The Implementation of Integrated Management of Childhood Illness ...

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Table of Contents Abstract ....................................................................................................................................4 List of Abbreviations.............................................................................................................5 1. Introduction ....................................................................................................................6 a. Millennium Development Goals ..............................................................................6 b. Reasons for High Child Mortality in the World.....................................................8 c. Preventing Child Mortality .......................................................................................9 d. Integrated Management of Childhood Illness......................................................10 i. Rationale for an Integrated Approach ...............................................................10 i. IMCI and its Components ...................................................................................12 ii. Implementation of IMCI in Developing Countries..........................................14 iii. The IMCI Classifications......................................................................................14 iv. Evaluation of the IMCI.........................................................................................18 2. Objectives......................................................................................................................20 3. Material and Methods.................................................................................................21 a. The Setting .................................................................................................................21 i. Malawi....................................................................................................................21 ii. Mangochi District..................................................................................................23 iii. Monkey Bay health zone......................................................................................23 b. Collection of Data .....................................................................................................25 i. Location ..................................................................................................................25 ii. Time ........................................................................................................................26 iii. Interviews with Health Workers ........................................................................26 iv. Children Attending the Outpatient Department .............................................26 v. Interviews with Mothers......................................................................................27 vi. Drugs and Equipment at the Health Facility....................................................27 vii. Children admitted to MBCH...............................................................................27 c. Data Processing .........................................................................................................27 d. Ethical Permission.....................................................................................................28 4. Results............................................................................................................................29 a. Health Care Workers................................................................................................29 b. Health Facility Attendance......................................................................................29 c. Diagnoses ...................................................................................................................33 i. Malaria....................................................................................................................34 ii. Pneumonia .............................................................................................................35 iii. Other Respiratory Tract Infections.....................................................................36 iv. Diarrhoea................................................................................................................37 v. Ear Infection...........................................................................................................38 d. Drugs ..........................................................................................................................38 e. Interviews with Mothers..........................................................................................39 5. Discussion .....................................................................................................................41 a. Health Facility Attendance......................................................................................41 2
. Diagnoses ...................................................................................................................43 i. Respiratory Infections ..........................................................................................43 ii. Malaria....................................................................................................................44 iii. Malaria versus Pneumonia...................................................................................44 iv. Diarrhoea................................................................................................................45 v. Ear Infection...........................................................................................................46 vi. Malnutrition and anaemia...................................................................................46 c. Health Care Workers................................................................................................47 d. Drugs ..........................................................................................................................48 e. Interviews with Mothers..........................................................................................48 Conclusion .........................................................................................................................49 Acknowledgments...............................................................................................................51 References .............................................................................................................................52 Annexes..................................................................................................................................57 3
Page 1: The Implementation of Integrated Ma
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 and 20: guidelines after training seems unn
Page 21 and 22: 3. Material and Methods a. The Sett
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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