An evaluation thesis to be submitted to the Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar for the partial fulfillment of the requirements of Masters of Public Health in Monitoring and Evaluation

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