Factors affecting the implementation of integrated management of neonatal and childhood illness by Indian health professionals

Background and Aim of Study: Integrated management of neonatal and childhood illness (IMNCI) is a globally proven, primarily community-based strategy to improve child survival and is being implemented worldwide in countries with high burden of child mortality. The aim of the study: to identify the factors that affect the implementation of IMNCI by healthcare professionals in healthcare facilities, and to assess their attitude towards the implementation of IMNCI. Material and Methods: The study was conducted at health care facilities of Thiruvarur district, Tamilnadu, India. A total of 100 health professionals were included in the present study. Mean age of the study participants was 36± 3 years. Most of them were males. Mean age of their work experience was 5.7± 2.1. In the study 79% of respondents attended IMNCI training at different time. Almost 86% of study participants have not received any follow up training in last 2 years. All participants was administered a predesigned, pretested, semi structured questionnaire on IMNCI. Version 21 of the SPSS software was used to record and analyse the responses. Results: Health system related factors identified as hindrance to IMNCI implementation on case management skills according to this study are, overcrowding of people (26%), time consuming (21%), shortage of staffs (17%), untrained staff (10%), lack of supervision(6%), and lack of supplies(12%). Attitude of the health care providers on treating children’s based on algorithm were found to be unsatisfactory. Conclusions: Efforts to improve the quality of child health services provided by health care providers in the less developed countries should focus not only on resource-intensive structural improvements, but also on cheap, cost-effective measures, especially the proper use of national guidelines for case management, and meaningful supervision. Government leadership, along with more structured and continued resource and training support, is necessary to foster sustainable IMNCI health care services within the needs of the local community.