Health care for under-fives in Ile-Ife, South-West Nigeria: effect of the integrated management of childhood illnesses (IMCI) strategy on growth and development of under-fives

ABSTRACT

Background: The study obtained information on key growth promotion and developmental household and community health practices in Community-Integrated Management of Childhood Illnesses (C-IMCI) and non-C-IMCI in local government areas (LGAs) in Osun State; Nigeria; to determine the differences that existed; between these LGAs. Method: A cross-sectional comparative study to compare Integrated Management of Childhood Illnesses (IMCI) key growth promotion and development health practices in two LGAs in Osun State was conducted using quantitative and qualitative techniques. Data analysis was done using Epi Info version 6.0 for the quantitative survey and a content analysis method for the qualitative survey. The subjects were mothers or caregivers of children 0-59 months of age; and their index children. Results: Findings revealed that the IMCI key growth and development health practices were generally better rated in the CIMCI-compliant LGA than in the non-CIMCI compliant LGA. Breastfeeding practice was widespread in both LGAs. However; the exclusive breastfeeding (EBF) rate among children under six months was higher in the compliant LGA (66.7) than in the non-compliant LGA (25). More caregivers (59.7) from the non-compliant LGA introduced complementary feeds earlier than six months. Growth monitoring activities revealed that there were more underweight children (19.1) in the non-compliant LGA. Community Resource Persons (CORPs) and health workers were the most popular sources of information on IMCI key practices in the compliant LGA; while in the non-compliant LGA the traditional healers; elders and; to a lesser extent; health workers provided information on these key practices. Conclusion: The IMCI strategy; if well implemented; is an effective and low-cost intervention that is useful in achieving optimal growth; development and survival of Nigerian children