Abstract:
Introduction: Integrated community case management is a program that allowed Health
Extension Workers treat the three most common Childhood illnesses; pneumonia, Diarrhea and
malaria through delivering closer and accessible care to community. In Ethiopia, this proven
strategy is on stage of preparation for expansion, but few researches were done to assess the
challenges encountered in the ongoing implementation.
Objective: The objective of the study was to assess factors affecting implementation of community
case management of childhood illnesses in the health posts of selected woredas of South West shoa
Zone, Central Ethiopia.
Methods and materials: Facility based cross-sectional study were employed. All functional health
posts (99) and HEWs trained in ICCM (157) of four districts were included in the study. Pre-tested
structured questionnaires and observation checklist was deployed to collect data on the study
variables. Data was entered in to Epi data v.3.1 and transported to SPSS v.21.0 for analysis
.Descriptive statistical methods were done to indicate the frequency of the variables and bivariate
and multiple binary logistic regression analysis were used to determine independent effects of
factors affecting ICCM implementation status.
Results: - based on mean percentage coverage of all health posts 39(39.4%) them were in good
implementation category and the ret majority in poor category. During the survey, 24(15.3%) of
kebelles were found lacking two HEWs, 26.8% had recommended three CHAs and 26(16.6%)
lacking any CHAs. Only 39(39.5%) received supportive supervision by either of woreda or health
center. Essential ICCM commodities were available in 87.93% of Health posts. After Multivariate
regression analysis number of CHAs per kebelle (AOR3.63,95%CI[1.16-6.41]),average hours of
open health post per day(AOR 2.74,95%CI[1.38-5.61]),sessions community mobilization (AOR
4.26,95%CI[1.98-9.18]),proper documentation of reports and files (AOR0.041,95%CI[0.008-
0.216])and onsite mentoring (AOR3.14,95%CI[1.65-6.52]) had disentangled independent effect
on implementation status of ICCM services.
Conclusion: Inadequacy of HEWs and CHAs in kebelles as per the standard, irregular supervision,
monitoring, lower hours of health posts and lower sessions of community sensitization were major
challenges to better implementation of the program. Construction of shelters for HEWs by either
of government or community was also crucial for optimal functioning of the ICCM services.
