Improving the Assessment and Classification of Sick Children according to the Integrated Management of Childhood Illness (IMCI) Protocol at Sanja Primary Hospital, Northwest Ethiopia: A Pre-Post Interventional Study.

Mohammed Abayneh,Tsegaye Gebremedhin,Asmamaw Atnafu,Endalkachew Dellie,Chalie Tadie Tsehay,Samuel Menahem

doi:10.1155/2020/2501932

Abstract

Background A complete and consistent use of integrated management of childhood illness (IMCI) protocol is a strategic implementation that has been used to promote the accurate assessment and classifications of childhood illnesses, ensures appropriate combined treatment, strengthens the counseling of caregiver, and speeds up the referrals to decrease child mortality and morbidity. However, there is limited evidence about the complete and consistent use of IMCI protocol during the assessment and classifications of childhood illness in Ethiopia. Therefore, this intervention was implemented to improve the assessment and classifications of childhood illness according to the IMCI protocol in Sanja primary hospital, northwest Ethiopia. Methods A pre-post interventional study was used in Sanja primary hospital from January 01 to May 30, 2019. A total of 762 (381 for pre and 381 for postintervention) children from 2 months up to 5 years of age were involved in the study. Data were collected using a structured questionnaire prepared from the IMCI guideline, and a facility checklist was used. A five-month in-service training, weekly supportive supervision, daily morning session, and availing essential drugs and materials were done. Both the descriptive statistics and independent t-test were done. In the independent t-test, a p value of <0.05 and a mean difference with 95% CI were used to declare the significance of the interventions. Results The findings revealed that the overall completeness of the assessment was improved from 37.8 to 79.8% (mean difference: 0.17; 95% CI: 0.10-0.22), consistency of assessment with classification from 47.5 to 76.9% (mean difference: 0.34; 95% CI: 0.27-0.39), classification with treatment from 42.3 to 75.4% (mean difference: 0.35; 95% CI: 0.28-0.47), and classification with follow-up from 32.8 to 73.0% (mean difference: 0.36; 95% CI: 0.29-0.42). Conclusion The intervention has a significant improvement in the assessment and classification of childhood illness according to the IMCI protocol. Therefore, steps must be taken to ensure high quality of training, adequate supervision including the observation of health workers managing sick children during supervisory visits, and a constant supply of essential drugs and job aids for successful implementation of IMCI in the hospital and also to other facilities.

Highlights

The integrated management of childhood illness (IMCI) is a globally proven evidence-based intervention designed to improve child survival and is being implemented worldwide in countries with a high burden of child mortality [1, 2].The guidelines for the IMCI were introduced by the World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) in the mid1990s to enable health care workers to diagnose and treat a sick child in locations with limited access to laboratories and medical equipment targeting on major causes of under-International Journal of Pediatrics five mortality [3,4,5]
The study findings suggested that with good quality training and consistent supportive supervision, adequate performance on the assessment and classifications of the childhood illness among IMCI trained service providers can be sustained to have a more tremendous effect
After the intervention, the under-five departments were visited weekly by trained supervisors who spent a substantial amount of time observing the health workers as per the IMCI protocol that can sustain a good quality of care for sick children

Summary

Introduction

The integrated management of childhood illness (IMCI) is a globally proven evidence-based intervention designed to improve child survival and is being implemented worldwide in countries with a high burden of child mortality [1, 2].The guidelines for the IMCI were introduced by the World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) in the mid1990s to enable health care workers to diagnose and treat a sick child in locations with limited access to laboratories and medical equipment targeting on major causes of under-International Journal of Pediatrics five mortality [3,4,5]. The complete and consistent use of IMCI protocol in Ethiopia was introduced since 1997 and is considered as an evidence-based intervention for accurate identification of childhood illnesses, ensures appropriate combined treatment of all major diseases, strengthens the counseling of caregiver, and speeds up the referral of severely ill children. A complete and consistent use of integrated management of childhood illness (IMCI) protocol is a strategic implementation that has been used to promote the accurate assessment and classifications of childhood illnesses, ensures appropriate combined treatment, strengthens the counseling of caregiver, and speeds up the referrals to decrease child mortality and morbidity. Steps must be taken to ensure high quality of training, adequate supervision including the observation of health workers managing sick children during supervisory visits, and a constant supply of essential drugs and job aids for successful implementation of IMCI in the hospital and to other facilities

Methods

Findings

Discussion

Conclusion