Integrated Management of Neonatal and Childhood Illness (IMNCI): Skill Assessment of Health and Integrated Child Development Scheme (ICDS) Workers to Classify Sick Under-five Children

The decline in under-five mortality remains target of health development in Indonesia. One effort that can be done, among others, is to improve the skills of health workers in dealing with sick children through the Integrated management of Chilhood Illness (IMCI). This study aims to evaluate the implementation of IMCI in 10 selected districts/cities in Eastern Region of Indonesia with a sample of 20 puskesmas selected randomly. In total 40 under-five children were observed when receiving IMCI services at the puskesmas. In addition, an assessment of the completeness of filling out of 200 forms of IMCI under-five children who had come to the puskesmas a week before the survey was conducted. Information related to the availability of equipment to support IMCI services is collected through direct observation in 20 selected puskesmas assisted by a check list form. The results showed that 80% of puskesmas in the eastern region have implemented IMCI, but only 25% of puskesmas reaching all the under-five children. As many as 90% of puskesmas have been trained for IMCI, however only 15% have been monitored post training. Only 25% of puskesmas received supervision from the District Health Office in implementing IMCI. The observation results at the IMCI service for children under five showed that, the lowest score for compliance with IMCI was counseling (25.8%) and the highest was diarrhea assessment (73.8%). The results of observing the IMCI forms showed that the lowest score was feeding practice (30.4%) and repeat visits (30.8%). Meanwhile, oral rehydration facilities for diarrhea are reported to be inadequate, because they are only available at 50% of puskesmas. There needs to be monitoring and supervision of officer compliance and increasing the availability of supporting equipment and facilities/insfrastructure in the implementation of IMCI. Abstrak Penurunan angka kematian balita masih menjadi target pembangunan kesehatan di Indonesia. Salah satu upaya yang dapat dilakukan antara lain meningkatkan keterampilan tenaga kesehatan dalam menangani balita sakit, melalui pendekatan Manajemen Terpadu Balita Sakit (MTBS). Penelitian ini bertujuan untuk mengevaluasi pelaksanaan MTBS di 10 Kabupaten/Kota terpilih di regional timur, dengan jumlah sampel 20 puskesmas yang dipilih secara acak. Secara total, 40 pasien balita diobservasi pada saat mendapatkan pelayanan MTBS di puskesmas. Selain itu, dilakukan asesmen kelengkapan pengisian dari 200 formulir MTBS balita yang pernah datang ke puskesmas dalam kurun waktu seminggu sebelum survei. Infomasi terkait dengan ketersediaan peralatan untuk mendukung pelayanan MTBS dikumpulkan melalui observasi secara langsung di 20 puskesmas terpilih dibantu dengan formulir check list. Hasil analisis menunjukkan bahwa 80% puskesmas di regional timur telah melaksanakan MTBS, namun hanya 25% puskesmas yang menjangkau seluruh balita. Sebesar 90% puskesmas telah terlatih MTBS, namun hanya 15% yang dilakukan monitoring pasca pelatihan. Hanya 25% puskesmas yang mendapatkan supervisi dari Dinas Kesehatan Kabupaten/Kota dalam pelaksanaan MTBS. Hasil observasi pada saat pelayanan MTBS pada balita menunjukkan, skor kepatuhan pelaksanaan MTBS yang terendah adalah konseling (25,8%) dan tertinggi adalah asesmen diare (73,8%). Hasil observasi pengisian formulir MTBS menunjukkan, skor terendah pada pengisian pemberian makan (30,4%) dan kunjungan ulang (30,8%). Sementara itu, fasilitas rehidrasi oral untuk diare dilaporkan belum memadai, karena hanya tersedia di 50% puskesmas. Perlu adanya monitoring dan supervisi terhadap kepatuhan petugas serta peningkatan ketersediaan peralatan dan sarana/prasarana pendukung dalam pelaksanaan MTBS.

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Factors associated with adherence to the Integrated Management of Childhood Illness (IMCI) guidelines for under-five years’ old care in Burkina Faso primary health care facilities

10.1101/510099 ◽

2019 ◽

Author(s):

Sabere Anselme Traoré ◽

Serge M.A. Somda ◽

Joël Arthur Kiendrébéogo ◽

Jean-Louis Kouldiati ◽

Paul Jacob Robyn ◽

...

Keyword(s):

Health Care ◽

Health Workers ◽

Integrated Management ◽

Health Care Facilities ◽

Childhood Illness ◽

Under Five ◽

Danger Signs ◽

Primary Health ◽

Primary Health Care Facilities

AbstractObjectiveTo assess the adherence to Integrated Management of Childhood Illness (IMCI) guidelines in primary health care facilities in Burkina Faso and to determine the factors associated.Materials and MethodsWe used data from a large survey on health facilities, held from October 2013 to April 2014. Primary health facilities were evaluated, health workers interviewed and consultations observed. The standard guideline for an under five year’s old child consultation was the Integrated Management of Childhood Illness (IMCI).Results1,571 consultations were observed, carried out by 522 different practitioners. The danger signs were usually not checked (13.9% only checking for at least three general danger signs). The adherence for cough (74.8%), diarrhoea (64.9%), fever (83.8%) and anaemia (70.3%) was higher. The principal factors found to be associated with poorer adherence to guidelines of consultation were female sex (Rate Ratio (RR) = 0.91; 95% CI 0.86 – 0.95), non-nurse practitioner (RR=0.93; 95% CI 0.88 – 0.97), IMCI training (RR=1.06; 95% CI 1.01 – 1.11), non-satisfaction of the salary (RR=0.95 95% CI 0.91 – 0.99).ConclusionThis study highlights a poor adherence to the IMCI guidelines and by then, revealing a poor quality of under-five care. Indeed, many characteristics of health workers including gender, type of profession, training satisfaction with salary were found to be associated with this adherence. Therefore, more initiatives aiming at improving the quality of care should be developed and implemented for improving the child health care.

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Quality of Care for Children Under Five with Malaria Using IMCI Approach at Public Health Centre: Literature Review

10.1101/2022.01.14.22269271 ◽

2022 ◽

Author(s):

Orpa Diana Suek ◽

Moses Pandin

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Care Services ◽

Integrated Management ◽

Childhood Illness ◽

Public Health Centre ◽

Children Under Five ◽

Under Five ◽

Care Services

Integrated Management of Childhood Illness is one of the strategies in health care services for infants and children under five at primary health care facilities. Children with fever in high malaria endemic areas must have a blood test done to check whether the children have malaria or not. IMCI is one of the interventions recommended by WHO to screen and also ensure that children receive proper initial treatment at first-level health facilities. This article aims to discuss the quality of care for children under five with malaria using IMCI approach. This is a systematic review by searching 4 databases including Scopus, Web of Science, SAGE and Proquest. Health care services for children under five with an integrated management of childhood illness are intended to provide immediate and appropriate treatment. The guideline for treating children under five with malaria using IMCI approach is very helpful for nurses both in assessing, classifying, treating/curing and making decisions for pre-referral measures for severe cases. Several factors to support quality of care are trained officers, supervision and procurement of essential medicines, RDT and malaria microscopy. Enforcement of the right diagnosis will improve the quality of life of children and prevent death in children under five. Keywords: IMCI, Malaria, Children under five

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High common childhood illnesses while treatment seeking behavior of mothers’/care givers’ was low at rural northwest Ethiopia

10.21203/rs.2.17005/v3 ◽

2020 ◽

Author(s):

Zemene Tigabu Kebede ◽

Kassahun Alemu Gelaye ◽

Mehari Woldemariam Merid ◽

Temesgen Yihunie Akalu ◽

Ashenafi Tazebew Amare ◽

...

Keyword(s):

Health Care ◽

Health Center ◽

Childhood Illness ◽

Treatment Seeking ◽

Health Seeking ◽

Under Five ◽

Under Five Children ◽

Childhood Illnesses ◽

Care Givers ◽

Seeking Behavior

Abstract Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, identification of determinants of childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval and P-value <0.05 in the multivariable model were reported to show the significance and direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.

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Health Care Seeking Behavior during Childhood Illness among Mothers of Under Five Children Residing in Slum Areas of Kathmandu, Nepal

International Journal of Scientific and Research Publications (IJSRP) ◽

10.29322/ijsrp.10.06.2020.p10224 ◽

2020 ◽

Vol 10 (06) ◽

pp. 195-200

Author(s):

Memona Prasai ◽

Bhawana Shrestha ◽

Sanjeeb Shah ◽

Aasis Paneru

Keyword(s):

Health Care ◽

Childhood Illness ◽

Health Care Seeking ◽

Care Seeking ◽

Under Five ◽

Under Five Children ◽

Care Seeking Behavior ◽

Seeking Behavior ◽

Health Care Seeking Behavior ◽

Slum Areas

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High common childhood illnesses while treatment seeking behavior of mothers’/care givers’ was low at rural northwest Ethiopia

10.21203/rs.2.17005/v2 ◽

2020 ◽

Author(s):

Zemene Tigabu Kebede ◽

Kassahun Alemu Gelaye ◽

Mehari Woldemariam Merid ◽

Temesgen Yihunie Akalu ◽

Ashenafi Tazebew Amare ◽

...

Keyword(s):

Health Care ◽

Health Center ◽

Childhood Illness ◽

Treatment Seeking ◽

Health Seeking ◽

Under Five ◽

Under Five Children ◽

Childhood Illnesses ◽

Care Givers ◽

Seeking Behavior

Abstract Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, the identification of determinants of this childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers with at least one under-five child were included. Mothers were interviewed at their homes using structured questionnaire. Adjusted Odds Ratio with a 95% Confidence Interval for variables with P-value <0.05 in the multivariable model were reported to show the significance and the direction of association.Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illness was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95% CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), two under-five children (AOR=1.33;95%CI: 1.029,1.74) and three or more children in the house (AOR=2.70; 95%CI: 1.12, 6.53). About 22.8% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: In this study, common childhood illnesses remain high while the treatment-seeking behavior of the mothers’/caregivers’ was low. Mothers’ age, occupation, distance from the nearest health center, and two or more children in the house were independent factors of childhood illness. Being a skilled/semi-skilled mothers was significantly associated with health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children. Besides, providing access to health care facilities in their nearby area would be essential in reducing childhood illness.

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High common childhood illnesses while treatment seeking behavior of mothers’/care givers’ was low at rural northwest Ethiopia

10.21203/rs.2.17005/v1 ◽

2019 ◽

Author(s):

Zemene Tigabu Kebede ◽

Kassahun Alemu Gelaye ◽

Mehari Woldemariam Merid ◽

Temesgen Yihunie Akalu ◽

Ashenafi Tazebew Amare ◽

...

Keyword(s):

Health Center ◽

Childhood Illness ◽

Treatment Seeking ◽

Multivariable Model ◽

Health Seeking ◽

Under Five ◽

Under Five Children ◽

Childhood Illnesses ◽

Care Givers ◽

Seeking Behavior

Abstract Background: In most developing countries, childhood illness and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, identification of determinants of these childhood disease illness would help to guide strategic planning, and prioritize interventions. Method: Community based cross-sectional study was conducted. Two stage cluster sampling technique was used to select kebeles and then households. A total of 2,158 mothers/care givers with at least one under-five child were included. Mothers/care-givers were interviewed at their homes using a pretested and structured questionnaire. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) for variables with P-value <0.05 in the multivariable model were reported to show significance and direction of association<0.05 in the multivariable model were reported to show significance and direction of association. Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). The treatment seeking behavior of the mothers/caregivers was 22.8% (95% CI: 18.7, 27.4). Of the illnesses, 6.5% (95% CI: 5.5, 6.72) were diarrhea, 7.5% (95% CI: 6.5, 8.76) were ARI, and 12.0% (95% CI: 10.66, 13.40) were fever. Mothers’ age 40 years and above (AOR=0.35; 95%CI: 0.16, 0.76), mothers’ occupation (AOR=2.28; 95%CI: 1.84, 4.39), distance from nearest health center (AOR=1.02; 95%CI: 1.01, 1.03), and presence of three or more under-five children in the house (AOR=2.59; 95%CI: 1.03, 5.76) were predictors of childhood illness. Conclusion: In this study, the common childhood illness remains high while treatment seeking behavior of the mothers’/care givers’ was so low. Mothers’ age and occupation, distance from nearest health center, and presence of three or more under-five children in the house were independent determinants of childhood illness. Thus, addressing significant determinants and enhancing mothers’/care givers health seeking behavior would help in reducing morbidity and mortality of under-five children with common childhood illness. Key word: Childhood illness, determinants, rural, health seeking behavior, Ethiopia

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High common childhood illnesses while the treatment-seeking behavior of mothers/caregivers’ was low in rural northwest Ethiopia in 2018. A community-based cross-sectional study

10.21203/rs.2.17005/v4 ◽

2020 ◽

Author(s):

Zemene Tigabu Kebede ◽

Kassahun Alemu Gelaye ◽

Mehari Woldemariam Merid ◽

Temesgen Yihunie Akalu ◽

Ashenafi Tazebew Amare ◽

...

Keyword(s):

Cross Sectional Study ◽

Childhood Illness ◽

Treatment Seeking ◽

Health Seeking ◽

Community Based ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Childhood Illnesses ◽

Seeking Behavior

Abstract Background: In most developing countries, childhood illness, and deaths are among the most challenging health issues. Most of these deaths were due to preventable causes including acute respiratory infections (ARI), diarrhea, and febrile illnesses. Thus, the identification of determinants of this childhood illness would help to guide strategic planning and prioritize interventions.Method: Community based cross-sectional study was conducted. A two-stage cluster sampling technique was used to select households and mothers/caregivers. A total of 2,158 mothers/caregivers with at least one under-five child were included. Mothers/caregivers were interviewed at their homes using a pretested and structured questionnaire. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) for variables with P-value <0.05 in the multivariable model were reported to show the significance and the direction of the association. Result: The overall prevalence of childhood illnesses was 16.5% (95% CI: 15.0, 18.2). Of all, 6.5% (95% CI: 5.5, 6.72), 7.5% (95% CI: 6.5, 8.76), and 12.0% (95% CI: 10.66, 13.40) had diarrhea, ARI, and fever, respectively. The treatment-seeking behavior of mothers/care-givers for any of the childhood illnesses was 22.7% (18.72, 27.42). The odds of childhood illness was higher among mothers’ age 15-19 years (AOR=2.87-; 95%CI: 1.33, 6.13), employed mothers’ (AOR=2.28; 95%CI: 1.84, 4.39), living far away from the nearest health center (AOR=1.02; 95%CI: 1.005, 1.027), presence of two under-five children (AOR=1.33;955CI: 1.029,1.74) and three or more under-five children in the house (AOR=2.70; 95%CI: 1.12, 6.53) than a single child. About 23% (95% CI: 18.7, 27.4) of mothers/caregivers sought health care for the sick child. Mothers’ occupation (AOR= 4.08 (95% CI: 1.35, 12.39) was the only independent predictor of treatment-seeking behavior.Conclusion: The common childhood illness remains high while the treatment-seeking behavior of the caregivers’ was low. Mothers’ age, occupation, distance from the health center, and the presence of two or more under-five children in the house were independent factors of childhood illness. Being skilled mothers was significantly associated with good health-seeking behavior of mothers/caregivers. Thus, involving women in skilled/semi-skilled occupations would help in decreasing childhood illness and enhance health-seeking behaviors for their under-five children.

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