Assessment of Implementation of Integrated Management of Childhood Illnesses in Primary Health Care Centers/ Baghdad 2021

Abstract

Background: Every year some 12 million children in developing countries die before they reach
their fifth birthday. Seven in ten of these deaths are due to acute respiratory infections (mostly
pneumonia), diarrhea, measles, malaria, or malnutrition. The IMCI was developed in response to
many global under-five deaths in low- and middle-income countries in the 1990s. This study aimed
to assess the compliance of health workers to the guiding booklet of IMCI in the management of
cases.
Methods: A cross-sectional study was conducted in the four primary healthcare centers (PHCCs)
in Baghdad for 5 months. A total of 223 children aged between 2 months to 5 years who attended
the selected four PHCCs in their initial visit were recruited. A structured questionnaire was
designed for this study, including information about the recruited children and assessment criteria
of the IMCI guiding booklet for case management.
Results: The assessment of the 6 domains of IMCI guidelines were as follows: high/perfect scores
were detected in 86.6% for cough/difficulty breathing, 100% for diarrhea, 37.6% for fever, 100%
for ear problems, 78.5% for throat problems, while weak score was detected in 71.8% for anemia
and malnutrition. Out of the 223 children, 182 (81.6%) received treatment, antibiotics were
prescribed for 99 (44.4%) of them, and (88.9%) of these cases received antibiotics according to the
IMCI guidelines. In most of the cases (94.5%) treatment administration was explained to the
patient's relative and 59.9% were asked if they understood how to administer it.
Conclusions: Adherence of physicians to IMCI guidelines regarding cough/difficulty breathing,
diarrhea, ear problems, and throat problems was high, while it was low in terms of fever and
anemia/malnutrition. We recommend the installation of an internal audit system with clear criteria
to allow evaluation of PHCCs and their employees' performance at regular intervals.