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Working Paper KMPK Online

Manajemen Terpadu Balita Sakit: Evaluasi Pelaksanaan MTBS di Puskesmas Tanah Laut 17 Jan 2008
Evaluation of The Implementation of Integrated Management of Childhood Illness at The Health Center of Tanah Laut District, Province of Kalimantan Selatan
H. Pratono, L. Lazuardi, M. Hasanbasri (WPS No.3, Januari 2008)
Background: Every year more than 12 millions children in developing countries die before their fifth birthday, and 70% of their death is caused by pneumonia, diarrhea, malaria, measles and malnutrition. Integrated Management of Childhood Illness (IMCI) is a strategy to minimize infant mortality through integrated approach which includes prevention, promotion and medication. The issue of IMCI program sustainability becomes important because there are so many constraints in the implementation of IMCI.Objective: To identify the practice of IMCI at the health center with the support of the management of the Health Office at District of Tanah Laut and find out how the health center maintained the sustainability of IMCI implementation.Methods: This was a descriptive study with a case study approach. Direct observation was conducted to learn the service procedure and service integration. Staff's compliance was assessed by comparing checklist based on IMCI flowchart. Interview, focus group discussion and supporting documents were used to see managerial support of the Health Office to the practice of IMCI.Results: There were some actual efforts of integrating child health services. Logistic forms of recording and reporting as well as training carried out by the health office supported the implementation of activities. In practice IMCI had involved team man-aged by a case manager. The process of medication, promotion and prevention had been carried out under the situation which enabled coordination. Compliance with IMCI recording and reporting system reached 67% out of all items which should be implemented. Case managers of IMCI were midwives and staff in charge of training. However, the health center still had temporary organizational structure which did not have authority to manage resources needed to overcome problems of implementation. Conclusions: The health center had morale to implement innovative programs. For the time being they could make samples of case management from aspects of room, service flow, recording and reporting. The health office was just able to develop IMCI program in training and supporting the health center to start IMCI. This was limited to just continuing the national and WHO program. The function of case manager was supported by the health center management. The development of IMCI program required wider autonomy of the health center in order that the health center could develop strategies relevant with needs and solution to problems in implementation.Keywords: integrated management of childhood illness, managerial support, Tanah Laut.[download]

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