Factors influencing the implementation of integrated management of childhood illnesses among nurses working at health center level in a selected district hospital in Rwanda

Abstract

Background: Nearly six million Children aged under five years died in 2015. Nearly 16 000 every day and 83% of these deaths are due to infectious diseases, neonatal conditions or nutritional conditions. Integrated management of childhood illnesses (IMCI) is designed to improve child health, also reduce under-five mortality, especially in poor countries by integrating the case management of the most common childhood problems. The aim of the study: This study intended to assess the factors influencing the implementation of IMCI among nurses working at the health center level in a selected health district in Rwanda Methodology: A descriptive cross - sectional was used and stratified random sampling method used to select a sample of 91 nurses working in health centers of Masaka district Hospital. A self- administered questionnaire was used to collect the data then analyzed using SPSS version 21 using both descriptive and inferential statistics with CI set at 95% and p-value ≤ 0.05. Results: Slightly more than a half of nurses 53% poorly implemented IMCI. Reported challenges included staff shortage 80.2%, untrained staff 74%, lack of refresher training 20(54.1%), spring scale 52%. Furthermore. Again slightly more than a half of nurses were interested in applying IMCI 53.8% and applied all stage of IMCI 59.3%. Younger age among nurses (P= 0.001), married status (P=0.001), institutional organization (P= 0.026), scheduling and daily activity planning (P=0.042), time consuming nature (P= .0039), child weighing scale (P=.009) were found statistically associated with IMCI implementation. Conclusion: There was a poor IMCI implementation among nurses working in health centers of Masaka district hospital’s catchment area. Barriers and facilitators to IMCI implementation were identified. In addition, demographic characteristics of nurses, institutional organization, the availability of equipment at Masaka health centers were found to influence IMCI implementation.