Utilization of Integrated Management of Neonatal and Childhood Illness (IMNCI) Guidelines and Associated Factors among Health Professionals Working in Health Centers in the West Shoa Zone, Oromia, Ethiopia

Abstract

Background: The Integrated Management of Neonatal and Childhood Illness is a strategic approach to enhancing the health, growth,  and development of under-fives by reducing mortality, morbidity, and disability. Implementing the IMNCI guideline and associated  factors still need to be discovered in the study area.

Objective: To assess the utilization of the IMNCI guidelines and associated factors among health professionals working in health centers in West Shoa Zone, Oromia, Ethiopia, 2022.

Methods: A facility-based cross-sectional study was conducted from June 20 to July 20, 2022, in the West Shoa Zone, Oromia. Among the  22 districts, six were selected by simple random sampling. A sample size 255 was proportionally allocated to 27 health centers (HCs) in the selected districts.  Finally, the study unit was selected using simple random sampling. Data were collected through selfadministered  questionnaires, checklist observation used to evaluate adherence, an inventory checklist used to assess the availability of resources, and  a key informant's interview guide. Quantitative data were coded, entered into Epi-data 3.1, and exported to SPSS version 25 for  processing and analysis. In a bi-variable analysis, variable with a p-value< 0.25 was selected for multivariate logistic regression analysis.  The strength of association was measured by the AOR at 95% CI and significance variables of P-value< 0.05. Qualitative data were  analyzed thematically and triangulated, and associated factors were presented in narrative form.

Results: 27 inventories, 162 observation  sessions and ten KIIs were conducted, and participants’ response rate of 98%. This study's overall IMNCI guideline  implementation rate was low at 64.1%. Factors that affected the utilization of IMNCI guidelines among health professionals were a  shortage of staff [AOR = 1.2, 95% CI: 1.12 - 3.36], lack of knowledge [AOR=3, 95% CI: 1.25- 7.21], and always referring to the IMNCI  guidelines while managing children [AOR = 6.53, 95% CI: 2.03 - 21.01].

Conclusions: The utilization of IMNCI guideline status in the study  area was low. The identified factors associated with health professionals were lack of knowledge, shortage of staff, and always referring  to the IMNCI guidelines while managing under-fives. Health professional emphasize to IMNCI guideline while managing under-fives.