Quality of Integrated Management of Newborn and Childhood Illness Services at Health Centers in Jimma, Southwest Ethiopia

Abstract

Background

The Integrated Management of Newborn and Childhood Illness (IMNCI) strategy includes both preventive and curative interventions to improve practices in health facilities, the health system and at home. The quality of these interventions has been very rarely subjected to scientific inquiry in Ethiopia. This study assessed quality of IMNCI services in health centers of Jimma, South West Ethiopia, 2014.

Methods

A facility based cross-sectional study was conducted from March 2–15, 2014 in the health centers of Jimma among 411 care takers exit interview and total of 60 consultation sessions were observed using checklist and participants enrolled through convenient sampling technique. Descriptive statistics were used and factor analysis was employed to create measurement scales for satisfaction of caretakers. Factor scores were used in linear regression analyses to determine presence of statistically significant association between explanatory variables and the outcome variable at P value <0.05.

Results

The response rate for the exit interview was 411 (97.4%). The mean score of overall caretakers satisfaction was 63.4. Specifically 23.4%, 33.6%, and 19.2% of the respondents were dissatisfied with waiting time, amount of explanation they received about the problem or treatment, and availability of medicines, respectively. Availability of prescribed medications (95% CI: 0.577 to 0.047), receiving first dose of medication at health facility (95% CI: 0.087, 0.552), receiving laboratory services (95% CI:0.455,0.056) were among factors that significantly associated with the caretakers’ satisfaction score.

Conclusion and Recommendations

Perceived mean of caretakers’ satisfaction at the health centers of Jimma town was low as compared to national standards and long waiting time while providing services. Availability of prescribed medications, receiving first dose of medication and receiving laboratory services were factors associated with patients’ satisfaction. Respective health centers need to ensure availability of medications and supplies and professionals need to pay special attention on medical services like laboratory services, medication and decrease waiting time while providing health services.

Keywords:

• Integrated Management of Newborn and Childhood Illnesses
• quality
• satisfaction
• Jimma

Abbreviations

AIDS, Acquired Immune Deficiency Syndrome; ART, Anti retroviral therapy; CI, confidence interval; C-IMCI, Community Integrated Managements of Childhood Illness; DHS, demography and health survey; EDHS, Ethiopian Demographic and Health Survey; EPI, Expanded Program on Immunization; ETB, Ethiopian Birr; GNI, Gross National Income; GSPA, Ghana Service Provision Assessment; HIV, Human Immunodeficiency Virus; HCT- HIV, counseling and testing; IMCI, Integrated Managements of Childhood Illness; IMNCI, Integrated Managements of Newborn and Childhood Illness; KSPA, Kenya Service Provision Assessment; MDGs, Millennium Development Goals; ORS, Oral rehydration salt; PAHO, Pan-American Health Organization; PHCs, primary health cares; PIHCT, provider initiated HIV counseling and testing; SPA, Service Provision Assessment; USPA, Uganda service provision assessment; TB, Tuberculosis; WHO, World Health Organization.

Data Sharing Statement

Data and materials will be available upon request. You can contact Mr. Musa Kumbi, and Mr. Adem Abdulkadir if you want the data and materials at any time.

Ethics Approval and Consent to Participate

Ethical clearance was obtained from Research Ethics Committee of college of public health and medical sciences of Jimma University in compliance with the Declaration of Helsinki. Moreover, Verbal informed consent was approved by the ethics committee of college of public health and medical sciences of Jimma University. Letter of permission was obtained from Jimma town health department.Finally verbal consent was obtained from the health centres, study participants and service providers included in the study immediately before the data collection. Verbal consent was obtained from guardian (Mother and father) of children under 5. Anonymity and confidentiality was ensured for information obtained from study participants before the Interview and the participants were informed about the purpose of the study.

Authors’ Information

MK, AH and AA are Assistant Professor and lecturers at Madda Walabu University respectively.

Acknowledgments

Authors are thankful to Jimma University Graduate Study program for supporting this study. We are also very thankful to mothers for their collaboration to achieve this study.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest for this work.

Additional information

Funding

This study was funded by Jimma University, Ethiopia.The University has supported this study financially and technically during the design of the study, collection, analysis, interpretation of data and in writing the manuscript.