hypothetical model to predict the potential impact of government and management support in implementing integrated management of childhood illness practices

Objectives: Despite broad adoption and implementation of Integrated Management of Childhood Illness [IMCI] in more than 100 countries, childhood mortality and morbidity rates continue to prevail. This calls for further investigation to identify the factors that prevent actual application of IMCI-recommended clinical practices. This study tests a hypothetical structural model to investigate potential role of government and healthcare policymakers on improving implementation and application of IMCI-recommended practices in clinical setting

Methods: The study was carried out at Sur and Ibra Nursing Institutes in Oman, in June 2016. We used six pre-tested and validated constructs for developing a hypothetical structural model. The constructs were used as underlying variables to examine the probable influence of government and policymakers on actual application of IMCI-recommended practices. Data were collected through structured questionnaires, which designed to measure healthcare professionals' perceptions. Each construct was pre-loaded with three sub-constructs. Cronbach's alpha [CA] was used to calculate the internal consistency and reliability

Results: Factor loadings for each item in the model were >/= 0.700. CA values for all the studied constructs were > 0.600. The average variance extracted values for all the constructs were > 0.500

Conclusions: The findings support the hypothetical structural model and highlights governments could play a significant role in ensuring that IMCI strategy is not only implemented, but also its recommended practices are applied in clinical setting

Preferral antibiotic treatment policy to be adopted in the [integrated management of childhood illness strategy in all the developing countries?]

To review the rationale and practice for the use of single dose antibiotics in [children below five years] as pre-referral treatment in the emergency triage and treatment protocol of IMCI in the developing countries and also, to assess the available evidence on the suitability of adopting the use of pre-referral antibiotic treatment as a standard strategy of Emergency Triage and Treatment [ETAT] in [integrated Management of Childhood Illnesses] [IMCI] for all developing countries. Scientific, reliable information from the international articles [published and unpublished] were collected. A series of Medline search with key words were performed. Opinions of epidemiologists, public health officers and researchers University Alumni and senior health officials of some developing countries were included in this review. Indirect evidence regarding for or against adopting pre-referral antibiotic treatment were found in developing countries where IMCI was implemented. It was also noted that the efficiency ranking based on the health system performance correlated negatively with the per capita income [r=-0.7, p=<0.001] and the per capita health expenditure. [r=-0.6, [=0.001]. the gap between mortality rates of the [<1] and [1 to 4] years age groups was narrow in countries such as Oman and Argentina compared to the other developing countries. While the doctor population ratio was higher in countries with better efficiency rankings, [r=0.66, p=0.01]. The differences found within the developing world indicate that the use of pre-referral antibiotic is certainly open to modification depending on the resources and health system performance