The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67480

Sameh Alfred Saleeb, MD, MPH¹, Robert Mwesigwa, Master of Health², Abdalla Meftuh, MD, MPH², and Alan Alemian, MPH¹. (1) Health Unit, Africare Inc., 440 R Street, NW, Washington, DC 20001, (2) Ntungamo Office, Africare, Uganda, Plot 28 Nakasero Road, P.O. Box 7655, Kampala, Uganda, 256-41-230266/34860/346170, mwesigwar@africaonline.co.ug

The Ntungamo Community Integrated Management of Childhood Illnesses (IMCI) is a dynamic partnership in Southwest Uganda involving Africare, the Ntungamo District Health Department and the population of over 400 communities. It benefits approximately 31,000 children and 48,400 women of reproductive age. The project aims at improving knowledge and practices of caretakers of under-five children with respect to malaria, diarrhea, pneumonia, breastfeeding and nutrition. Key strategies include behavior change communication, expansion of related community health services and the establishment of linkages between communities and health facilities. The program is complemented by inter-sectoral interventions that include water and sanitation and the growing of vegetable gardens. To evaluate the impact of the program at midterm, a knowledge, attitude and coverage survey was conducted in the fall of 2001. This was supplemented with qualitative focus groups. Direct program benefits are clearly evidenced in the improved knowledge and behavior of beneficiaries. For example, mother/caretaker recognition of stiff neck as a danger sign to seek treatment has increased from 4.7% to 68%. Use of bed nets, to protect against malaria, has increased three-fold. Community mobilization has increased referral of children to health facilities by 97%. Health providers are now seeing children with less severe conditions, and local community leaders and development committees are taking ownership in sustaining project activities. Recognized by the Uganda Ministry of Health, the program provides a model and lessons learned for the application of the Community/Household IMCI framework and its different elements.

Learning Objectives:

At the conclusion of the session, the participant (learner) in this session will be able to:
• Describe the different elements of the community/household component for the Integrated Management of Childhood Diseases (IMCI) strategy.
• Develop community strategies in response to the three elements of the community IMCI framework and its multi-sector platform.
• Identify some of the challenges arising from the application of the framework.

Keywords: Behavior Modification, Child Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.