Adherence and Implementation-related Challenges of Integrated Management of Childhood Illness Guidelines among Nurses at Health Centers in Port Harcourt, Nigeria

Abstract

Background: The Integrated Management of Childhood Illness (IMCI) guidelines are a standardized diagnostic and treatment approach developed by the World Health Organization for the management of common childhood diseases. Objective: This study assessed the adherence and implementation-related challenges of the IMCI guidelines among nurses at health centers in Port Harcourt, Nigeria. Materials and Methods: A cross-sectional descriptive-analytical design was employed to examine nurses in all the 12 Model Comprehensive Primary Healthcare Centers (MCPHCs) in Port Harcourt, Nigeria. The census sampling technique was used to enroll 52 consenting participants. Data were collected by (1) observation and recording on a checklist and then (2) semi-structured questionnaire. Collected data were analyzed using frequency, percentages, Chi-square, and prevalence ratio at a 5% level of significance with the aid of IBM-SPSS version 25. Results: About half (53.8%) of the participants demonstrated adequate overall adherence to all the steps of the IMCI guidelines. Adequate adherence to all the steps of the IMCI guidelines was 83% higher among participants trained on the IMCI guidelines (P = 0.038). The participants’ educational qualifications (P = 0.722) and years of professional nursing practice (P = 0.477) were not associated with adherence to the IMCI guidelines. The categories of the IMCI guidelines implementation-related challenges reported by the participants were a lack of training update on the IMCI guidelines (94.2%), a lack of the IMCI booklets (69.2%), and work-time pressure (53.8%) among others. Conclusion: Adherence to the IMCI guidelines was short of desired levels. In recommendation, frequent training and regular provision of the IMCI booklets in the MCPHCs are required.