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.

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)

Made available in DSpace on 2015-07-22T20:49:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-06-30 / Introdução: Apesar de relatos sobre a Atenção Integrada às Doenças Prevalentes na Infância (AIDPI) melhorar a assistência à saúde da criança até cinco anos, não são identificados estudos direcionados ao componente peri-neonatal dessa estratégia. Objetivo: avaliar, após a capacitação em AIDPI Neonatal, o conhecimento e a percepção de médicos e enfermeiros quanto à assistência à gestante e à criança do nascimento até os dois meses de vida, e sua aplicabilidade prática em uma região da Amazônia. Método: estudo de coorte constituída de 31 médicos e 61 enfermeiros provenientes de 24 municípios, que participaram de sete capacitações em seis Pólos Regionais de Saúde no interior do Pará, Amazônia, realizado de abr/2006 a dez/2008. O estudo foi conduzido em duas fases, consistindo a 1ª fase na aplicação presencial de cinco questionários antes (T1) e imediatamente após 24 horas (T2) de capacitação em AIDPI Neonatal, conforme diretrizes da OPAS em 2007, adaptadas ao nosso meio. A 2ª fase compreendeu a aplicação presencial dos mesmos questionários aos 92 profissionais, em média 16 (14-20) meses após a 1ª fase (T3). Os questionários abordaram dados demográficos dos profissionais em T1, o conhecimento sobre assistência à gestante, reanimação neonatal, puericultura e doenças até dois meses em T1, T2 e T3, além da avaliação da capacitação em T2 e da percepção das condições de assistência no município e no local de prática clínica em T1 e T3. Para estimar as diferenças entre os tempos e as categorias profissionais foram criados escores de zero (inadequação completa) a 100 (adequaçãocompleta) comparados por meio da análise de variância com medidas repetidas. Resultados: os 92 profissionais caracterizaram-se por ser do sexo feminino (83%), nascidos (74%) e graduados (79%) no Pará, atender crianças duas ou mais vezes por semana (86%) e possuir pós-graduação (63%). Os médicos eram graduados há 17 (1-35) anos e os enfermeiros há nove (0-31) anos (p<0,001). Os primeiros relataram maior atuação em pediatria, e qualificação específica, com residência ou especialização, do que os últimos. Observou-se variação do conhecimento de acordo com o tempo (T1, T2 e T3) e a profissão (médicos>enfermeiros: p<0,001). Entre T1 e T2 constatou-se acréscimo deconhecimento dos profissionais sobre a assistência à gestante (p=0,026), reanimação neonatal (p<0,001), puericultura (p<0,001) e doenças até dois meses (p<0,01). Tal conhecimento perdurou, no mínimo, após 16 meses da capacitação nas áreas de reanimação neonatal (p=0,028) e doenças até dois meses (p<0,001). A capacitação teve avaliação positiva dos profissionais (94%) que perceberam melhora na prática clínica no seu local de trabalho (p<0,001), porém sem relato de alteração nas condições de saúde do município (p=0,066) entre T1 e T3. Conclusão: os médicos e enfermeiros apresentaram acréscimo, no mínimo por 16 meses, no conhecimento sobre a assistência à gestante e à criança até dois meses, além de perceberem melhora em sua condição de prática clínica após a capacitação em AIDPI Neonatal. Essa capacitação pode servir de modelo a ser aplicado em outras regiões com semelhante contexto epidemiológico / Objective: to assess knowledge and perception of professionals about care of pregnant women and children to two months of life, after training in Neonatal Integrated Management of Childhood Illness (IMCI), and its practical applicability in the Amazon Region. Method: a cohort study comprising 92 professionals who participated in seven Neonatal IMCI training courses in Para, from April/2006 to December/2008. Five questionnaires were applied face-to-face before (T1) and 24h (T2) after training in Neonatal IMCI (PAHO, 2007), and 16 (14-20) months after training (T3). Scores ranging from zero (complete inappropriateness) to 100 (complete appropriateness) were compared by ANOVA with repeated measures. Results: Time since graduation was 17y (1-35) for physicians and 9y (0-31) for nurses (p<0.001). Variation of knowledge was observed according to time and profession (physicians>nurses: p<0.001). Between T1 and T2, enhanced knowledge was verified in care of pregnant women (p=0.026), neonatal resuscitation (p<0.001), neonatal and infant care (p<0.001) and diseases up to two months (p<0.01). Such knowledge was observed at least for 16 months in neonatal resuscitation (p=0.028) and diseases up to two months (p<0.001). The capacity-building was positively evaluated by professionals (94%), who perceived improvement in clinical practice (p<0.001), without report of change in health conditions of the city (p=0.066) between T1 and T3. Conclusion: Training in Neonatal IMCI enhanced knowledge about care of pregnant women and infants up to two months, in addition to acknowledging better clinical practice for physicians and nurses. This training can be a model to be applied in other regions with similar epidemiological context. / TEDE / BV UNIFESP: Teses e dissertações

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)

This explorative, descriptive quantitative survey attempted to determine whether the reduced number of consultations and admissions of sick children less than five years in Emfuleni sub- district clinics is due to the utilisation of the IMCI strategy or other health services. The research population comprised of all the mothers/caretakers of children less than five years who utilised the clinics and those who consulted the private medical doctor. The convenient sample consisted of 169 candidates. Data was collected by means of a questionnaire and analysed using the SAS/Basic computer statistical software package. Findings of the study revealed a need to address the major concern about the waiting time and operational times in all the three clinics. Recommendations were made that staff allocation procedures and policies be reviewed in order to abate long waiting periods at the clinics where children with childhood illnesses are treated. / Health Studies / M.A. (Health Studies)