Abstract
Background Every year some 12 million children in developing countries die before they reach their fifth birthday. Seven in ten of these deaths are due to acute respiratory infections (mostly pneumonia), diarrhea, measles, malaria or malnutrition. The WHO Department of Child and Adolescent Health and Development (CAH), in collaboration with eleven other WHO programmes and UNICEF, has responded to this challenge by developing the Integrated Management of Childhood Illness (IMCI) strategy. Research that examines assessment of factors influencing the implementing the integrated management of neonatal and childhood illnesses (IMCI) strategy in Ethiopia is limited. Objective To assess factors influencing the implementation of the IMNCI strategy by health professionals in public health institutions of Yifat cluster in North Shewa zone, Ethiopia, 2018. Method An institutional based cross-sectional study will be conducted from March to May. A total of 201 health professionals will be selected using proportionally allocated to population size and interviewed using structured and pretested questionnaires. Data will be coded, entered and cleaned using SPSS version 20 for analysis. Univariate (frequency), Bivariate, Multiple logistic regression analysis will be employed. P-value and 95% confidence interval (CI) for OR will be used in judging the significance of the associations. P-value less than 0.05 will be taken as significant association. Results Data were obtained from 201 health care professionals, yielding a response rate of 100%. The overall IMNCI implementation was 58% as high level implementation and 42% as low level implementation. In multivariate analysis the implementation of IMNCI was higher among IMNCI trained health care professionals ([AOR = 2.7, 95% CI: (1.1.278, 4.562)]) and among those whose always referring chart booklet [AOR = 2.76, 95% CI: (1.753, 5.975)]. Conclusion IMNCI strategy can be better implemented through provision of training for the health workers. However, a variety of factor found to be a barrier to IMNCI implementation in a consistent way. Recommendations have been made related to provision of the training to the nurses and Health Care system strengthening among others.
Highlights
This study revealed that the proportion of Integrated Management of Neonatal and Childhood Illness (IMNCI) implementation in the study setting was low (58%)
This study identified barriers by health care workers which include: shortage of essential drugs and supplies, inadequate trained staff, time consuming nature of the protocol, lack of supervision, lack of knowledge about the strategy and lack of good attitude of healthcare workers/professionals towards the IMNCI strategy
Recommendation (i) As IMNCI training is an important predictor of IMNCI implementation, there should be increasing the number of health workers trained in IMNCI and capacitated to deliver IMNCI services by Scaling up both pre-service and in service IMNCI training
Summary
The IMCI strategy aims to reduce illness, disability, and death, and to promote improved growth and development among children under 5 years of age. The strategy includes both preventive and curative elements that are implemented by families, communities, and health care facilities [1,2,3]. Implementation of integrated management of childhood illness (IMCI) in comprehensive and holistic approach that forms bench mark for basic child health in promoting celebration of fifth birth day for children below five years of age, free from Malaria, Pneumonia, Diarrhea, Measles and Malnutrition [2,3,4]. Recommendations have been made related to provision of the training to the nurses and Health Care system strengthening among others
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