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Integrated Management of Childhood Illnesses strategy: compliance with referral and follow-up recommendations in Gezira State, Sudan

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dc.contributor.author Al Fadil, Sumaia Mohammed
dc.contributor.author Abd Alrahman, Samira Hamid
dc.contributor.author Cousens, Simon
dc.contributor.author Bustreo, Flavia
dc.contributor.author Shadoul, Ahmed
dc.contributor.author Farhoud, Suzanne
dc.contributor.author El Hassan, Samia Mohamed
dc.date.accessioned 2018-07-17T13:46:37Z
dc.date.available 2018-07-17T13:46:37Z
dc.date.issued 2003
dc.identifier.uri http://repo.uofg.edu.sd/handle/123456789/747
dc.description Bulletin of the World Health Organization 2003;81:708-716 en_US
dc.description.abstract Objectives To determine the extent to which families follow referral and follow-up recommendations given in accordance with the Integrated Management of Childhood Illnesses (IMCI) strategy and the factors that influence families’ responses to such recommendations. Methods Children aged 2 months–5 years who presented to an IMCI-trained health worker in Massalamia Health Area, Sudan, were recruited. Children with an IMCI classification that indicated the need for referral or follow-up were traced to determine whether the family complied with the referral or follow-up recommendation. Caretakers were interviewed to find out why they had or had not complied. Focus group discussions were held with health workers, caretakers, and community members. Findings Overall, 5745 children were enrolled. Of these, 162 (3%) were considered to be in need of urgent referral: 53 (33%) attended a hospital on the day of the referral, with a further 37 (23%) visiting the hospital later than the day of referral. About half of families cited cost as the reason for not visiting a hospital. A total of 1197 (21%) children were classified as needing follow-up. Compliance with a follow-up recommendation was 44% (529 children). Almost 165 (90%) of caretakers who were aware of and did not comply with follow-up, said they had not done so because the child was better. Compliance increased with the caretaker’s level of education, if drugs were provided during the first visit, and if the follow-up period was short (2 or 5 days). Conclusion In Massalamia — a resource-constrained environment in which IMCI implementation was well received by the community — only about half of children judged to be in need of urgent referral were taken for that care within 24 hours. Most children in need of follow-up received their first treatment dose in the health facility. This aspect of IMCI was commented upon favourably by caretakers, and it may encourage them to return for follow-up. Rates of return might also improve if return visits for children currently asked to return after 14 or 30 days were scheduled earlier. en_US
dc.language.iso en en_US
dc.publisher Bulletin of the World Health Organization en_US
dc.subject Child health services en_US
dc.subject Primary health care en_US
dc.subject Delivery of health care en_US
dc.subject Integrated en_US
dc.subject Referral and consultation en_US
dc.subject Patient compliance en_US
dc.subject Child en_US
dc.subject Family en_US
dc.subject Socioeconomic factors en_US
dc.subject Sudan en_US
dc.title Integrated Management of Childhood Illnesses strategy: compliance with referral and follow-up recommendations in Gezira State, Sudan en_US
dc.type Article en_US


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