Evaluating the IMCI counseling skills of professional nurses in a district of the North West Province, South Africa
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INTRODUCTION: The Millennium Development Goal number 4 focuses on the reduction of under-5 child mortality with two-thirds by the year 2015 using the Integrated Management of Childhood Illness strategy. This strategy provides guidelines to improve health system support through case management skills, assessment process, provision of treatment, counseling and follow-up care to children under-5 of age, nevertheless not without its own challenges. These challenges include child malnutrition, HIV/AIDS, pregnancy and birth complications, under-5 illness, weak health systems and financial challenges still exists, with the main challenge imputed to malnutrition and therefore concluded that under-5 child mortality still persist after the introduction and implementation of the Integrated Management of Childhood Illness strategy. Assessment of ill under-5 children was frequently incomplete, resulting in the prescription of inappropriate medication. Lack of records contributed to the failure of child survival. The major challenge persisting is the poor level of counseling rendered which is the key to correct administration of medication, return dates to the clinic, advice on feeding and breastfeeding, signs and symptoms that needs immediate attention, referrals and the assessment of caregivers understanding after counseling. Rural areas in South Africa which include the North West Province do not show progress to meet the goal in reducing child under-5 mortality. The lack of information through counseling plays a determining role in the under-5 child mortality rate. RESEARCH AIM AND OBJECTIVE: The aim of the study is to determine the current counseling practice of Professional Nurses in community health care centres in order to improve counseling provided by Professional Nurses to caregivers to decrease under-5 mortality based on the Integrated Management of Childhood Illness strategy. The objective of the study is to determine how Integrated Management of Childhood Illness counseling is currently conducted in community health care centres in the Dr Ngaka Modiri Molema District of North West Province. RESEARCH DESIGN: A quantitative, typical descriptive and observational design was used to meet the objective. RESEARCH METHOD: A checklist was used to collect data. The checklist was developed from the Health Facility Survey on Outpatient Child Care by the Ministry of Health and Population, Egypt, and the WHO Regional Office for the Eastern Mediterranean countries. The counseling observation were ticket according to the checklist. The checklist were adapted to ensure applicability within the South African context. RESULTS: The results revealed that IMCI counseling to the caregiver of an under-5 child, involves feeding, administering of medication and follow-up care advice. Counseling on feeding was conducted overall well and it seems that nurses know how to counsel caregivers regarding the nutrition of the under-5 child, although certain aspects were not addressed. All the observed IMCI case managements of the sick under-5 children who received oral medication, an explanation on how to give oral medication were given quite well. Attention to the caregiver’s health during observed IMCI of the under-5 sick children counseling was not done. This could be due to the fact that in some of the CHC centres still use the 2011 IMCI guidelines. Information given when an under-5 sick child should return to CHC centre is not given to all caregivers. However all caregivers in all the participating CHC centres were informed that they should return to the clinic if the child becomes ill. With observed IMCI case management, the researcher observed that more time was spent with the very ill under-5 children. The caregiver was not informed about the reason for referral in 1 observed IMCI case management. The total of very ill under-5 children were 3 out of 237 observed IMCI counselings, this is very low especially. The very sick under-5 children were directly taken to the nearest hospital which leads to overburden of these hospitals.
- Health Sciences