Abstract

Aim: To evaluate the quality of IMCI care for under-five children in Mulanje District. Design: A cross sectional, observational study was conducted at all fifteen government health facilities in Mulanje District. Convenience sampling was used to select three hundred and fifty children and their caretakers. The standardized Multi-Country Evaluation (MCE) tool for IMCI developed by WHO/UNICEF was used. In addition a semi-structured questionnaire was developed to interview key informants in Integrated Management of Childhood Illnesses. The study was conducted between the months of January and March, 2007.Results: A total of 233 sick children and 117 well child visits were observed. All observed health workers were trained in IMCI with no performance difference by year of IMCI trained(X2 =3.309, p=0.508). Despite this, many IMCI assessments processes in the sick child visits were variably deficient. An antibiotic was prescribed for almost 52.78% of the sick children- its use was unwarranted in 33.2% of instances. Antimalarials were correctly prescribed in 94.1% of instances. Growth monitoring and nutritional counselling at well child visits was performed by Health surveillance Assistants. Three quarters of the children qualifying for food supplementation did not receive it. Conclusion: The study found out that there are easily remediable deficiencies in the provision of quality IMCI care in Mulanje District. However, the study findings also suggest that implementation of IMCI has lead to gains in some aspects of health systems support. Relatively small changes in equipment provision and supportive supervision of IMCI providers will make significant improvements in achieving the Millennium Development Goals (MDGS) of reducing child mortality by two-thirds by 2015.

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School	: College of Medicine
Issued Date	: 2008

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