[Integrated management of mother and child health in the region of Monastir [Tunisia]]

The programme of integrated management of child health [IMCI] was established in Tunisia in 2002 in some health districts. This study evaluated the management of children under 5 years of age and their mothers using the IMCI programme in Zeramdine, a town 20 km south-west of Monastir. A cross-sectional study was conducted on a convenience sample of 526 medical records of children under 5 years attending the Zeramdine maternal and child health centre. The study evaluated preventive and curative aspects of child health. The mean age was 21.9 [SD 16.7] months. On the curative side, respiratory diseases were the leading reason for consultation [71.2%] followed by diarrhoea [15.4%]. For preventive services, physicians systematically checked the child's immunization status and height and weight on the growth charts, and screened for strabismus and anaemia. The contribution to child health of IMCI is undeniable; it allows comprehensive care of the child, develops staff skills, upgrades the health system and improves family and community practices

[ birth register as an evaluation tool of maternal and child health activities at district level]

Relevant epidemiological data are essential to improving management of maternal and child health services at district level. In public maternity hospitals of the health region of Monastir, Tunisia, a perinatal register has been established recording information related to pregnancy, childbirth and the condition of the newborn. During 1994, 7750 deliveries were registered, of which 46% took place in the university teaching hospital. Use of peripheral maternity hospitals varies according to the resources of the hospital; the university teaching hospital is highly attractive, especially for women from neighbouring districts. These findings raise the problem of the cost-effectiveness and relevance of opening new health facilities, particularly in times of economic crisis in the health care system