Integrated Management of Childhood Illness (IMCI) training in Zambia: Lessons learnt

Introduction: IMCI strategy aims to contribute to the reduction of morbidity and mortality in children under- five years of age.. There has been no systematic review to determine factors such as status of IMCI implementation, the numbers of IMCI trained staff, integration of IMCI in district action plans and overall effect on under-five mortality. This study aims to describe the status of IMCI implementation in Zambia and to determine possible factors that influence the district ability to train staff in IMCI.

Methods: Information collected through checklists from all 72 districts included number of trained workers in IMCI ,number of supervisors trained in IMCI at district level, under five mortality by district, IMCI inclusion in the 2006 district action plan, and location (Rural or urban).Qualitative information through IMCI orientation visits was also analysed.

Results: The study revealed that less than 25% of health centres and less than 10% districts had more than 60% health workers trained in IMCI. However, majority of districts had included IMCI in their 2006 action plan. Higher Under five mortality was reported in rural districts irrespective of IMCI implementation status. Factors found to influence training of at least 30% of health workers in IMCI included having IMCI in the action plan, location, under five mortality and being IMCI implementing districts.

Conclusion: The study has revealed major gaps in IMCI training in both rural and urban areas. The absence of trained health workers in some of the health centres make it difficult to reach the desired saturation levels.