Belete Abraham Addis, Agumas Yeshambel, Tsehay Asmamaw Ketemaw, Ayele Habtamu Molla
School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Maternal and Child Health Directorate, Federal Ministry of Health, Addis Ababa, Ethiopia.
Front Health Serv. 2024 Apr 22;4:1364661. doi: 10.3389/frhs.2024.1364661. eCollection 2024.
Globally, 11 million children have died before reaching their fifth birthday. The introduction of the Integrated Management of Newborn and Childhood Illness (IMNCI) protocol reduces the morbidity and mortality rates among children under the age of 5. However, the share of neonatal mortality is increasing. As a result, the United Nations has established sustainable development goals to reduce national neonatal death rates through the utilization of the Integrated Management of Newborn and Childhood Illness protocol as the main tool for 12 per 1,000 live births by 2030. However, the death rate from preventable causes has increased owing to the low utilization of the protocol.
The objective of this research is to assess the utilization of the IMNCI protocol and associated factors among healthcare workers (HCW) in health centers at the South Gondar Zone, Northwest Ethiopia, in 2022.
The institution-based mixed study design was conducted from November to December 2022 at the South Gondar Zone, Amhara. A total of 422 HCW were selected using a computer-generated random-number generator. Data were cleaned and entered into EpiData 3.1 software and analyzed using SPSS version 25.0. Binary logistic regression was used to identify candidates for multivariable logistic analysis with -value < 0.2, and for multivariable analysis, -value < 0.05, with a 95% confidence interval, was considered significant. Thematic analysis was used for the qualitative data.
In total, 417 respondents were included in the final analysis. The overall response rate was 98.8%, and the mean age was 30.01 years. The results showed that the proportion of IMNCI utilization was 63.1%. The odds of the utilization of IMNCI protocol among HCW who took training were 3.13 times higher than those among HCW who did not take training [adjusted odds ratio (AOR) = 3.13, 95% CI: 1.594, 6.147]. The lack of drugs reduces the utilization of the IMNCI protocol by 75.7% compared with the use of drugs (AOR = 0.243, CI: 95%:0.128, 0.464). HCW who always referred to the chart booklet during case management were 3.34 times more likely to utilize the IMNCI protocol (AOR = 3.34, 95% CI: 1.99, 5.60) compared with those who did not refer to the chart booklet.
The utilization of the IMNCI protocol was low. A shortage of medical consumables and equipment attitude and training were identified as factors that affected the utilization of the protocol. Therefore, the availability of necessary logistics and training for employees with regular supportive supervision and monitoring should be conducted with the integration of sectors at the district and zone levels.
全球范围内，有1100万儿童在5岁前死亡。新生儿和儿童疾病综合管理（IMNCI）方案的引入降低了5岁以下儿童的发病率和死亡率。然而，新生儿死亡率所占比例正在上升。因此，联合国制定了可持续发展目标，到2030年通过将新生儿和儿童疾病综合管理方案作为主要工具，将国家新生儿死亡率降至每1000例活产12例。然而，由于该方案利用率低，可预防原因导致的死亡率有所上升。
本研究的目的是评估2022年埃塞俄比亚西北部南贡德尔地区卫生中心医护人员对IMNCI方案的利用率及相关因素。
2022年11月至12月在阿姆哈拉的南贡德尔地区进行了基于机构的混合研究设计。使用计算机生成的随机数生成器共选取了422名医护人员。数据进行清理后录入EpiData 3.1软件，并使用SPSS 25.0版本进行分析。二元逻辑回归用于识别多变量逻辑分析的候选因素，P值<0.2，对于多变量分析，P值<0.05，95%置信区间被认为具有统计学意义。定性数据采用主题分析法。
最终分析纳入了417名受访者。总体回复率为98.8%，平均年龄为30.01岁。结果显示，IMNCI方案的利用率为63.1%。接受培训的医护人员使用IMNCI方案的几率比未接受培训的医护人员高3.13倍[调整优势比（AOR）=3.13，95%置信区间：1.594，6.147]。与有药品相比，药品短缺使IMNCI方案的利用率降低了75.7%（AOR=0.243，置信区间：95%：0.128，0.464）。在病例管理过程中经常查阅图表手册的医护人员使用IMNCI方案的可能性是未查阅图表手册的医护人员的3.34倍（AOR=3.34，95%置信区间：1.99，5.60）。
IMNCI方案的利用率较低。医疗耗材和设备短缺、态度及培训被确定为影响该方案利用率的因素。因此，应在地区和区域层面整合各部门，为员工提供必要的后勤保障和培训，并进行定期的支持性监督和监测。
