per
8
week for each participant,
Overall organization
• 3 Working groups was established at the
national, provincial and district level
• National working group:
– Consist of consultants, MoH, UGM
– Responsible for the overall coordination incl.
development of INO ICATT, documentation,
monitoring- evaluation of the training.
– Roles and responsibilities of the different
members of the working group should be
clearly defined.
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• Provincial working group:
– include 1 PHO and 2 active IMCI facilitators
– involved in coordination, monitoring and
evaluation
• District working group:
– include 1 DHO, 1 pediatrician from the
District hospital and 2 active IMCI
facilitators (who will be the ICATT tutors).
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ICATT tutors training
• 3 days ICATT tutors training
• Involving the tutors for group A and B plus the
coordinator and other selected staff from the
working groups and medical/paramedical
schools (nursing/midwifery)
• A total of 24 participants will be involved
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ICATT Training (10 PH’s, @ 2 participant,
doctor and nurse)
 Encounter 1 (1 day).
Purpose of this encounter:
– Introduction of IMCI/ICATT
– Practice on how to use ICATT
navigation  explain principles of
Assess & Classify child 2 mos – 5 yrs,
incl. clinical demonstration.
– Explain details of course agenda
Encounter 2 (1 day), in District A
• Conducted in District Hospital  3 – 4 weeks
after encounter 1
• Purpose of this encounter:
– assess the progress of the trainees and
solve problems
– to ensure that the trainees understand the
Assess & Classify process (including clinical
session)
Encounter 2 for District B
• Will be done by the tutors in the HCs
• Purpose of this encounter: same as District A
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Encounter 3 (1 day).
• Will take place in a District Hospital
• After the trainees would have finished the
course  3 - 4 weeks after the second
encounter
• Purpose of this encounter:
– Assess progress
– Evaluate knowledge and skills by practice in
out-patient clinic.
– Solve problems
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TEST AND CERTIFICATION
• Preceded by follow up after training = fuat (8
weeks after third encounter)
• Test will be done during regular meeting in
District (1.5 hours)  4 weeks after fuat
• Purpose of test:
– Evaluate the knowledge
– Get certificate (with credit point) if 80% passed the
test
• Other incentives such as IMCI support materials
should be considered.
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Trial – Study Finding
• At the end of the training, 82%participants finished the
25 training units in ICATT
Training method - Location
% Task answer correctly by the
participant – mean (range)
DL – Indonesia, Banyumas
83.2 (63.3-93.3)
DL – Indonesia, Boyolali
74.7 (73.3-83.3)
Individual – Tanzania, Ifakara
75 (62.5-79.2)
Individual – Peru
73.1 (59.4-82.8)
LCD projected - Tanzania,
Ifakara
76.1 (56.3-91.7)
LCD projected – Tanzania,
Kilosa
89.6 (79.2-95.8)
LCD projected - Peru
72.8 (62.5-82.2)
Trial – Study Finding
• General comments :
– Trainees  New learning method, easy to navigate
– Tutor  Adaptation of ICATT software for other
training will be useful
• IT problems were identified:
– Installation, transferring profile
– Execute ICATT from USB stick
• The video quality should be improved  done in
2011 (funded by USAID)
Challenges
• IT/ computer related problem:
– During adaptation: new developed software –
bugs
– Not all IMCI facilitator can operate computer
• Commitment from trainees – have extra
work after working hours
Next Steps
Last 2011- 2012
Funded by USAID and MoH regular budget
• Training for:
– Master of trainer (National)
– Trainer (Province and districts – 3
provinces: DKI Jakarta, Banten and West
Java)
– Health workers (nurse/ midwife) in
selected health centre in 3 provinces
– Pre-service setting (DKI Jakarta)
Next Steps
• Operational Research
– Compare ICATT and the regular IMCI
training
– Conducted in West Java
– Will be conducted by University of
Indonesia
Thank you
SCHEMA DISTANCE TRAINING IMPLEMENTATION
of ICATT FOR PHC HEALTH WORKERS
Self learning (introduction
IMCI 2-59 month &
assestment)
Clinical practice
Self learning (ICAATT)
Clinical practice
3 weeks
1 day
1st Meeting in District
• Introduction IMCI & ICATT
•Install & Navigation ICATT
• Patient Demonstration
• Planning & Scheduling
Training
4-5 weeks
1 day
4 – 8 weeks
1 day
3rd Meeting in District
• Progress review, Problem Solving , Feed
Back
•Practice with patient
•Post Test
2nd Meeting in District
• Progress review , Problem Soving, Feed
Back
•Practice with patient (Assestment &
Classification)
Monitoring pasca
training
Field visit
tutor to PHC
Note :
After 3rd meeting, PHC will
implementation IMCI
CERTIFICATE
– 31 of 38 (82%) participant finished 25 unit
training at the end training
– the mean of correct answer
• 23.5 di Banyumas
• 20.3 di Boyolali
– The participant interest  28% of participant
doing excercise more after ecounter 1
– Number of case done by every participant 9 –
69!, compare IMCI training konventional 8 –
12 case
The frekwensi ICATT session &
by participant
How many times the
participant learn ICATT by
them self after Ecounter 1
Boyolali
(Mean dan rata-rata)
6.5 (3-16)
How many times the
9.8 (5-19)
participant learn ICATT by
them self after Ecounter 2
16.3
Total
Banyumas
(Mean dan rata-rata)
8.5 (6-11)
10.2 (4-24)
18.7
Individual Praktic Clinics
Amount of Clinis
session by
participant after
encounter 1
Amount of Clinis
session by
participant after
encounter 2
Total
Boyolali
(Mean dan rata-rata)
7.2 (2-16)
Banyumas
(Mean dan rata-rata)
6.1 (2-11)
9.9 (2-16)
8.2 (4-14)
17.1
14.3