The implementation of the Integrated Management of Childhood Illnesses (IMCI) strategy guidelines in Botswana

Abstract

The purpose of the study was to explore the challenges encountered in implementing the Integrated Management of Childhood Illness (IMCI)strategy guidelines by primary healthcare (PHC) nurses at first level healthcare facilities in the Francistown area of Botswana. An exploratory, descriptive and quantitative research design was used and data were collected using self-administered questionnaires. Out of the population of 68 PHC nurses, 60 (88.2%) trained professional PHC nurses working at first level health facilities in the Francistown area, completed questionnaires and comprised the respondents for this study. Respondents working in the outpatient and maternity departments had more knowledge about IMCI than those working in mother and child health services (MCH). Of the respondents, 61.7%% (n=37) reported that resources for implementing the IMCI strategy guidelines were available at their facilities and 38.3%% (n=23) stated that a lack of resources was one of the main difficulties they encountered in implementing the IMCI strategy. Most respondents (93.3%; n=56) agreed that they had opportunities to attend to sick children aged five and younger (referred to as 'under fives'), but only 45.0% (n=27) of them reported that they used the entire IMCI approach when attending to these sick children. PHC nurses stated that the implementation of the IMCI strategy could be enhanced if the lack of resources, shortage of staff, lack of time, untrained staff and lack of supervision could be addressed effectively.