Abstract:

Background: IMCI was developed by WHO/UNICEF and aims at reducing childhood morbidity and mortality in resource-limited setting including Tanzania. It was introduced in 1996 and has scaled up in districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza City.

Methods: A Cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza City were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the facilitators. Data were analyzed using SPSS and presented using figures and tables.

Results and discussion: Only 51% healthcare workers interviewed had been trained and understood the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illness especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, the lack of onsite mentoring and the lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through capacity building and strengthening the healthcare system were the major interventions that could assist in IMCI implementation.

Conclusion and Recommendation: The healthcare workers can implement better IMCI through the collaboration of supervisors, IMCI focal person, CHMT and other stakeholders interested in child health. However, significant barriers impede a sustainable IMCI implementation. Recommendations have been made related to supportive Supervision and Healthcare system strengthening among others.