Challenges to the implementation of the integrated management of childhood illness (IMCI) at community health centres in West Java province, Indonesia

Titaley, Christiana Rialine; Jusril, Hafizah; Ariawan, Iwan; Soeharno, Nugroho; Setiawan, Tri Agus; Weber, Martin

doi:10.4103/2224-3151.206732

Cited by 28 publications

(22 citation statements)

References 4 publications

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“…Despite the significances of training for IMNCI utilization, only 57.8% of nurses in four districts of west Arsi zones had attended IMNCI training, which was less than WHO recommendation which stated that at least 60% of health care workers seeing sick children in the health facilities should trained how to utilize IMNCI guidelines [15]. However, the finding from present study was higher compared to similar study carried out in Indonesia [16]. The difference could be related to trained staff turnover and high cost of training.…”

Section: Discussioncontrasting

confidence: 93%

“…IMNCI includes both preventive and curative elements that are implemented by families and communities as well as by health facilities. In summary, the IMNCI strategy includes three main components these include: Improving case management skills of healthcare staff, improving the health systems and improving family and community health practices [3,[5][6].…”

Section: Introductionmentioning

confidence: 99%

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Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Nurse at Public Health Institutions in West Arsi Zone, South East Ethiopia

Seid¹,

Sendo²,

Haso³

et al. 2019

Clinics Mother Child Health

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Background: World health organization (WHO) and United Nations for Children's Fund (UNICEF) in the early 1990s developed Integrated Management of Childhood Illness (IMCI), a strategy designed to reduce child mortality and morbidity in developing countries. This study is aimed at assessing factors associated with utilization of IMNCI protocol by nurses West Arsi Zone, Oromia Region, Ethiopia. Methods: An institutional based cross-sectional study was conducted on a total of 185 nurses who were included from health facilities selected using simple random sampling technique. Data was coded, entered and cleaned using Epi-data 3.1 and exported to SPSS version 22 for analysis. Univariate and bivariate analysis was performed. Multivariate analysis was also done to control for possible confounding variables. Results: Data were obtained from 185 nurses, of which 131 (70.8%) were males. More than half 103 (55.7%) of the respondents was aged between 25-29 years. The mean (± SD) age was 26.65 ± (1.7) with the range of 20-43 years and 107 (57.8%) were diploma nurses. The overall IMNCI protocol utilization was 58.7%. In multivariate analysis, the odd of IMNCI utilizations among nurses who had attended IMNCI training were 2.76 times higher compared to nurses who had not attended IMNCI training [AOR=2.76, 95% CI:1.388, 5.51]. Nurses who had practice of always referring chart booklet during every case management process were three times more likely to utilize IMNCI protocols [AOR=2.95, 95% CI: 1.48, 5.89] compared to their counterparts. Conclusions: The proportion of IMNCI utilizations in the selected districts was low and less than the WHO recommendations. Training and frequent referring of chart booklet were found to significantly associate with the utilization of the IMNCI protocols. Therefore the emphasis should be given to the provision of IMNCI training to the nurse by the stakeholders and motivating the nurses to always refer chart booklet, in order to enhance proper utilization of the protocols.

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Section: Discussioncontrasting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Nurse at Public Health Institutions in West Arsi Zone, South East Ethiopia

Seid¹,

Sendo²,

Haso³

et al. 2019

Clinics Mother Child Health

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“…10 Selain itu, penelitian yang dilakukan oleh Pusat Kajian UI menunjukkan hanya 57% puskesmas yang menjangkau ke seluruh balita. 11 Oleh sebab itu, perlu dilakukan evaluasi terkait pelaksanaan MTBS di Puskesmas pada regional timur Indonesia.…”

Section: Pendahuluanunclassified

“…Temuan ini lebih rendah dibanding hasil penelitian Pusat Kajian UI di Provinsi Jawa Barat, yaitu sebesar 57% Puskesmas telah melayani MTBS ke seluruh balita. 11 Salah satu kunci keberhasilan penerapan MTBS adalah kepatuhan petugas dalam melakukan pemeriksaan balita sakit dengan mengikuti standar yang telah ditentukan. Kepatuhan petugas dalam tata laksana MTBS sangat penting, sehingga balita yang sakit tidak hanya didiagnosis menurut keluhan tetapi dapat didiagnosis secara menyeluruh.…”

Section: Pembahasanunclassified

Pelayanan Manajemen Terpadu Balita Sakit (MTBS) pada Puskesmas di Regional Timur Indonesia

Suparmi¹,

Maisya²,

Rizkianti³

et al. 2018

mpk

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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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“…23 Further problems identified during implementation of IMCI in some Southeast Asia countries include the nonuniversal application of management strategies to all children, shortage of trained staff and insufficient supply of IMCI drugs and equipment, as well as lack of facilities and infrastructure. 24 Disease-specific guidelines produced by the WHO have also been implemented in some countries in this region. Evaluation performed by the authors in some of these countries has revealed that only some portions of these intervention packages are adhered to.…”

Section: Prehospital Emergency Medical Carementioning

confidence: 99%

The Assessment, Evaluation, and Management of the Critically Ill Child When Resources are Limited—Southeast Asian Perspective

Tang

Lum

2016

J Pediatr Intensive Care

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The Southeast Asia region comprises 10 independent countries with highly divergent health systems and health status. The heterogeneity in infant and child mortality rates suggests that there is still scope for improvement in the care of critically ill children. There is, however, a paucity of published data on outcomes and processes of care that could affect planning and implementation of intervention programs. Significant challenges in the delivery of care for the critically ill child remain, especially in pre-hospital and in-hospital triaging and emergency care and inpatient hospital care. Potential areas for continued improvement include strengthening of health systems through sustained commitment by local governments, capacity building, and sharing of research output. Simple, low cost, locally available, and effective solutions should be sought. The introduction of standards and auditing tools can assist in determining effectiveness and outcomes of intervention packages that are adapted to local settings. Recognition and acknowledgment of shortfalls between expectations and outcomes is a first step to overcoming some of these obstacles necessary to achieve a seamless interface among pre-hospital, emergency, inpatient, and critical care delivery processes that would improve survival of critically ill children in this region.

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Challenges to the implementation of the integrated management of childhood illness (IMCI) at community health centres in West Java province, Indonesia

Cited by 28 publications

References 4 publications

Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Nurse at Public Health Institutions in West Arsi Zone, South East Ethiopia

Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Nurse at Public Health Institutions in West Arsi Zone, South East Ethiopia

Pelayanan Manajemen Terpadu Balita Sakit (MTBS) pada Puskesmas di Regional Timur Indonesia

The Assessment, Evaluation, and Management of the Critically Ill Child When Resources are Limited—Southeast Asian Perspective

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