Consistency of Integrated Management of Newborn and Childhood Illness (IMNCI) in Shire Governmental Health Institution in 2017

Abstract

ObjectiveIn an effort to reduce infant mortality and morbidity, the World Health Organization and other technical partners developed the Integrated Management of Newborn and Childhood Illness (IMNCI). This study focuses on assessment of consistency and completeness of integrated management of neonatal and child hood illness in primary health care units.ResultsA total of 384 cases were taken from 3562 cases both from young infant registration (under-2 month old) and child registration (2 months–5 year old). Out of 384 cases, 241 (62.8%) cases were correctly classified and 143 (37.2%) were incorrect classifications. Similarly 164 (42.7%) cases were treated correctly where as 220 (57.3%) treated incorrectly. Only 95 (24.7%) cases have given appropriate appointments where as 289 (75.3%) cases were appointed incorrectly. The overall consistency of IMNCI management is poor. Unless continuous follow up of and training was given, children are not treated as expected. More over using electronic method of IMNCI may alleviate the problem.

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

“…In our study, the consistency of treatment of childhood illness with the classification of disease at the pre- and postintervention was 48.9 and 85.2%, respectively. The finding was higher than a study conducted in Benin, which showed about 63.6% [ 23 ], and in the Shire, northern Ethiopia, about 42.7% [ 20 ] of the children treated according to IMNCI guideline. The possible difference might be the difference in the performance of individual health workers and skills to manage a sick child using the IMCI guideline.…”

“…Our interventional study also showed that consistency in assessing and classifying sick children was 49.4 and 82.5% for pre- and postinterventions, respectively, which was better than that of a study conducted in the Shire, northern Ethiopia, which showed that only 62.8% were correctly classified [ 20 ]. Moreover, this study also indicates higher consistency in assessing and classifying sick children from the research conducted in China, which showed that only 43.8% [ 21 ] and Tanzania 28.4% [ 22 ].…”

“…The more enormous changes were observed in the assessment of HIV/AIDS status (37.8 to 79.9%) and giving of appointment (32.8 to 73.0%), and lower results were observed in the assessment of ear problem (60.3 to 87.5%) and fever status (63.0 to 85.3%). Those findings were better than the studies conducted in China which showed a sick child who was checked for the weight (4.9%), body temperature (60.3%), danger signs (2.87%), cough, diarrhea, and fever (10.9%), height (0.3%), vaccination (4.6%), feeding problem (5.21%), and other problems (29.95%) [ 21 ]; in Shire which showed a sick child who was checked for danger signs (40%), vaccination status (22.5%), and HIV status (15%) [ 20 ], and the WHO assessment of IMCI showed that a sick child was checked for pneumonia (34%), diarrhea (18.6%), and cough or difficulty of birthing (39.8%) [ 7 ]. The possible reasons for this difference might be the difference in study setup and study design; some of the studies were a cross-sectional study like in China and the WHO assessment.…”

“…The sample size was determined for chart review (under-five child individual folder) the assessment of the preintervention and postintervention results using a single population proportion formula with the assumption proportions of the completeness of IMCI was 54.2% taken from a study conducted in Shire government hospitals, Ethiopia [ 20 ], 95% confidence level (CI), and a margin of error (5%). Then, putting the value in the formula, it gives the final sample of 381.…”

Key challenges of health care workers in implementing the integrated management of childhood illnesses (IMCI) program: a scoping review

“…Such incomplete case assessments could lead to misclassification and missed referrals. For example, in Ethiopia, Gerensea and colleagues [34] documented that out of 384 cases, 37.2% were classified incorrectly and 57.3% were wrongly treated. Despite nationwide training and expansion of the program, in their study of 4 sub-Saharan African countries (Namibia, Kenya, Tanzania and Uganda), Krüger and colleagues [35] also reported that HCWs failed to recognize IMCI danger signs and primary symptoms, which are crucial for the succeeding steps in the IMCI algorithm.…”