Mark Donald C Reñosa1,2, Kate Bärnighausen3,4, Sarah L Dalglish5, Veronica L Tallo6, Jhoys Landicho-Guevarra6, Maria Paz Demonteverde6, Carol Malacad6, Thea Andrea Bravo6, Mary Lorraine Mationg6, Socorro Lupisan6, Shannon A McMahon3,5. 1. Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany. drmarkdonaldrn@gmail.com. 2. Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Muntinlupa, Philippines. drmarkdonaldrn@gmail.com. 3. Heidelberg Institute of Global Health, Ruprecht-Karls Universität Heidelberg, Heidelberg, Germany. 4. School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 5. International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA. 6. Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Department of Health, Muntinlupa, Philippines.
Abstract
BACKGROUND: Studies focusing on the Integrated Management of Childhood Illness (IMCI) program in the Philippines are limited, and perspectives of frontline health care workers (HCWs) are largely absent in relation to the introduction and current implementation of the program. Here, we describe the operational challenges and opportunities described by HCWs implementing IMCI in five regions of the Philippines. These perspectives can provide insights into how IMCI can be strengthened as the program matures, in the Philippines and beyond. METHODS: In-depth interviews (IDIs) were conducted with HCWs (n = 46) in five provinces (Ilocos Sur, Quezon, National Capital Region, Bohol and Davao), with full transcription and translation as necessary. In parallel, data collectors observed the status (availability and placement) of IMCI-related materials in facilities. All data were coded using NVivo 12 software and arranged along a Social Ecological Model. RESULTS: HCWs spoke of the benefits of IMCI and discussed how they developed workarounds to ensure that integral components of the program could be delivered in frontline facilities. Five key challenges emerged in relation to IMCI implementation in primary health care (PHC) facilities: 1) insufficient financial resources to fund program activities, 2) inadequate training, mentoring and supervision among and for providers, 3) fragmented leadership and governance, 4) substandard access to IMCI relevant written documents, and 5) professional hierarchies that challenge fidelity to IMCI protocols. CONCLUSION: Although the IMCI program was viewed by HCWs as holistic and as providing substantial benefits to the community, more viable implementation processes are needed to bolster acceptability in PHC facilities.
BACKGROUND: Studies focusing on the Integrated Management of Childhood Illness (IMCI) program in the Philippines are limited, and perspectives of frontline health care workers (HCWs) are largely absent in relation to the introduction and current implementation of the program. Here, we describe the operational challenges and opportunities described by HCWs implementing IMCI in five regions of the Philippines. These perspectives can provide insights into how IMCI can be strengthened as the program matures, in the Philippines and beyond. METHODS: In-depth interviews (IDIs) were conducted with HCWs (n = 46) in five provinces (Ilocos Sur, Quezon, National Capital Region, Bohol and Davao), with full transcription and translation as necessary. In parallel, data collectors observed the status (availability and placement) of IMCI-related materials in facilities. All data were coded using NVivo 12 software and arranged along a Social Ecological Model. RESULTS: HCWs spoke of the benefits of IMCI and discussed how they developed workarounds to ensure that integral components of the program could be delivered in frontline facilities. Five key challenges emerged in relation to IMCI implementation in primary health care (PHC) facilities: 1) insufficient financial resources to fund program activities, 2) inadequate training, mentoring and supervision among and for providers, 3) fragmented leadership and governance, 4) substandard access to IMCI relevant written documents, and 5) professional hierarchies that challenge fidelity to IMCI protocols. CONCLUSION: Although the IMCI program was viewed by HCWs as holistic and as providing substantial benefits to the community, more viable implementation processes are needed to bolster acceptability in PHC facilities.
Entities:
Keywords:
Child health; Child mortality; Childhood illness; Health care workers; Health programs; Health services; IMCI; Implementation research; Integrated Management of Childhood Illness; Primary health care
Authors: Y V Pradhan; Shyam Raj Upreti; Naresh Pratap K C; Ashish K C; Neena Khadka; Uzma Syed; Mary V Kinney; Ramesh Kant Adhikari; Parashu Ram Shrestha; Kusum Thapa; Amit Bhandari; Kristina Grear; Tanya Guenther; Stephen N Wall Journal: Health Policy Plan Date: 2012-07 Impact factor: 3.344
Authors: Tanya Doherty; Nhan Tran; David Sanders; Sarah L Dalglish; David Hipgrave; Kumanan Rasanathan; Thiagarajan Sundararaman; Rajani Ved; Elizabeth Mason Journal: BMJ Date: 2018-07-30
Authors: Helen Clark; Awa Marie Coll-Seck; Anshu Banerjee; Stefan Peterson; Sarah L Dalglish; Shanthi Ameratunga; Dina Balabanova; Maharaj Kishan Bhan; Zulfiqar A Bhutta; John Borrazzo; Mariam Claeson; Tanya Doherty; Fadi El-Jardali; Asha S George; Angela Gichaga; Lu Gram; David B Hipgrave; Aku Kwamie; Qingyue Meng; Raúl Mercer; Sunita Narain; Jesca Nsungwa-Sabiiti; Adesola O Olumide; David Osrin; Timothy Powell-Jackson; Kumanan Rasanathan; Imran Rasul; Papaarangi Reid; Jennifer Requejo; Sarah S Rohde; Nigel Rollins; Magali Romedenne; Harshpal Singh Sachdev; Rana Saleh; Yusra R Shawar; Jeremy Shiffman; Jonathon Simon; Peter D Sly; Karin Stenberg; Mark Tomlinson; Rajani R Ved; Anthony Costello Journal: Lancet Date: 2020-02-19 Impact factor: 202.731