Implementation Evaluation of IMNCI Program at Public Health Centers of Soro District, Hadiya Zone, Southern Ethiopia, 2017

Abstract

Background: Integrated Management of Neonatal and childhood illnesses an integrated approach to child health that focuses on the wellbeing of the whole child. The program aims to reduce death, illness and disability, and to promote development of under-five child. Since implementation status of IMNCI is not known in the study area, this evaluation study assesses the program implementation from the dimension of availability, compliance and satisfaction of Care takers in selected health center of Soro district, Hadiya zone, southern Ethiopia. Objective: To assesses the implementation of IMNCI program in public health centers of Soro district, Hadiya Zone, Southern Ethiopia, 2016/17. Methods: Facility-based cross-sectional study design with both qualitative and quantitative data collection methods was used in 9 HCs from March5-April 3,2017 in Soro District. A total of 390(92%) care givers were included by proportion of under-five outpatient coverage of HCs.19 key informants for in-depth interview were selected purposely, and 18 health workers observed for 90 observation sessions. Data was collected through face to face interviewer-administered questionnaires, document review checklist, observation checklist and In-depth interview guide. Qualitative data were coded, thematized and categorized manually based on dimensions of study. Formative approach was used. Quantitative data were analyzed using SPSS version 20. Logistic regression was used to identify factors associated with satisfaction of care takers. Result: Based on agreed criteria resources availability were 80.11%, and judged as fair. Less than50% of HCs had Cotrimoxazol and Gentamycin drug than others. Compliance of health workers was 85.79%, and judged as good. About 85% of prescribed drugs were provided correctly for classified disease. Counseling on medication and follow up date were given for less than 80 percent of care takers. Overall satisfaction of clients on IMNCI was 79.5 percent according to the judgment criteria. Care taker who took less than 30 minute to reach health center on foot(AOR=7.7, 95% CI [3.787- 15.593]), caretakers who waited for less than 30 minute to see the health care provider (AOR=2, 95% CI[ 1.00- 3.77]),care taker who found prescribed drugs in HCs pharmacy(AOR = 3.7,95% CI [1.91-7.34] ), care takers who have less than four family size (AOR=2, 95% [1.109-4.061] )to be more satisfied in IMNCI service, whereas, care givers who measured weight of child were negatively associated to satisfaction on(AOR= 0.24, 95% CI [0.13-0.45]). Conclusion and recommendation: this study found that overall implementation of Integrated Management of Neonatal and childhood illnesses was judged as good. Availability and compliance were good in health, but still there were gaps observed on correct assessment, classification and treatment of diseases. Care taker satisfaction was fair. Zonal health department, Soro district, and Development partners continue their effort to strengthen the program with trained man power, supplies and improve HWs compliance. Health center have to find different mechanisms to address satisfaction of care givers on availability of drugs, medical equipment’s, and waiting time.