A survey on Integrated Management of Neonatal and Childhood Illness implementation by nurses in four districts of West Arsi zone of Ethiopia

Abstract

Background

In Ethiopia, one in 17 children dies before 1 year of age and one in 11 children dies before 5 years. Research that examines the factors influencing the implementation of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) strategy in Ethiopia is limited. This study aimed to identify the factors compelling the execution of IMNCI by nurses in four districts of West Arsi zone of Ethiopia.

Methods

A mixed-method cross-sectional study was conducted from February to March 2016 in West Arsi zone of Oromia regional state, Ethiopia. A total of 185 Integrated Management of Childhood Illness (IMCI)-trained registered nurses working at Under-Five Clinic were purposively chosen for the study among 291 registered nurses based at health centers and hospitals in the Arsi zone. The study was complemented by a qualitative method.

Results

More than half (57.8%) of the nurses interviewed had been trained (51.35% of them attended in-service training). The most common issues encountered in the implementation of IMCI were: lack of trained staff (56.2%), lack of essential drugs and supplies (37.3%), and irregular supportive supervision (89.2%). The qualitative data supplemented the factors that influence IMNCI implementation, including drug unavailability, lack of human resources, and lack of effective supportive supervision and follow-up visits. Therefore, interventions aiming at training nurses, with emphasis on performing supportive consistent supervision and supporting the system of health care by enhancing admittance to indispensable drugs and supplies, are recommended to help IMCI implementation.

Keywords:

• IMNCI-trained nurses
• implementation
• West Arsi Zone
• Ethiopia

Acknowledgments

This study was funded by Addis Ababa University postgraduate office. The authors are thankful to School of Allied Health, College of Health Sciences, Addis Ababa University, for its financial and technical support. They are also grateful to the health bureau of West Arsi zone of the Oromia regional state and the district administration office for their support in the whole process of the study. They thank the study participants for their time to participate in the study. Finally, they thank the research assistants who contributed to data collection.

Author contributions

SS Seid hypothesized the study, searched literature, and trained the research assistants in data collection. He also wrote the results and discussion sections, and drafted the manuscript. EG Sendo contributed to the design of the study, advised on methods and data interpretation, and analyzed the qualitative data. He also critically revised and edited the manuscript. Both the authors read and approved the final manuscript.

Disclosure

The authors declare that they have no competing interests in this work.