Factors inhibiting implementation of Integrated Management of Childhood Illnesses (IMCI) in primary health care (PHC) facilities in Mafikeng sub-district

Abstract

Background: The main objective of the Integrated Management of Childhood Illnesses (IMCI) strategy was to reduce child mortality and morbidity, which are associated with major childhood illnesses. IMCI offers a comprehensive health programme that is directed at the development needs of children under five years of age. This strategy also focuses on good nutrition, health promotion, immunization and preventive measures, provides counselling services to mothers or care givers, and engenders an appropriate referral system for seriously ill children. Purpose: The purpose of this study was to explore and describe factors inhibiting implementation of IMCI in primary health care (PHC) facilities in selected sub-district of North West Province, South Africa. Methods: A qualitative, exploratory, descriptive-contextual framework was used. The target population of this study was professional nurses (PNs) working in community health centres (CHC) and primary health care (PHC) facilities. The sample size of the study included 15 participants as determined by data saturation reached by the 12th participant. The study included professional nurses trained in IMCI. Data was collected through in-depth individual semi-structured interviews, using an audio tape recorder and field notes, with data transcribed verbatim. Data was analysed using Atlas TI. Results: Participants were professional nurses aged between 25 and 50 years. Themes emerging from the data included organizational and structural factors inhibiting IMCI implementation; education, training and awareness; the behaviour and attitude of nurses towards IMCI implementation; and caregiver related factors affecting IMCI implementation. Conclusion: The study revealed that professional nurses need effective support, mentoring and supervision throughout IMCI implementation by the Mother, Child and Women Health (MCWH) coordinators. Caregivers and mothers need to know the importance of providing a comprehensive child history to professional nurses and therefore they need to be encouraged to disclose all relevant information during the IMCI process. Keywords: Implementation, Caregivers, PHC, WHO and IMCI