Factors influencing the implementation of integrated management of childhood illness in the area military health unit Gauteng and 1 military hospital in Tshwane Gauteng

Cilliers, Anna Christina Maria (2019-04)

Thesis (MNur)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : The fourth Millennium Development Goal aimed to reduce the global under-five mortality rate. In line with this aim, the South African Military Health Nursing College included the Integrated Management of Childhood Illness (IMCI) approach in all nursing training. However, the researcher observed that the majority of military staff members were not utilising the IMCI approach. It was therefore deemed necessary to conduct this study to identify and describe the factors influencing the successful implementation of IMCI in the Area Military Health Unit of Gauteng and 1 Military Hospital in Tshwane, South Africa. The objectives for the study were to identify and describe the organisational (structure) factors influencing the successful implementation of IMCI, the case management skills (process) of health workers influencing the successful implementation of IMCI and the benefits (outcomes) when utilising the IMCI approach. The conceptual and theoretical departure of this study was based on the Donabedian structure-process-outcomes model for the assessment of quality in healthcare. A quantitative, non-experimental and descriptive design was applied in this study. The target population of 135 participants included an all-inclusive sample of all the Medical Practitioners, Registered Nurses and Clinical Associates, working in the 14 selected clinics. The data-collection instrument was a self-administered questionnaire, consisting of 63 closed-ended questions and one open-ended question. The questions were structured according to a four-point Likert scale. A pilot test was conducted before the main study, and these results were excluded from the main study. One hundred and thirty-five questionnaires were distributed and a response rate of 78% was achieved. A statistician of Stellenbosch University conducted the analysis and interpretation of the data with the SPSS software program. Descriptive statistical analysis was applied. The results revealed that the main factors influencing the implementation of IMCI is lack of follow-up training, not enough IMCI-trained staff, no supervisory support, unavailability of IMCI wall charts and staff not utilising standardised IMCI checklists. The researcher recommends that all supervisors attend IMCI training and that training be extended to include other categories of healthcare workers, such as medical practitioners and clinical associates. Furthermore, continuous monitoring, evaluation and supervisory support should be reflected in monthly reports. Lastly, follow-up training, workshops, symposiums and refresher courses on IMCI should be offered.

AFRIKAANSE OPSOMMING : Die vierde Millenniumontwikkelingsdoelwit was daarop gemik om die globale sterftesyfer van kinders onder vyf jaar te verlaag. In ooreenstemming met hierdie doelwit sluit die Suid-Afrikaanse Militêre Verpleegkollege die Geïntegreerde Bestuur van Kindersiektes (IMCI) by alle verpleegonderwys in. Die navorser het egter waargeneem dat die meerderheid militêre personeellede nie die IMCI-benadering gebruik nie. Die belang van die studie was dus duidelik ten einde die faktore te identifiseer en beskryf wat die suksesvolle implementering van IMCI in die Area Militêre Gesondheidseenheid van Gauteng en 1 Militêre Hospitaal in Tshwane, Suid-Afrika, beïnvloed. Die doelstellings van die studie was die identifisering en beskrywing van die organisasiefaktore (struktuur) wat die suksesvolle implementering van IMCI beïnvloed, die gevallebestuursvaardighede (proses) van gesondheidswerkers wat die suksesvolle implementering van IMCI beïnvloed en die voordele (uitkomste) van gebruik van die IMCI-benadering. Die konseptuele en teoretiese vertrekpunt van hierdie studie is gegrond op die Donabediaanse struktuur-proses-uitkomstemodel vir die assessering van gehalte in gesondheidsorg. ʼn Kwantitatiewe, nie-eksperimentele en beskrywende ontwerp is in die studie toegepas. Die teikenpopulasie van een honderd vyf en dertig deelnemers het ʼn inklusiewe steekproef van al die mediese praktisyns, profesionele verpleegkundiges en kliniese medewerkers, in die 14 gekoste klinieke ingesluit. Die data-insamelingsinstrument was ʼn selftoegediende vraelys wat uit 63 geslote en een oop vraag bestaan het. Die vrae is volgens ʼn vierpunt-Likertskaal gestruktureer. ʼn Loodstoets is voor die hoofstudie uitgevoer, en hierdie resultate het nie deel van die hoofstudie gevorm nie. Een honderd vyf en dertig vraelyste is uitgestuur en ʼn responskoers van 78% is behaal. ʼn Statistikus van die Universiteit Stellenbosch het die data met die SPSS-sagtewareprogram ontleed en geïnterpreteer. Beskrywende statistiese analise was toegepas. Die resultate het getoon dat die hooffaktore wat die implementering van IMCI beïnvloed gebrek aan opvolgopleiding, tekort aan IMCI-opgeleide personeel, geen toesighoudende ondersteuning, onbeskikbaarheid van IMCI-muurkaarte en gebrek aan benutting van gestandaardiseerde IMCI-kontrolelyste is. Die navorser beveel aan dat alle toesighouers IMCI-opleiding ondergaan en dat opleiding uitgebrei word om ander kategorieë gesondheidsorgwerkers, soos mediese praktisyns en kliniese medewerkers, in te sluit. Voorts moet deurlopende monitering, evaluering en toesighoudende ondersteuning in maandelikse verslae weerspieël word. Laastens word aanbeveel dat opvolgopleiding, werkswinkels, simposia en opknappingskursusse oor IMCI aangebied word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/106060
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