ArticleBMJ paediatrics open2021
Integrated Management of Childhood Illnesses (IMCI): a mixed-methods study on implementation, knowledge and resource availability in Malawi.
Article in BMJ paediatrics open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Health care worker-reported barriers and potential facilitators of acute lower respiratory infection care deliver for children at Mchinji District Hospital in Malawi.IJID regions · 2026Article
- Bridging the diagnostic gap: diagnostic capacity and pediatric quality of care in LMICs.BMC medicine · 2025Article
- Exploring Community Roles in Managing Childhood Illnesses in Vhembe District, Limpopo: Perspectives from Nurses and Caregivers.International journal of environmental research and public health · 2025Article
- Evaluation of a Scalable Design for a Pediatric Telemedicine and Medication Delivery Service: A Prospective Cohort Study in Haiti.The American journal of tropical medicine and hygiene · 2025Article
- Ubuntu philosophy as a strategy to promote access to under-five child healthcare services.Curationis · 2025Review
- Factors influencing the implementation of Integrated Management of Neonatal and Childhood Illness (IMNCI) by nurses in Bhutan: A predictive correlational study.Belitung nursing journal · 2025Article
- The Impact of integrated management of childhood illness training on knowledge levels of healthcare workers in Botswana.PLOS global public health · 2025Article
- Medical Students' Clinical Knowledge of Integrated Management of Childhood Illness: A cross-sectional comparative study.Sultan Qaboos University medical journal · 2024Article
- Article
- Survival time and predictors of death among HIV infected under five children after initiation of anti -retroviral therapy in West Amhara Referral Hospitals, Northwest Ethiopia.BMC pediatrics · 2022Article
- Prospective cohort study of referred Malawian children and their survival by hypoxaemia and hypoglycaemia status.Bulletin of the World Health Organization · 2022Article
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Authors and funding
10 authors.
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Abstract
Background: The introduction of the WHO's Integrated Management of Childhood Illnesses (IMCI) guidelines in the mid-1990s contributed to global reductions in under-five mortality. However, issues in quality of care have been reported. We aimed to determine resource availability and healthcare worker knowledge of IMCI guidelines in two districts in Malawi. Methods: We conducted a mixed-methods study, including health facility audits to record availability and functionality of essential IMCI equipment and availability of IMCI drugs, healthcare provider survey and focus group discussions (FGDs) with facility staff. The study was conducted between January and April 2019 in Mchinji (central region) and Zomba (southern region) districts. Quantitative data were described using proportions and χ Results: Forty-seven health facilities and 531 healthcare workers were included. Lumefantrine-Artemether and cotrimoxazole were the most available drugs (98% and 96%); while amoxicillin tablets and salbutamol nebuliser solution were the least available (28% and 36%). Respiratory rate timers were the least available piece of equipment, with only 8 (17%) facilities having a functional device. The mean IMCI knowledge score was 3.96 out of 10, and there was a statistically significant association between knowledge and having received refresher training (coeff: 0.42; 95% CI 0.01 to 0.82). Four themes were identified in the FGDs: IMCI implementation and practice, barriers to IMCI, benefits of IMCI and sustainability. Conclusion: We found key gaps in IMCI implementation; however, these were not homogenous across facilities, suggesting opportunities to learn from locally adapted IMCI best practices. Improving on-going mentorship, training and supervision should be explored to improve quality of care, and programming which moves away from vertical financing with short-term support, to a more holistic approach with embedded sustainability may address the balance of resources for different conditions.
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