Abstract:
Background: The Integrated management of Neonatal and Childhood Illness program an
integrated approach which aim were to reduce under-five morbidity and mortality entire world.
However Poor adherence, in sufficient follow up, high cost IMNCI training, lack of planning,
coordination and wide communication gaps between various stakeholder are difficulties for the
IMNCI implementation. This evaluation assessed the implementation status of the program from
the dimensions of availability, compliance, and satisfaction of caretakers in selected public
primary hospitals in East Gojjam, northern Ethiopia.
Objective: To evaluate the processes of Integrated management of Neonatal and Childhood Illness
program implementation at public primary hospitals in East Gojjam Zone of north-west Ethiopia
in 2023.
Methods: A facility-based case study design with concurrent mixed data collection methods was
used at public primary hospitals from March 28–April 28, 2023, in East Gojjam Zone for
evaluating the Integrated management of Neonatal and Childhood Illness program. The formative
approach was used. A total of 408 caregivers were included. Ten key informant interviews were
purposefully selected, and ten health care providers were observed for 50 observation sessions.
The data was collected through a face-to-face interviewer, a structured questioner, a document
review checklist, an observation checklist, and a key informant interview guide. Qualitative data
manual thematic analysis and Quantitative data were analyzed using Stata version 17 were used.
The association between the outcome variable and the independent variable was identified using
the binary logistic regression model, with a p-value of 0.25 for a candidate for multivariable
analysis. A p-value of 0.05 and a confidence interval were used to declare an association.
Result: The overall level of implementation of Integrated management of Neonatal and Childhood
Illness according to judgmental parameters was judged fair. Resource availability was 70.98
percent, and the compliance of HCWs was 68.92 percent. The satisfaction level of caretakers was
77.36 percent. Caretakers who were being urban were AOR = 2.56 CI 95% [1.37, 4.78], caretakers
who got the prescribed drug in the hospital pharmacy were AOR = 2.9 CI 95% [1.49, 5.8],
caretakers who came to the hospital for less than 30 minutes were AOR = 6.3 CI 95% [3.12, 12.86],
and caretakers who measured the weight of a sick child were AOR = 3.78, CI 95% [2.02, 7.06]
were more satisfied with the Integrated management of Neonatal and Childhood Illness service.
Conclusion and Recommendation: The process of the Integrated management of Neonatal and
Childhood Illness program was fair but needs improvement. It can achieve more by providing
training for front line workers, a review meeting, refreshment training, and timely supportive
supervision to ensure adherence to Integrated management of Neonatal and Childhood Illness
guidelines. Caretaker satisfaction is affected by time to reach hospitals, residency, availability of
prescribed drugs, and weight measure of the sick child. Encourage health care provider to take
vital sign every sick child, availing of drugs, infrastructure and give emphasis for caretaker who
come from rural
