Universidad de Los Andes, School of Medicine, Bogotá, Colombia.
BMC Public Health. 2020 Jul 16;20(1):1122. doi: 10.1186/s12889-020-09216-0.
Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF in 1992. It was deployed as an integrated approach to improve children's health in the world. This strategy is divided into three components: organizational, clinical, and communitarian. If the Integrated Management of Childhood Illnesses implementation-related factors in low- and middle-income countries are known, the likelihood of decreasing infant morbidity and mortality rates could be increased. This work aimed to identify, from the clinical component of the strategy, the implementation-related factors to Integrated Management of Childhood Illnesses at 18 Colombian cities.
A quantitative cross-sectional study was performed with a secondary analysis of databases of a study conducted in Colombia by the Public Health group of Universidad de Los Andes in 2016. An Integrated Care Index was calculated as a dependent variable and descriptive bivariate and multivariate analyses to find the relationship between this index and the relevant variables from literature.
Information was obtained from 165 medical appointments made by nurses, general practitioners, and pediatricians. Health access is given mainly in the urban area, in the first level care and outpatient context. Essential medicines availability, necessary supplies, second-level care, medical appointment periods longer than 30 min, and care to the child under 30 months are often related to higher rates of Integrated Care Index.
Health care provided to children under five remains incomplete because it does not present the basic minimums for the adequate IMCI's implementation in the country. It is necessary to provide integrated care that provides medicine availability and essential supplies that reduce access barriers and improve the system's fragmentation.
儿童疾病综合管理（IMCI）是世界卫生组织（WHO）和联合国儿童基金会于 1992 年制定的一项战略。它作为一种综合方法被部署，以改善全球儿童的健康。该战略分为三个组成部分：组织、临床和社区。如果了解低收入和中等收入国家儿童疾病综合管理实施相关因素，就有可能降低婴儿发病率和死亡率。这项工作旨在从该战略的临床部分确定 18 个哥伦比亚城市与儿童疾病综合管理实施相关的因素。
这是一项定量的横断面研究，对安第斯大学公共卫生组于 2016 年在哥伦比亚进行的一项研究的数据库进行二次分析。将综合护理指数作为因变量进行计算，并进行描述性的双变量和多变量分析，以找到该指数与文献中相关变量之间的关系。
从护士、全科医生和儿科医生的 165 次医疗预约中获得了信息。卫生服务的提供主要集中在城市地区，一级保健和门诊环境中。基本药物的供应、必要的用品、二级保健、医疗预约时间超过 30 分钟以及对 30 个月以下儿童的护理通常与较高的综合护理指数相关。
为五岁以下儿童提供的医疗保健仍然不完整，因为它没有提供国家充分实施儿童疾病综合管理的基本最低条件。有必要提供综合护理，提供药物供应和基本用品，以减少准入障碍并改善系统的碎片化。
