Abstract:

Zambia adopted the Intergrated Management of Newborn and Childhood Illnesses (IMNCI) strategy in 1995 as a key strategy for addressing the high morbidity and mortality among under-five children. Despite its introduction, implementation of IMNCI has not been optimal as it can be seen from the 2018 Zambia’s health facility assessment, which found that only 56% of health facilities did not meet the programmatic threshold of having at least 60% of health workers managing sick children trained in IMCI, and 20% of sick children were not accessed for cough, diarrhoea and fever and 56% for HIV infection. The purpose of this study was to explore barriers to implementation of the IMNCI strategy among primary healthcare workers at health facility level in Chongwe and Lusaka districts. Data were collected from observation of health workers during assessment of sick under five children, Key Informant Interviews with health workers, National and District Focal-point persons and Health facility assessment. The study revealed Health systems factors such as lack of supervision, training and mentorship, shortage of supplies and equipment, shortage of health workers and inadequate infrastructure; Health workers skills such as poor attitude, Lack of motivation, long duration and difficult steps for IMNCI assessment as barriers to health workers’s adoption of IMNCI during assessment of sick children. Therefore, this study proposes the adoption of a holistic strategy for addressing the non-adherence to IMNCI protocols among health workers that encompasses health systems related factors and health workers skills, attitudes and practice.

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