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2013, Number 2

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Revista Cubana de Salud Pública 2013; 39 (2)

Implementation of the strategy of Integrated Management of Childhood Illnesses

Quizhpe A, Uphoff E, Encalada L, Andrade D, Barten F

Language: Spanish
References: 19
Page: 197-207
PDF size: 66.62 Kb.


ABSTRACT

Introduction: the strategy of Integrated Management of Childhood Illnesses (IMCI) developed by the World health Organization and the UNICEF is aimed at reducing infant mortality and at promoting the rational use of antibiotics.
Objective: to evaluate the performance of the above-mentioned strategy for children with acute respiratory infections in Ecuador, in terms of diagnosis and treatment, particularly antibiotic therapy.
Methods: the medical histories of patients aged two months to five-years old, who had been diagnosed with ARI and treated at 2 primary health care centers in urban or rural areas in the period of July 2010 through June 2011, were checked. Data about the characteristics of the patients, the diagnosis and the treatment followed were retrospectively collected.
Results: in both primary health centers and in most of the medical records, information about the lines of treatment and administration of antibiotics was missing. Data collected on 1 063 patients revealed that over-prescription of antibiotics occurred more frequently in health centers located in rural areas (6.5 %).
Conclusion: future research should focus on identifying the causes of failure in the IMCI implementation. The inaccessibility to health centers may be an example of associated causes, especially in rural areas. The contextualization of the IMCI strategy may be needed to improve child health, to promote the rational use of antibiotics and to reduce the spread of antimicrobial resistance.


REFERENCES

  1. Okeke IN, Laxminarayan R, Bhutta ZA, Duse AG. Antimicrobial resistance in developing countries. Part I: recent trends and current status. Lancet Infect Dis. 2005;5:481-93.

  2. World Health Organization. Medicines: Rational use of medicines. Descriptive note Nº 338. May 2010. Spanish. Geneva: WHO; 2010.

  3. Valenzuela MT, Quadros C. Antibiotic resistance in Latin America: A cause for alarm. Vaccine. 2009;27(suppl 3):C25-8.

  4. Roberts RR, Hota B, Ahmad I. Hospital and societal costs of antimicrobialresistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clin Infect Dis. 2009;49:1175-84.

  5. ReAct Latinoamérica. A fact sheet from ReAct Action on antibiotic resistance. Economic aspects of antibiotic resistance. 2007 [cited 2011 Oct 11];(1). Available from: http://www.reactgroup.org/what-we-do/reactivities/react-activities-2008- 2009.html

  6. Black RE, Cousens S, Johnson HL. Child Health Epidemiology Reference Group of WHO, UNICEF. Global, regional and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375:1969-87.

  7. Ruuskanen O, Lahti E, Jennings LC, Murdoch DR. Viral pneumonia. Lancet. 2011;377:1264-75.

  8. Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361:2226-34.

  9. Mason E, Scherpbier R, Lawe-Davies O. WHO position statement on IMCI. Lancet. 2009;374:782-3.

  10. Adam T, Edwards SJ, Amorim DG. Cost implications of improving the quality of child care using integrated clinical algorithms: evidence from Northeast Brazil. Health Policy. 2009;89:97-106.

  11. Bishai D, Mirchandani G, Pariyo G, Burnham G, Black R. The cost of quality improvements due to integrated management of childhood illness (IMCI) in Uganda. Health Ecom. 2008;17:5-19.

  12. Adam T, Manzi F, Schellenberg JA, Mgalula L. Does the Integrated Management of Childhood Illness cost more than routine care? Results from the United Republic of Tanzania. Bull World Health Organ. 2005;83:369-77.

  13. Strategic Council on Resistance in Europe. Resistance: a sensitive issue, the European roadmap to combat antimicrobial resistance. Utrecht, the Netherlands: SCORE; 2004.

  14. World Health Organization and Unicef. Integrated Management of Childhood Illness (IMCI). Geneva: WHO; 2008 [cited 2011 Oct 21]. Available from:http://www.who.int/maternal_child_adolescent/documents/IMCI_chartbooklet /en/index.html

  15. López-Acevedo G, Tinajero. Worldbank Policy Research Working Paper. Poverty in Latin America. Sources of welfare disparities in Ecuador. Washington, D.C.: Worldbank; 2009 [cited 2011 Sept 19]. Available from: http://www.worldbank.org/en/country/ecuador/research/all?qterm=&teratopic_exa ct=Poverty+Reduction&docty_exact=Policy+Research+Working+Paper

  16. Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO; 2008.

  17. López-Cevallos DF, Chi C. Health care utilization in Ecuador: a multilevel analysis of socio-economic determinants and inequality issues. Health Policy Plan. 2010;25:209-18.

  18. Mulholland E, Smith L, Carneiro I, Becher H, Lehmann D. Equity and childsurvival strategies. Bull World Health Organ. 2008;86:399-407.

  19. Rudan I; WHO Child Health Epidemiology Reference Group. Global estimate of the incidence of clinical pneumonia among children under five years of age. Bull World Health Organ. 2004;82:895-903.




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