TRENDS IN HEALTH SERVICE UTILIZATION OF ICCM AND IMNCI IN FOUR REGIONS OF ETHIOPIA

Abstract

Background: Integrated Management of Newborn and Child hood Illness (IMNCI), Integrated Community Case  Management (ICCM),and Community Based Newborn Care (CBNC) are proven strategies used in Ethiopia to reduce child mortality, by treating major killer diseases of newborns and children, utilization of which can contribute to reduction of under five mortality.                                                                                                                                                                                             Methodology: We conducted cross sectional household surveys every year from January to March 2011-2015 to monitor outcomes of health interventions in Integrated Family Health Program (IFHP) target areas. Data were collected using checklists for household containing selected questions for each area of focus. The data were entered and analyzed using SPSS16.0 version.                                                                                                                                                                         Results: In the last four years (2011 -2015), children 0-23 months who had illness with diarrhea/fever and cough, within two weeks of the survey declined significantly, from 32.5 to 29%, and health seeking behavior raised from 56.6 to 67.6% (p value 0.0391 and 0.0001 respectively). The number of children treated in Health Post (HP) was 13-17 per month, but decreased in Health Centers (HCs) from 112 to 80 per month, which is significant (p value 0.00). Proportion of children who sought advice or treatment for the illness, in HCs was 57.7% and HPs 30.8%. Mothers or caretakers were asked why they did not seek treatment or HPs, 37.9% said that HPs were not always open and, 29.2% do not know about treatment in HPs.
Conclusion: The significant drop in incidence of disease and increase in health seeking behavior showed that preventive interventions have brought change in Ethiopia which may be due to strengthening of Health Extension Program (HEP) and ICCM/CBNC scale up to treat sick children. Many mothers are still taking their children HCs for treatment which are far from HPs. There is a need to keep HPs open daily and conduct social mobilization about  treatment given in HPs, which will increase utilization.