Integrated Management of Childhood Illnesses implementation-related factors at 18 Colombian cities

Abstract

Background Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF in 1992. It was deployed as an integrated approach to improve children’s health in the world. This strategy is divided into three components: organizational, clinical, and communitarian. If the Integrated Management of Childhood Illnesses implementation-related factors in low- and middle-income countries are known, the likelihood of decreasing infant morbidity and mortality rates could be increased. This work aimed to identify, from the clinical component of the strategy, the implementation-related factors to Integrated Management of Childhood Illnesses at 18 Colombian cities. Methods A quantitative cross-sectional study was performed with a secondary analysis of databases of a study conducted in Colombia by the Public Health group of Universidad de Los Andes in 2016. An Integrated Care Index was calculated as a dependent variable and descriptive bivariate and multivariate analyses to find the relationship between this index and the relevant variables from literature. Results Information was obtained from 165 medical appointments made by nurses, general practitioners, and pediatricians. Health access is given mainly in the urban area, in the first level care and outpatient context. Essential medicines availability, necessary supplies, second-level care, medical appointment periods longer than 30 min, and care to the child under 30 months are often related to higher rates of Integrated Care Index. Conclusion Health care provided to children under five remains incomplete because it does not present the basic minimums for the adequate IMCI’s implementation in the country. It is necessary to provide integrated care that provides medicine availability and essential supplies that reduce access barriers and improve the system’s fragmentation.

Consulta de enfermagem em saúde da criança e competências para Enfermeiros de Prática Avançada

“…Estudo na Etiópia demonstrou que os problemas mais comuns encontrados na implementação do AIDPI estão relacionados à falta de treinamento, de medicamentos, suprimentos essenciais e principalmente de supervisão e visita de acompanhamento (20) . Outro estudo quantitativo, realizado na Colômbia, revelou que a assistência realizada para as crianças menores de cinco anos continua incompleta, pois não apresenta o mínimo necessário para implementação adequada do AIDPI no país (21) .…”

A Nursing Philosophy of Family Empowerment in Caring Under-Five Children Illness

“…WHO recommends one of the treatments for sick toddlers in developing countries through the Integrated Management of Childhood Illness (IMCI), which is an integrated approach to the management of sick toddlers with a focus on the health of children aged 0-5. years (toddlers) as a whole, in this IMCI-based management one of the components is improving family and community practices in-home care and efforts to seek help for sick toddlers (impact increasing community empowerment in health services) (García Sierra & Ocampo Cañas, 2020) (Kementrian kesehatan Republik Indonesia, 2022).…”

“…A nurse is someone who is highly educated in nursing and carries out nursing activities based on nursing science by providing care to individuals, families, groups, or communities. Family empowerment interventions in sick children based on scientific evidence can be used as the basis for interventions for nurses in the care of sick toddlers (García Sierra & Ocampo Cañas, 2020).…”

Antibiotic Use for Febrile Illness among Under-5 Children in Bangladesh: A Nationally Representative Sample Survey

“…Several studies have reported the overuse of antibiotics obtained from unqualified providers and drug shops in Bangladesh, and 80-90% of drug shops and medicine vendors operate without a license [8,13,19,28]. Additionally, the adequate supervision and inspection of drug outlets are complicated by the limited availability of drug inspectors (i.e., one drug inspector supervises 2236 pharmacy shops) [6]. Initiatives, such as the 'model pharmacy', which accredit pharmacies for meeting high standards of practice, may help to reduce over the counter purchases of antibiotics [29].…”

“…These illnesses include acute respiratory infections (ARIs), accounting for 50-75% of febrile presentations at outpatient clinics, and gastroenteritis, accounting for 10-25% of febrile illnesses. Clinical practice guidelines (CPGs), such as the Integrated Management of Childhood Illness (IMCI), aim to standardise the symptomatic management of fever in children [6]. These guidelines promote the rational use of antimicrobials by recommending antibiotics be exclusively prescribed to children who are presumed to have a disease that can be treated using antibiotics, based on World Health Organisation (WHO) recommendations [7].…”