Assessment of Primary Health Care Professionals' Knowledge and Practices Regarding the Integrated Management of Childhood Illness-Gaza Strip
Younis Ramadan Awadallah
يونس رمضان عوض الله
Acute respiratory infections and diarrhoeal diseases affecting the children under age five are considered the most causative diseases correlating to mortality and morbidity. As a reflection on that, the World Health Organization/United Nations Children's Fund standardized protocols were activated by many countries including Palestine to improve the standard case management implementation. Therefore, the overall aim of this study is to assess knowledge and practices of the primary health care physicians in Ministry of Health and United Nations Relief and Works Agency about the integrated management of childhood illness, mainly acute respiratory infections and childhood diarrhoeal diseases protocols. This study is a descriptive, correlational, cross-sectional one conducted in the years "2003-2004". A sum of 185 physicians represented the entire study population were asked to complete a structured interviewed questionnaire and 540 randomly selected facility prescriptions were reviewed, with a response rate of 100%. The study revealed low level of compliance with the implementation of the protocols in general, especially with the classification step (25%) and the treatment step (40%) according to the protocols. Of the study population, 49% reported currently using the protocols in their practice. Only 15% of the physicians were had copies of protocols and 53% had received training on the protocols. There were obvious variations in practices and compliance with protocols among physicians in relation to their organizational and demographic characters such as female physicians were more compliant than males ones and physicians from United Nations Relief and Works Agency were more complaint than physicians from the Ministry of Health. The study showed inadequacy of the material and equipment needed for implementation of the protocols such as wall charts, timers, ENT sets and so on. Moreover, the study pointed to the main obstacles preventing physicians from following the protocols such as inadequate training, lack of resources required, work overload, lack of supervision and feedback. The study provided several tentative recommendations that could improve physician's practices such as, designing and implementing more in-service training, provision of the needed equipment and supplies, empowering the management capacity of the health care system such as follow up, supervision and referral services. Conscious efforts are needed to tackle the conclusions of this study in order to support the implementation and the adherence to the concerned protocols.