Challenges to implementation of IMNCI strategy in First Level Care Facilities.

Abstract

Objective: To assess IMNCI implementation strategy and identify challenges towards effective implementation in first level care facilities of district Jamshoro.

Methodology: This mixed method research was carried out from Jan 2020 to March 2020 at Rural Health Centers (RHC) in District Jamshoro using semi-structured, pre-tested, written questionnaires after taking due approval and written informed consent from respondents. The respondents (representing different cadres of healthcare providers i.e., medical officers (male & female), lady health workers (LHWs), vaccinators, pharmacists and 13 administrative staff. The data obtained (pertaining to perception and views regarding IMNCI implementation and availability of relevant logistics for service provision) was analyzed using SPSS version 22.0 for windows.

Results: The mean age of the sample stood at 42 (SD ± 4) years with a majority comprising of male, dispensing/nursing staff with a mean work experience of 13.2 years (SD ± 1.1) Pneumonia was deemed the commonest childhood problem by most respondents, followed by malaria and others uniformly across all catchments. The understanding regarding IMNCI was common (despite the absence of formal training) yet often, the strategies were not implemented while caring for children.

Conclusion: Effective implementation is a seldom sight with many challenges, including but not limited to shortage of human resource and a rather limited supply of medicines. Thus, efforts must be dedicated at ensuring an ample human resource and a consistent supply of necessary medication.

Keywords: IMNCI, Childhood Illness, Neonatal Illness, Integrated Management, Primary care facility.