Madhankumar V. 1, Uppili V. R. 1, Prabakaran S. 1, Prasanth S. 1
| 1 Govt Thiruvarur Medical College, Tamilnadu, India |
Abstract
Background and Aim of Study: Integrated management of neonatal and childhood illness (IMNCI) is a globally proven, primarily community-based strategy to improve child survival and is being implemented worldwide in countries with high burden of child mortality.
The aim of the study: to identify the factors that affect the implementation of IMNCI by healthcare professionals in healthcare facilities, and to assess their attitude towards the implementation of IMNCI.
Material and Methods: The study was conducted at health care facilities of Thiruvarur district, Tamilnadu, India. A total of 100 health professionals were included in the present study. Mean age of the study participants was 36± 3 years. Most of them were males. Mean age of their work experience was 5.7± 2.1. In the study 79% of respondents attended IMNCI training at different time. Almost 86% of study participants have not received any follow up training in last 2 years. All participants was administered a predesigned, pretested, semi structured questionnaire on IMNCI. Version 21 of the SPSS software was used to record and analyse the responses.
Results: Health system related factors identified as hindrance to IMNCI implementation on case management skills according to this study are, overcrowding of people (26%), time consuming (21%), shortage of staffs (17%), untrained staff (10%), lack of supervision(6%), and lack of supplies(12%). Attitude of the health care providers on treating children’s based on algorithm were found to be unsatisfactory.
Conclusions: Efforts to improve the quality of child health services provided by health care providers in the less developed countries should focus not only on resource-intensive structural improvements, but also on cheap, cost-effective measures, especially the proper use of national guidelines for case management, and meaningful supervision. Government leadership, along with more structured and continued resource and training support, is necessary to foster sustainable IMNCI health care services within the needs of the local community.
Keywords
integrated management of neonatal and childhood illness, factors, health care providers, implementation
References
Abebe, A.M., Kassaw, M.W., & Mengistu, F.A. (2019). Assessment of factors affecting the implementation of integrated management of neonatal and childhood illness for treatment of under five children by health professional in health care facilities in Yifat cluster in North Shewa zone, Amhara region, Ethiopia. International Journal of Pediatrics, 1, Article 9474612. https://doi.org/10.1155/2019/9474612
Afolalu, T. D. (2020). Factors influencing the implementation of integrated management of childhood illnesses in selected health centers. International Journal of Family Medicine and Primary Care, 1(6), Article 1027. https://www.remedypublications.com/international-journal-of-family-medicine-primary-care-abstract.php?aid=6579
Bharani, S., Parmar, T., Kantharia, N., Parmar, R., & Kharod, N. (2012). A study to assess the implementation and effectiveness of IMNCI programme and evaluation of skills of rural Anganwadi workers in Vadodara taluka. National Journal of Community Medicine, 3(2), 207–212. https://njcmindia.com/index.php/file/article/view/1680
Bhandari, N., Mazumder, S., Taneja, S., Sommerfelt, H., Strand, T. A., & IMNCI Evaluation Study Group (2012). Effect of implementation of integrated management of neonatal and childhood illness (IMNCI) programme on neonatal and infant mortality: Cluster randomised controlled trial. BMJ, 344, Article e1634. https://doi.org/10.1136/bmj.e1634
Darmstadt, G. L., Bhutta, Z. A., Cousens, S., Adam, T., Walker, N., & de Bernis, L. (2005). Evidence-based, cost-effective interventions: How many newborn babies can we save? The Lancet, 365(9463), 977–988. https://doi.org/10.1016/S0140-6736(05)71088-6
Haryanti, F., Laksanawati, I. S., Arguni, E., Widyaningsih, S. A., Ainun, N. A., & Rastiwi, N. (2022). Evaluation of the implementation of integrated management of childhood illness in special region of Yogyakarta Province, Indonesia. Open Access Macedonian Journal of Medical Sciences, 10(B), 570–575. https://doi.org/10.3889/oamjms.2022.8670
Ingle, G. K., & Malhotra, C. (2007). Integrated management of neonatal and childhood illness: An overview. Indian Journal of Community Medicine, 32(2), 108–110. https://doi.org/10.4103/0970-0218.35646
Isangula, K., Ngadaya, E., Manu, A., Mmweteni, M., Philbert, D., Burengelo, D., Kagaruki, G., Senkoro, M., Kimaro, G., & Kahwa, A. (2023). Implementation of distance learning IMCI training in rural districts of Tanzania. BMC Health Services Research, 23(1), Article 56. https://doi.org/10.1186/s12913-023-09061-y
Jones, G., Schultink, W., & Babille, M. (2006). Child survival in India. Indian Journal of Paediatrics, 73, 479–487. https://doi.org/10.1007/BF02759891
Jones, G., Steketee, R. W., Black, R. E., Bhutta, Z. A., & Morris, S. S. (2003). How many child deaths can we prevent this year? The Lancet, 362(9377), 65–71. https://doi.org/10.1016/S0140-6736(03)13811-1
Madhankumar, V., Udhayabashkaran, K., Arularasan, S., & Kayalvizhli, P. (2022). Impact of knowledge and perception of the Swachh Bharat Abhiyan on the health behavior patterns of rural residents in India. International Journal of Science Annals, 5(1-2), 9–18. https://doi.org/10.26697/ijsa.2022.1-2.2
Mayhew, M., Ickx, P., Newbrander, W., Stanekzai, H., & Alawi, S. A. (2015). Long and short integrated management of childhood illness (IMCI) training courses in Afghanistan: A cross-sectional cohort comparison of post-course knowledge and performance. International journal of health policy and management, 4(3), 143–152. https://doi.org/10.15171/ijhpm.2015.17
Mohan, P., Kishore, B., Singh, S., Bahl, R., Puri, A., & Kumar, R. (2011). Assessment of implementation of integrated management of neonatal and childhood illness in India. Journal of Health, Population, and Nutrition, 29(6), 629–638. https://doi.org/10.3329/jhpn.v29i6.9900
Renosa, M. D., Dalglish, S., Barnighausen, K., & McMahon, S. (2020). Key challenges of health care workers in implementing the integrated management of childhood illnesses (IMCI) program: A scoping review. Global Health Action, 13(1), Article 1732669. https://doi.org/10.1080/16549716.2020.1732669
Seid, S. S., Sendo, E. G., Haso, T. K., & Amme, S. (2019). Utilization of integrated management of neonatal and childhood illness (IMNCI) guidelines and associated factors among nurse at public health institutions in West Arsi Zone, South East Ethiopia. Clinics in Mother and Child Health, 16(2), Article 313. https://doi.org/10.4172/2090-7214.1000313
Subedi, R. K., Vander Zanden, A., Adhikari, K., Bastola, S., Hirschhorn, L. R., Binagwaho, A., & Maskey, M. (2024). Integrated management of childhood illness implementation in Nepal: Understanding strategies, context, and outcomes. BMC Pediatrics, 23(Suppl 1), Article 645. https://doi.org/10.1186/s12887-023-03889-3
Titaley, C. R., Jusril, H., Ariawan, I., Soeharno, N., Setiawan, T., & Weber, M. W. (2014). Challenges to the implementation of the integrated management of childhood illness (IMCI) at community health centres in West Java province, Indonesia. WHO South-East Asia Journal of Public Health, 3(2), 161–170. https://doi.org/10.4103/2224-3151.206732
UNICEF. (2025). Levels and trends in child mortality: Report 2024. UNICEF. https://data.unicef.org/wp-content/uploads/2025/03/UNIGME-2024-Child-Mortality-Report_28-March.pdf
Venkatchalam, J., Aggarwal, A. K., Gupta, M., & Sathya, G. R. (2012). Evaluation of IMNCI practices among health care providers in a district of North India. IOSR Journal of Dental and Medical Sciences, 1(6), 46–50. https://doi.org/10.9790/0853-0164650
World Health Organisation. (2005). Handbook: IMCI integrated management of childhood illness. WHO. https://iris.who.int/server/api/core/bitstreams/6db9960b-5dd9-4a8e-82de-e20ba2deaa69/content
World Health Organisation. (2003). Integrated management of neonatal and childhood illness. WHO. https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/child-health/integrated-management-of-childhood-illness
Madhankumar Velu (Corresponding Author) – https://orcid.org/0000-0002-3453-126X;
Uppili Venkat Ragavan – https://orcid.org/0009-0004-2806-3246б; MD Community Medicine, Assistant Professor, Department of Community Medicine, Govt Thiruvarur Medical College, Tamilnadu, India.
Prabakaran Sakthivel – https://orcid.org/0009-0005-1276-9604; Assistant Professor, Department of Ear Nose Throat, Govt Thiruvarur Medical College, Tamilnadu, India.
Prasanth Selvakumar – https://orcid.org/0009-0002-0684-9569; Govt Thiruvarur Medical College, Tamilnadu, India
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APA
Madhankumar, V., Uppili, V. R., Prabakaran, S., & Prasanth, S. (2025). Factors affecting the implementation of integrated management of neonatal and childhood illness by Indian health professionals. International Journal of Science Annals, 8(2), 1–10. https://doi.org/10.26697/ijsa.2025.2.6
Harvard
Madhankumar, V., Uppili, V. R., Prabakaran, S., & Prasanth, S. "Factors affecting the implementation of integrated management of neonatal and childhood illness by Indian health professionals" International Journal of Science Annals, [online] 8(2), pp. 1–10. viewed 25 December 2025, https://culturehealth.org/ijsa_archive/ijsa.2025.2.6.pdfVancouver
Madhankumar V., Uppili V. R., Prabakaran S., & Prasanth S. Factors affecting the implementation of integrated management of neonatal and childhood illness by Indian health professionals. International Journal of Science Annals [Internet]. 2025 [cited 25 December 2025]; 8(2): 1–11. Available from: https://culturehealth.org/ijsa_archive/ijsa.2025.2.6.pdf https://doi.org/10.26697/ijsa.2025.2.6
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