Integrated Management of Childhood Illnesses: Perception and Practice of Primary Health Care Physicians at Zagazig District, Egypt, MARWA B. AWADALLAH and AMIRA E. ABD ELSALAM
Abstract
Background: Integrated Management of Childhood Illness (IMCI) is a cost-effective strategy for management of the most common childhood morbidity and mortality.
Objectives: To identify the opinion of physicians about IMCI. To assess the level of adherence of physicians to IMCI guidelines.
Subjects and Methods: A cross sectional study was con-ducted in facilities applying IMCI on (157) physicians.
Tools: A structured questionnaire: Assessing physicians' perception and recommendations towards IMCI. Checklist to assess adherence to IMCI guidelines.
Results: (54.1%) and (61.8%) of physicians apply most IMCI stages, and had negative attitude towards it. The most difficult steps were in classifying the child's illness and counseling the care takers. The most perceived disadvantages of IMCI were lack of training for physicians and supervisors and high patient-doctor ratio. 80.9% of practice of IMCI guidelines was suboptimal, mainly anemia and fever manage-ment. Significant relation between training and total practice and attitude was noticed, but no relation between practice and attitude.
Conclusion: Most of physicians had negative attitude towards IMCI strategy; due to lack of training, lack of super-vision and high patient/physician ratio. Adherence to IMCI was suboptimal. Training was found to be effective in changing practice and attitude towards IMCI.