“The staff are not motivated anymore”: Health care worker perspectives on the Integrated Management of Childhood Illness (IMCI) program in the Philippines

Abstract

Background Studies focusing on the Integrated Management of Childhood Illness (IMCI) program in the Philippines are limited, and perspectives of frontline health care workers (HCWs) are largely absent in relation to the introduction and current implementation of the program. Here, we describe the operational challenges and opportunities described by HCWs implementing IMCI in five regions of the Philippines. These perspectives can provide insights into how IMCI can be strengthened as the program matures, in the Philippines and beyond. Methods In-depth interviews (IDIs) were conducted with HCWs (n = 46) in five provinces (Ilocos Sur, Quezon, National Capital Region, Bohol and Davao), with full transcription and translation as necessary. In parallel, data collectors observed the status (availability and placement) of IMCI-related materials in facilities. All data were coded using NVivo 12 software and arranged along a Social Ecological Model. Results HCWs spoke of the benefits of IMCI and discussed how they developed workarounds to ensure that integral components of the program could be delivered in frontline facilities. Five key challenges emerged in relation to IMCI implementation in primary health care (PHC) facilities: 1) insufficient financial resources to fund program activities, 2) inadequate training, mentoring and supervision among and for providers, 3) fragmented leadership and governance, 4) substandard access to IMCI relevant written documents, and 5) professional hierarchies that challenge fidelity to IMCI protocols. Conclusion Although the IMCI program was viewed by HCWs as holistic and as providing substantial benefits to the community, more viable implementation processes are needed to bolster acceptability in PHC facilities.

Implementation of distance learning IMCI training in rural districts of Tanzania

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Healthcare workers’ perspectives on the availability and use of mobile health technologies for disease diagnosis and treatment support in the Ashanti Region of Ghana

“…Our current study shows that some healthcare workers in the Ashanti Region of Ghana have inadequate skills and training in using mHealth apps for disease screening and treating conditions. These findings have been shown in other resource-limited settings where some healthcare workers have insufficient training and skills to use mHealth applications to promote healthcare access [46][47][48]. In these studies, despite the insufficient training and skills, healthcare professionals intimated that mHealth applications such as text messages and mHealth apps are very useful.…”

“Respect my opinion and I'll respect yours!”: Exploring the challenges, concerns, and informational needs of vaccine‐hesitant caregivers and pregnant women in the Philippines

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