Dear CHIFA colleagues,
It's regrettable that the full text of this paper is behind a paywall so most of us cannot read it.
But a finding jumped out for me in the abstract: "a tedious protocol"
Indeed, if IMCI is considered 'tedious', it seems likely it will simply not be used.
Is this problem with tedious IMCI guidance a phenomenon in other countries?
How can IMCI be made less tedious and more engaging to understand and apply?
CITATION: J Child Health Care
2024 Mar 7:13674935241238474. doi: 10.1177/13674935241238474. Online ahead of print.
Perspectives of healthcare workers on integrated management of childhood illness in Pakistan: A phenomenological approach
Saidul Abrar 1, Asad Hafeez 2, Muhammad Naseem Khan 3, Muhammad Imran Marwat 4
https://pubmed.ncbi.nlm.nih.gov/38451029/
ABSTRACT
In 2019, an estimated 5.2 million deaths were reported among children less than 5 years of age. At primary healthcare level, healthcare workers (HCWs) mostly rely on history and clinical findings and less on inadequate diagnostic facilities. To enhance case management skills of HCWs, World Health Organization devised an integrated management of childhood illnesses (IMCI) strategy in 1995, modified to distance learning IMCI in 2014. A qualitative phenomenological study was conducted to explore perceptions of HCWs about standard and distance IMCI. Four focus group discussions were conducted with purposively selected 26 HCWs (IMCI trained) from 26 basic health units of Abbottabad district in Pakistan. Gadamer's philosophical hermeneutics were adopted during the inductive thematic analysis. Five themes that emerged are inexorable health seeking behaviors, IMCI being a comprehensive algorithm for consultation, a tedious protocol, scaling up protocol to specialists and private practitioners, and administrative insufficiency by the department of health. Improvement in case management skills of HCWs was reported as a result of IMCI trainings. It needs administrative support, regulations to control poly-pharmacy and provision of drugs without prescription, and a curb on political and bureaucratic interference.
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
