Evaluation of the Integrated Management of Childhood Illness Strategy in the Menoua Department - Cameroon Público
Cardon, Amelie (2012)
Abstract
Background: Between 1991 and 2011, the under-five
mortality rate in Cameroon has made very
little progress, slightly dropping from 126 to 122 deaths per 1,000
live births. As developing
countries around the world renew their efforts to reach Millennium
Development Goal 4 -
Reduce under-five mortality by two thirds from 2000 to 2015 -
Cameroon recently adopted the
Integrated Management of Childhood Illness as a strategy to
accelerate the reduction of under-
five mortality.
Objective: This paper examines the effect of the Integrated
Management of Childhood Illness
(IMCI) program implemented by local organization Tockem, in the
Menoua Department, to reduce
under-five mortality in the department and provide a model to be
replicated in other provinces of
the country in an effort to achieve Millennium Development Goal
4.
Methods: Data on the knowledge and practices of mothers of
children under the age of two were
gathered in three IMCI intervention groups to determine the impact
of the IMCI strategy on the
health of children, and health behaviors of caretakers. A
Knowledge, Practice and Coverage
survey was performed using a 30x10 complex sampling method in each
IMCI group to measure
coverage of thirteen key health practices.
Results: There is no evidence that the IMCI strategy
procured an advantage to the population
served compared to the population living in non IMCI areas. In
fact, coverage of child illness
home-based management was found to be significantly lower in the
IMCI area than in the two
other areas. Overall, coverage of births assisted by a qualified
attendant and of mothers who
received at least two tetanus toxoid shots during their last
pregnancy reached program goals.
Discussion: The full potential of the IMCI strategy
implemented in the Menoua Department is
not being met. Areas of weakness identified as priority areas are
for the most part dependent on
the work and performance of Community Health Workers acting as
health messages relays for the
community. Improved health behaviors and practices will necessitate
continued supervision and
evaluation of community health workers' performance by Tockem,
along with supervision of
health facility personnel by local health districts through a more
efficient health system.
Table of Contents
TABLE OF CONTENTS
Abstract
.........................................................................................................................................................................
List of Tables
...................................................................................................................................................................
List of Figures
..................................................................................................................................................................
List of Acronyms
..............................................................................................................................................................
Acknowledgements
...........................................................................................................................................................
Introduction
.................................................................................................................................................................
1
The Integrated Development Model in
the Menoua Department - Cameroon
..............................................................................
4
The Integrated Development Project
.................................................................................................................................
6
Tockem
.......................................................................................................................................................................10
The Menoua Department
................................................................................................................................................
21
Literature Review
..........................................................................................................................................................
27
Child Health in
Cameroon.................................................................................................................................................
28
Health Policy
................................................................................................................................................................
31
The Integrated Management
of Childhood Illness Strategy (IMCI)
...........................................................................................
34
Introduction of
Community-IMCI in the East Province of Cameroon
.........................................................................................
48
Integrated Management of Childhood
Illness in the Menoua
Department....................................................................................
53
Introduction of the IMCI strategy in
The Menoua Department
................................................................................................
53
Methods
......................................................................................................................................................................
66
Results
........................................................................................................................................................................
77
Discussion
....................................................................................................................................................................
87
Comparison with Demographic Health
Survey 2011 Preliminary Results
......................................................................................
89
Comparison with past
LQAS surveys
..................................................................................................................................
92
Limitations
....................................................................................................................................................................
96
Conclusion
....................................................................................................................................................................
99
Recommendations
.........................................................................................................................................................
100
References
..................................................................................................................................................................
103
APPENDICES
................................................................................................................................................................
108
APPENDIX A
.................................................................................................................................................................
108
Map of Cameroon
..........................................................................................................................................................
108
Map of The Western Province of
Cameroon
........................................................................................................................
109
Map of Cameroon, the Western
Province and the Menoua Department
....................................................................................
110
APPENDIX B
.................................................................................................................................................................
111
KPC Questionnaire (English and French versions)
.................................................................................................................
111
APPENDIX C ................................................................................................................................................................. 129
Distribution of participants by village visited ....................................................................................................................... 129
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