Faculty of Health Science SChool of Public Health 0112677r burmamtk@iafrica.com / The study aimed to evaluate IMCI guidelines, developed to assess children with Suspected Symptomatic HIV [SSHIV] as a screening tool for AIDS. OBJECTIVES 1. To look at the agreement between IMCI classification for SSHIV and WHO clinical case definition for AIDS using a retrospective record review of the same hospitalised children. 2. To determine the sensitivity, specificity, positive predictive values and likelihood ratios of the IMCI SSHIV criteria (Guidelines 2001), WHO clinical case definition for paediatric AIDS and Bloemfontein Proposed simplified case definition for paediatric SSHIV, using HIV ELISA results in children older than 15 months as a gold standard. METHODS The study involved 304 children in the IMCI age range who were admitted to the Edenvale Hospital during the study period and who met all the inclusion and exclusion criteria. These children were assessed with IMCI criteria and WHO criteria for AIDS. [Objective 1] The findings of 50 children above 15 months of age with ELISA results were compared using 3 sets of criteria. [IMCI, WHO and Bloemfontein proposed simplified case definition for paediatric SSHIV] [Objective 2] FINDINGS IMCI and WHO criteria for AIDS were the same in 158 [52%] of the 304 children. Almost all [22 out of 23 children] with WHO criteria for AIDS were also classified by IMCI criteria as Suspected Symptomatic HIV. [Objective 1] v IMCI criteria had the highest sensitivity [85.7%], while WHO criteria had the highest specificity [88%] based on ELISA results. [Objective 2] CONCLUSION Based on the above findings, IMCI criteria could be considered as a screening tool to select children aged 15 months and above for appropriate laboratory investigation for HIV infection confirmation in remote areas. WHO criteria for AIDS could be considered for exclusion of AIDS in children aged 15 months and above in remote areas where laboratory facilities are not available. In this study, reliable findings could not be obtained in children younger than 15 months.

Aim: The study aimed at describing the status of implementation of pre-service IMCI training in the public nursing colleges of South Africa as at 2010. Methods: A cross sectional descriptive survey of public nursing colleges of South Africa was conducted from May to June 2011. There are 32 public nursing colleges in South Africa, and each of the nine provinces has at least one. All 32 nursing colleges were included in the study. Study population: The study population included all nurse educators in the public nursing colleges teaching pre-service IMCI of student nurses in South Africa. Sampling: Two nurse educators teaching the IMCI strategy from each of the 32 public nursing colleges was included in the survey. Two nurse educators from each completed the questionnaire.Results: Pre-service IMCI training was introduced into the four-year basic diploma curriculum in the public nursing colleges between 2004 and 2009. Nurse educators teaching IMCI are not all trained in this strategy. Teaching methods used at these public nursing colleges include lectures, group discussions, practical and video shows. The availability of facilitators and training material are key success factors to IMCI teaching in the public nursing colleges. Constraints experienced included lack of human, material and financial resources, poor planning, and limited time for both theoretical and practical teaching due to a packed curriculum, as well as a lack of managerial support at all administrative levels. Conclusion: The success in pre-service IMCI training in the public nursing colleges depends on the availability of resources and ongoing managerial support to the nurse educators. New teaching methods and approaches, such as computerised tools, can be introduced to increase number of student nurses trained in this method. A mixed approach is recommended as it enables students to have continuous exposure to IMCI sessions throughout their years of study.

Made available in DSpace on 2015-05-08T14:47:25Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 967601 bytes, checksum: 56f37691cffef2aa48967871fdd13857 (MD5) Previous issue date: 2012-04-03 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The strategy of Integrated Management of Childhood Illness, developed by the World Health Organization and United Nations Children's Fund, aims at reducing infant mortality through actions to improve the performance of health professionals, the organization of the health system and the family and community practices. This study aimed to evaluate the practices of nurses working on the Family Health Strategy related to the applicability of IMCI. It was used the exploratory descriptive method with a qualitative approach, carried out with nurses in the urban area of the Family Health Program in Campina Grande, from August to October 2011. The sample consisted of eight subjects. The data were collected through a structured interview. For the data analysis, the content analysis method of categorical theme proposed by Bardin was used. This study complied with Resolution 196/96 of the National Health Council in which the project was submitted to the ethics committee and research of the Center for Superior Teaching Development. It was carried out only after approval under protocol n. 00810.405.000.11. The qualitative results were arranged in two analytical categories: Applicability of IMCI by the nurses and difficulties to implement the IMCI. The results highlight the importance of IMCI as an instrument that facilitates the systematic approach and generates more driving safety consulting the nurse. As for the difficulties, the subjects emphasize the availability of a specific script to be used in consultation and lack of support for prescription drugs, generating uncertainty in attendance. The results lead us to conclude that a continuous education work is necessary to further the actions proposed by IMCI in such a way that it promotes a more comprehensive focus on health care to the child, based on scientific knowledge. / A estratégia da Atenção Integrada às Doenças Prevalentes na Infância, desenvolvida pela Organização Mundial da Saúde e Fundo das Nações Unidas para a Infância, pretende reduzir a mortalidade infantil por meio de ações que visam melhorar o desempenho dos profissionais de saúde, a organização do sistema de saúde e as práticas da família e da comunidade. Partindo desse pressuposto, o presente estudo teve como objetivo identificar as dificuldades e facilidades das práticas dos enfermeiros que atuam na Estratégia de Saúde da Família, relacionadas à aplicabilidade da AIDPI. Utilizou-se o método exploratório descritivo, com abordagem qualitativa, realizada com oito enfermeiros da zona urbana da Estratégia Saúde da Família de Campina Grande, no período de agosto a outubro de 2011. Os dados foram coletados por meio de um roteiro de entrevista semiestruturado. Para análise dos dados,utilizou-se o método de analise de conteúdo do tipo categorial temática, proposto por Bardin.Este estudo atendeu à Resolução 196/96 do Conselho Nacional de Saúde, e foi aprovado pelo comitê de ética e pesquisa do Centro de Ensino Superior e Desenvolvimento aprovado sob o protocolo de n° 00810.405.000.11.Os resultados foram dispostos em duas categorias analíticas: Aplicabilidade da Estratégia AIDPI pelos enfermeiros e Dificuldades para execução da AIDPI.Os resultados assinalam a importância da AIDPI por ser um instrumento sistematizado, que facilita a abordagem e gera mais segurança na condução da consulta do enfermeiro. Quanto às dificuldades, os sujeitos enfatizam a não disponibilização de um roteiro específico para ser utilizado na consulta e a falta de apoio para prescreverem medicamentos, gerando insegurança no atendimento. Os resultados nos levam a concluir que é necessário um trabalho de educação permanente para a aplicação das ações propostas pela AIDPI, de forma a promover uma atenção integral na assistência à saúde da criança, baseada em conhecimentos científicos.

This non-experimental, descriptive, quantitative survey attempted to evaluate IMCI implementation in the eThekwini district of KwaZulu -Natal. The study focused on IMCI implementation by IMCI trained registered nurses, health facility support and follow-up and supervision. The research population comprised of all IMCI trained registered nurses working in health facilities in the eThekwini district. The convenient sample consisted of 40 research subjects. Data was collected by means of an interview schedule and a checklist, and analysed using Microsoft Excel 2007. Findings of the study revealed that many of the IMCI trained registered nurses were unable to assess, classify and treat the sick child comprehensively and consistently. The recommended follow-up visit at six weeks after completion of IMCI training, and lack of on-going supervision remains an area of concern. Recommendations were that district or clinic supervisors can enhance the skills of IMCI trained registered nurses through recommended follow-up visits and on-going supervision and the provision of updated IMCI chart booklets. / Health Studies / M.A. (Public Health)

The study was a descriptive quantitative survey which endeavoured to identify challenges experienced by IMCI trained registered nurses in implementing the guidelines and procedures of the strategy when tending children under 5 years in Gaborone health district. The study also solicited for recommendations on how to address the identified challenges. The research population comprised of all the IMCI-1 trained registered nurses and systematic sampling was employed to randomly select study participants. Data were collected using a questionnaire and was analysed using Excel Advanced software package. Study findings identified challenges related to political support, cost of IMCI training, training coverage, health systems and features of the IMCI strategy. Recommendations for improving use of the strategy included garnering for more political support, adopting short duration training courses, scaling up both pre-service and in-service training as well as addressing the challenges related to health systems and the unique features of the strategy / Health Studies / M.A. (Public Health)

The study was a descriptive quantitative survey which endeavoured to identify challenges experienced by IMCI trained registered nurses in implementing the guidelines and procedures of the strategy when tending children under 5 years in Gaborone health district. The study also solicited for recommendations on how to address the identified challenges. The research population comprised of all the IMCI-1 trained registered nurses and systematic sampling was employed to randomly select study participants. Data were collected using a questionnaire and was analysed using Excel Advanced software package. Study findings identified challenges related to political support, cost of IMCI training, training coverage, health systems and features of the IMCI strategy. Recommendations for improving use of the strategy included garnering for more political support, adopting short duration training courses, scaling up both pre-service and in-service training as well as addressing the challenges related to health systems and the unique features of the strategy / Health Studies / M.A. (Public Health)

This non-experimental, descriptive, quantitative survey attempted to evaluate IMCI implementation in the eThekwini district of KwaZulu -Natal. The study focused on IMCI implementation by IMCI trained registered nurses, health facility support and follow-up and supervision. The research population comprised of all IMCI trained registered nurses working in health facilities in the eThekwini district. The convenient sample consisted of 40 research subjects. Data was collected by means of an interview schedule and a checklist, and analysed using Microsoft Excel 2007. Findings of the study revealed that many of the IMCI trained registered nurses were unable to assess, classify and treat the sick child comprehensively and consistently. The recommended follow-up visit at six weeks after completion of IMCI training, and lack of on-going supervision remains an area of concern. Recommendations were that district or clinic supervisors can enhance the skills of IMCI trained registered nurses through recommended follow-up visits and on-going supervision and the provision of updated IMCI chart booklets. / Health Studies / M.A. (Health Studies)

The study sought to determine the meaning and interpretation by facility managers and nurses on utilisation of expanded programme on immunisation and integrated management of childhood illnesses (EPI and IMCI) programmes for follow-up and antibody testing of HIV-exposed infants (HEI) at 18 months. Also to understand the factors within the health systems that influence the follow-up and antibody testing. The study setting selected was six facilities in Steve Tshwete subdistrict in Nkangala district of Mpumalanga province in South Africa. The study used a hermeneutic phenomenology using in-depth interviews for collecting data from 4 facility managers and 12 nurses. The major themes that emerged from the interviews were referral, defaulting, integration, stigma, and off-site ART initiation within the health system. These were found to influence the utilisation of HEI and IMCI services for follow-up and management of HEI. It was also found that the importance of integrating the management of HEI into the EPI and IMCI cannot be overemphasised. It was concluded that the Health Department needs to be vigilant and use all available resources to manage HEI to meet the MDG 4 of prevention of infant mortality / Health Studies / M.A. (Nursing Science)

The use of information and communication technologies and computerised training tools in nursing education has gained traction globally and locally. Nursing campuses in KwaZulu-Natal are yet to explore this avenue despite the existence of numerous challenges with conventional methods of teaching and learning, and Integrated Management of Childhood Illness (IMCI) pre-service training. Integrated Management of Childhood Illness Computerised Adaptation and Training Tool (ICATT), an e-learning tool has been identified as an innovative technology that has the potential to strengthen IMCI pre-service training and increase training coverage at nursing campuses. The aim of this study is to investigate the nursing campuses’ readiness for the use of ICATT, and to develop guidelines and a model for improving the use of ICATT at the nursing campuses. This study adopted a sequential exploratory mixed methods design and was conducted in three phases at ten nursing campuses in KwaZulu-Natal. In phases one and two, data was collected sequentially using a semi-structured interview schedule and self-administered questionnaires. The qualitative component involved seven individual administered questionnaires. The qualitative component involved seven individual interviews with campus principals, eight focus groups of nurse educators and eight focus groups of learners. The Interpretative Phenomenological Analysis framework was used to identify themes. In the quantitative component, data was collected from nine campus principals, 35 nurse educators and 235 learners and analysed using SPSS 23. Findings from phases one and two revealed that campus principals, nurse educators and learners had positive attitudes and identified enabling factors regarding ICATT use. Additional findings revealed that pre-existing barriers related to human, material, infrastructural and financial resources could impact on the nursing campuses, nurse educators and learners’ readiness to implement and use ICATT. Findings from phases one and two led to the development of guidelines and a model for ICATT implementation at nursing campuses. Phase three employed the Delphi method to obtain consensus opinion from 11 experts for the refinement of the guidelines. The readiness for ICATT use model and the guidelines can facilitate the successful implementation and use of ICATT. / Health Studies / Ph. D. (Health Studies)

Integrated Management of Childhood Illnesses (IMCI) is a strategy that was developed by the World Health Organisation (WHO) and the United Nations Children’s Fund (UNICEF) to reduce the mortality and morbidity rate of children younger than 5 years and to improve the quality of life of these children. The reduction of child mortality and morbidity is one of the Millennium Developmental Goals (MDGs) as sub-Saharan Africa has a high child mortality and morbidity prevalence. The IMCI strategy has three components namely case management, the health system and the household and community component. This strategy was implemented internationally, including South Africa, where it is implemented within Primary Health Care (PHC) facilities. The implementation of the IMCI strategy was introduced to the PHC environment of South Africa and aims to enhance the equity, accessibility, affordability and availability of health care to all South African citizens, with the focus in this study on the child younger than 5 years. The North West province started training the professional nurses and implemented IMCI in 1998. The Dr. Kenneth Kaunda district (one of the districts in North West Province) and with specific focus on the Matlosana sub-district identified challenges in the implementation of the IMCI strategy by professional nurses. Challenges such as a lack of trained staff, the short time frame available for consultation amidst an already overburdened clinic and the physical infrastructure of the PHC facilities are such examples. The main aim of this research was to explore and gain insight and understanding in the challenges professional nurses working in PHC facilities face regarding the implementation of the IMCI strategy. A qualitative research design was used to conduct this study on daily work-life experiences of the professional nurses. Individual, semi-structured interviews were used as the method of data collection. The main question asked was: “What are the challenges faced by professional nurses in PHC facilities regarding the implementation of the IMCI strategy?” Data saturation was reached after 18 professional nurses were interviewed (N=18). Digitally voice recorded interviews were transcribed and content analysis was conducted. The findings of this research suggest that the professional nurses in the PHC facilities indeed experienced challenges regarding IMCI implementation. The main themes that emerged were challenges regarding the organisation and service delivery; challenges specific to the implementation of the IMCI strategy and also challenges external to the clinic that impacted directly on the IMCI strategy implementation. The findings were discussed with literature integration. From the research results and conclusions, the researcher compiled recommendations for nursing education, nursing research, and community health practice. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.