Browsing by Author "Cilliers, Anna Christina Maria"

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    Factors influencing the implementation of integrated management of childhood illness in the area military health unit Gauteng and 1 military hospital in Tshwane Gauteng
    (Stellenbosch : Stellenbosch University, 2019-04) Cilliers, Anna Christina Maria; Eygelaar, Elsa; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    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.