Assessment of child health care services in Bac Giang and Ha Nam provinces

ABSTRACT

Background: The strategy of Integrated Management of Childhood Illness (IMCI) was developed as an approach/tool for reducing the childhood mortality in developing countries. IMCI was approved by the Ministry of Health of Viet Nam and has been implemented in more than 3500 communal health centers nationwide. Aims: 1) To discover the quality of health care services for children under-5 and the situation of IMCI in health facilities. 2) To propose solutions to improve the quality of health care services for children. Materials and method: The cross-sectional study using quantitative and qualitative approaches conducted 58 direct observations in health workers, interviewed 58 caretakers, comprehensively interviewed 20 local leaders and technical staffs, facilitated 12 focal group discussions and reviewed 120 records of 12 commune health centers. Results: IMCI was considered by all of the participants as a comprehensive approach to improving the quality of childhood health care at first-level health facilities. IMCI contributed towards improved case management skills of health workers, improved the supply of essential drugs and supplies for child health care. As a result, the quality of health services for children under-5 has been promoted (93% of illness children were correctly assessed and classified, 84.6% of them were correctly treated and counseled). Health workers in Ly Nhan district, Ha Nam province adhered to 8.4+/-1.5 out of 10 essential steps of comprehensive child health care. Contrarily, this indicator was low in the districts of Bac Giang province (4.8+/-1.5), not much different to untrained IMCI health workers. Conclusion: IMCI is a useful strategy to improving the quality of child health care. But there were some difficulties that affected the implementation of this strategy in first-level health facilities.