The Implementation of Integrated Management of Childhood Illness ...

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2. Objectives Describe and analyse the outpatient settings for children in a sub-Saharan country with a focus on the implementation of Integrated Management of Childhood Illness. In particular: • Describe and analyse the patient flow through primary health care facilities. • Identify and analyse the causes for children′s attendances to the primary health care facilities. • Assess what impact user fees have on health care seeking. • Outline and discuss health workers’ experience of the implementation of IMCI. • Evaluate the access to IMCI-recommended drugs at the primary health care level. • Describe the satisfaction of caretakers of sick children who seek care at the primary health care level 20
3. Material and Methods a. The Setting i. Malawi The Republic of Malawi is located in southern Africa, east of Zambia (see Figure 3-1). The country is land locked but is situated along Lake Malawi, which is an important source of food as well as being the country′s most striking physical feature. Furthermore, the lake holds 24,400 sq km of the total 118,480 sq km surface area (39). Malawi is divided into three regions: the Northern, Central, and Southern regions. There are 27 districts in the country: six districts are in the Northern, nine in the Central, and 12 in the Southern Region (40). The major problems that the country is facing are poverty, difficult political and economic situation, population growth, increasing pressure on agricultural lands, malaria and HIV/AIDS (39). The United Nations Development Programme ranks Malawi no. Figure 3-1: Map of Malawi (38) 165 of 177 on the Human Development Index scale (41). Despite high mortality rates due to HIV/AIDS and the lower life expectancy and higher infant mortality that result thereof, estimates hold that the population is increasing (Table 3-1) (39). The population structure is characteristic for developing 21
Page 1 and 2: The Implementation of Integrated Ma
Page 3 and 4: . Diagnoses .......................
Page 5 and 6: List of Abbreviations ARI………
Page 7 and 8: Since 1970 there has been a conside
Page 9 and 10: over half of all deaths associated
Page 11 and 12: (16). The vertical programmes were
Page 13 and 14: The case-management guidelines are
Page 15 and 16: The childhood deaths resulting from
Page 17 and 18: though ear infection is not one of
Page 19: guidelines after training seems unn
Page 23 and 24: perform surgical procedures. Illnes
Page 25 and 26: workload at the Mangochi District h
Page 27 and 28: The respiratory tract infections in
Page 29 and 30: 4. Results a. Health Care Workers I
Page 31 and 32: In all health facilities there were
Page 33 and 34: c. Diagnoses Children could be clas
Page 35 and 36: Pro ii. Pneumonia In total, about 7
Page 37 and 38: iv. Diarrhoea As shown in Figure 4-
Page 39 and 40: Table 4-10: Availability of IMCI-re
Page 41 and 42: 5. Discussion The results of this s
Page 43 and 44: . Diagnoses The fact that around 84
Page 45 and 46: This is interesting in the light of
Page 47 and 48: In the present study, of the just l
Page 49 and 50: eceived care from the trained healt
Page 51 and 52: Acknowledgments This project is a c
Page 53 and 54: area of Kenya with high malaria tra
Page 55 and 56: 53. Creese A, Kutzin J. Lessons fro
Page 57 and 58: Annexes 57
Page 59 and 60: Annex 2 59
Page 61 and 62: Annex 4 61

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