Table 3 Thematic table indicating Systemic and programmatic factors that hinder IMCI implementation

Factors related to the IMCI program.

• The new guideline for treatment of Malaria where the child with fever is not allowed to be given ALU (Artemisin Combined Therapy) until MRDT (Malaria Rapid Diagnostic test) test is done and is test positive. Therefore the IMCI need to be updated to reflect these changes. Also IMCI still recommends SP but the latest updates recommend ACT.

47 (30%)

• Drug resistance to the recommended drugs according to IMCI guidelines (especially Septrin/Cotrimoxazole

6 (4%)

• The guidelines have many classifications of illness and details therefore it becomes challenging when it is being referred to.

8 (5%)

Factors related to planning & allocation of resources.

• Shortage of essential drugs especially for treating pneumonia, diarrhea (ORS) and malaria.

27 (16%)

• Shortage/ high turnover of health care workers compared to very many children seeking treatment.

32 (19%)

Factors related to Healthcare workers attitude.

• The IMCI approach is a very basic approach in the treatment of childhood illnesses.

3 (2%)

• Lack of follow up (and if there not consistent) and adherence to IMCI guidelines.

17 (11%)

• Referring to IMCI guidelines is boring (sometimes not user friendly i.e. it has too many details in one page).

5 (3%)

Factors related to parental/ care takers issues.

• Some mothers/care takers don’t believe their children have the samples taken to the medical lab to be tested for the right diagnosis and management (drugs) to be given

7 (4%)

• Some mothers/care takers are not satisfied with the approach since most believe that the more drugs given to the child the better is the treatment/management. This is handled by giving health education to the mothers.

9 (6%)

TOTAL

161 (100%)