Abstract:
The Sustainable Development Goals adopted by the United Nations in 2015 were developed
to promote healthy lives and well-being for all children. The SDG Goal 3 is to end
preventable deaths of newborns and under-5 children by 2030. Currently the infant mortality
rate in Kenya is 39 deaths per 1,000 live births and under-5 mortality is 52 deaths per 1,000
live births. Since 1999 the Government of Kenya has introduced the Integrated Management
of Childhood Illness (IMCI) in an attempt to reduce child mortality. The main objective of
this study was to determine the factors influencing the effectiveness of the IMCI strategy
among mothers attending the MCH/FP clinic at Pumwani Maternity Hospital. A crosssectional survey was used in which quantitative data was collected using structured
questionnaires and qualitative data was collected using key informant interviews and focus
group discussions. The study comprised a sample size of 385 mothers, 2 groups of mothers
attending the MCH/FP clinic and 3 health workers at the clinic. Quantitative data was entered
using MS Access software and was analysed using IBM’s SPSS version 23. Pearson’s Chisquare test was used to test the strength between categorical varibles and a Binary logistic
regression was used for the multivariate analysis. Odds Ratio (OR) and 95% Confidence
Interval (CI) were used to estimate the strength of association between independent and the
dependent variables (effectiveness of IMCI). The threshold for statistical significance was set
at p<0.05. Qualitative data was analysed thematically. Ethical approval was sought from
KEMRI and ERC and written informed consent from the participants. The results showed
that the IMCI strategy was not fully effective. About 21.6% of the children had various
ailments, 25.7% were underweight and about 11% had not been fully immunized for their
ages. Living in Nairobi, practicing the Christian faith, starting complementary feeding at 6 –
9 months, mentorship and training of health workers, increasing health worker numbers in
facilities, availability of job aids, support supervision and improving the community health
strategy are factors influencing the effectiveness of IMCI. The National and County
governments need to have focused health information promotion to the caregivers and
community on the importance of regular interaction with a health facility or health workers,
regular mentorship and trainings for the health workers, increase the number of health
workers in the facilities, avail job aids, regular support supervision and regular trainings and
increasing the community health worker numbers. Information from this study will help in
the formulation of evidence based decisions by policy implementers to improve the
effectiveness of the IMCI strategy in preventing childhood morbidity and mortality.
