The Implementers of Illness
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About 32 participants completed the questionnaire. Data from the closed questions were statistically analysed. Descriptive statistics such as frequency distributions, measures of central location, and measures of dispersion were used to describe and summarise the data. The results were originally statistically analysed. However, they were also thematised and categorised as illustrated in Table 1. The rationale for this qualitative augmentation of the quantitative results was to convert the data into a format that could be used to collate results and to enable the researchers to use the data to make tangible recommendations that can be implemented in a primary healthcare setting.
The three themes identified indicated specific challenges related to the unique features of the IMCI strategy, low training coverage, and health system and client expectations. The study participants suggested that this challenge could be resolved by addressing the problem of understaffing, improving the patient—nurse ratio and advocating for more IMCI implementation resources.
Low IMCI training coverage of registered nurses posed a challenge, which was attributed to inadequate funding and the high cost of IMCI training courses. The study participants suggested that this challenge could be addressed by increasing the number of health workers trained in the IMCI strategy i. The second recommendation was that IMCI training should be extended to lower-level cadres, such as healthcare assistants, to increase the number of health workers able to deliver IMCI services.
However, the lower-level cadres can only assist with non-clinical aspects of the IMCI protocol, such as counselling the caregiver. Study participants indicated that the layout of the health facility was not conducive or fully equipped to support the practice of IMCI procedures. They recommended that the health system provide a spacious facility layout and give time to apply IMCI skills and procedures i.
Another health-related system was lack of support from supervisors and colleagues. Yet another challenge related to health systems was the lack of IMCI follow-up training and visits. They asserted that follow-up visits were important, as they could help newly trained practitioners to transfer their new skills to practice. Issues related to client expectations have been attributed to the lack of uniformity between the IMCI-trained and the non-IMCI-trained health workers, in their case management practices.
Health Programs in a Developing Country-why do we Fail?
Non-IMCI-trained nurses take less time because they use single-diagnosis approaches, which do not view the client holistically and do not consider health problems other than the reason for the visit. As a result, caregivers of under-five patients prefer to be seen by them. This defeats the entire purpose of introducing the integrated approach. Two recommendations were proposed to standardise the practices of all registered nurses who tend under-five patients.
The first recommendation was that all nurses tending under-five patients be IMCI-trained. The second recommendation was that IMCI training be the main criterion for the allocation of daily duties and the deployment of nurses to duty stations. This measure would help to ensure that only IMCI-trained nurses tend patients under the age of 5 years. The participants made relevant recommendations that could be applied to promote and improve the use of the IMCI strategy.
Recommendations for improving the use of the strategy included adopting short-duration IMCI training courses, scaling up both pre-service and in-service training, and extending IMCI training to lower-level cadres, as well as addressing the challenges related to health systems and the unique features of the strategy. If adopted, the proposed measures could lead to the promotion and improvement of the use of the IMCI strategy. This improvement could, in turn, lead to a decrease in the current morbidity and mortality rates in children under the age of five in Botswana.
Such a decrease would contribute to the realisation of the goals articulated in the third pillar of Botswana's Vision , as well as in MDG4.
The recommendations, although originally crafted for Botswana, can be adapted and used in various regions and countries to enhance the implementation of the IMCI strategy. If these challenges could be addressed, then maybe our children will have an opportunity to play. The authors have not received any funding or benefits from industry or elsewhere to conduct this study.
The data reported on in this manuscript originated from a formal study conducted by Mrs Mupara under the supervision of Dr Lubbe. Both authors contributed equally to the writing of this manuscript. National Center for Biotechnology Information , U. Journal List Glob Health Action v. Glob Health Action. Published online Feb Lucia U. Mupara 1, 2 and Johanna C. Johanna C. Author information Article notes Copyright and License information Disclaimer. Mupara and Johanna C. This article has been cited by other articles in PMC.
Abstract Background Under-five mortality has been a major public health challenge from time immemorial. Results The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. This goal comprises three objectives: Reducing infant mortality Reducing the incidence and seriousness of illnesses and health problems that affect boys and girls Improving growth and development during the first 5 years of a child's life 10 , 11 The IMCI strategy consists of three components Open in a separate window.
The Integrated Management of Childhood Illnesses integrated case management process. Methods An explorative, descriptive, quantitative study with qualitative enhancement was conducted to identify challenges faced by the IMCItrained, registered nurses in the Gaborone district when implementing the guidelines and procedures established by the IMCI-1 strategy.
Authenticity An extensive literature review was conducted to identify authentic topics for survey questions.
Results and discussion The results were originally statistically analysed. Table 1 Implementation challenges and recommendations. Challenges related to training coverage Low IMCI training coverage of registered nurses posed a challenge, which was attributed to inadequate funding and the high cost of IMCI training courses. Challenges related to health systems Study participants indicated that the layout of the health facility was not conducive or fully equipped to support the practice of IMCI procedures.
Challenges related to client expectations Issues related to client expectations have been attributed to the lack of uniformity between the IMCI-trained and the non-IMCI-trained health workers, in their case management practices. Conclusions If adopted, the proposed measures could lead to the promotion and improvement of the use of the IMCI strategy.
Conflict of interest and funding The authors have not received any funding or benefits from industry or elsewhere to conduct this study. Authors' contributions The data reported on in this manuscript originated from a formal study conducted by Mrs Mupara under the supervision of Dr Lubbe. References 1. Millennium Development Goals 4. Reduce child mortality.
Child and adolescent health overview. World Health Organization; Children: reducing mortality.
danawahafake.tk | The Implementers of Illness, MR Randall D Rankin | | Boeken
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