The Implementation of Integrated Management of Children Illness in Primary Health Community in Yogyakarta, Indonesia

Abstract

BACKGROUND: The mortality rate for infants and toddlers aged 12–59 months in Yogyakarta has shown a fluctuating trend between 2008 and 2014. To reduce infant and toddler mortality rates, the Yogyakarta city government has made some efforts to implement integrated management of children illness (IMCI). Thus, it can be said that one of the successful actions of the government in reducing mortality and morbidity of infants and toddlers is determined by optimizing the role of IMCI in the primary health community (PHC) as the vanguard in public health services. The results of the preliminary study found that all PHCs in the cities of Bantul and Yogyakarta had implemented IMCI, although there were no data related to how the inputs, processes, and outputs in the implementation of the IMCI were. AIM: This study aims to determine the implementation of IMCI related to its inputs, processes, and outputs at PHC in Bantul and Yogyakarta City. METHODS: This research method used descriptive research. RESULTS: Based on previous study results, in 2019, the average health center had fulfilled the “output” activities regarding 60% of toddler visits carrying out IMCI. CONCLUSION: It indicated that some health centers had implemented the IMCI program optimally.

Fishbone Diagram Analysis in the Implementation of Integrated Management of Childhood Illness (IMCI) in Indonesia

“…More than half (6 out 8) of the articles analyzed indicated that the implementation of IMCI was not following the standards or procedures/steps in the IMCI guidelines or chart (Casnuri & Rahayu, 2020;Hasibuan et al, 2019;Mansur, 2017;Rahmah & Astuti, 2021;Suparmi et al, 2018;Wartana & Herawaty, 2016). This is closely related to a large number of untrained health workers.…”

“…Of the eight articles analyzed, six articles describe the condition shortage of IMCI officers due to the gap between officers and patients, and there are still officers who have never received IMCI training (Casnuri & Rahayu, 2020;Hasibuan et al, 2019;Mansur, 2017;Mastuti et al, 2021;Rahmah & Astuti, 2021;Wartana & Herawaty, 2016). One of the reasons for the absence of trained IMCI officers at the puskesmas is that the trained officers have moved and are no longer on duty at the puskesmas (Hasibuan et al, 2019).…”

“…Four of the eight articles indicated that there were limitations or lack of adequate facilities and infrastructure (Hasibuan et al, 2019;Rahmah & Astuti, 2021;Suparmi et al, 2018;Tat et al, 2021), such as oral rehydration therapy facilities (Rahmah & Astuti, 2021;Suparmi et al, 2018), timers or stopwatches with seconds needle (Hasibuan et al, 2019), and medical consumables (BMHP) which are insufficient and not available in the IMCI room, but are available in other rooms, such as the Emergency Room (Rahmah & Astuti, 2021), as well as the absence of a custom room for the IMCI polyclinic for examination of sick toddlers (Hasibuan et al, 2019;Rahmah & Astuti, 2021). From a study in Bantul District, only two puskesmas (28.6%) had the complete equipment (Rahmah & Astuti, 2021).…”

“…Based on the research of Rahmah, et al (2021) in Yogyakarta there has been no support from the Health Office in funding the implementation of IMCI. This lack of support is one of the factors hindering the implementation of IMCI because almost 100% of puskesmas do not have a budget allocation for implementing IMCI (Rahmah & Astuti, 2021).…”

Challenges experienced by nurses regarding the involvement of guardians in integrated management of childhood illnesses in Vhembe District

“…Furthermore, the implementation of the strategy is affected by the lack of human resources. A study by Rahmah and Astuti (2021) found shortage of IMCI-trained healthcare workers compared to the number of under-five children seen in the PHC facilities. The shortage increased the waiting times in the facilities.…”