The Effectiveness of IMCI (Integrated Management of Childhood Illness) Mini Training in Improving Health Workers’ Skills in Primary Health Centers in Bantul

RR Anugrah Wiendyasari(1*), Hari Kusnanto(2), Tunjung Wibowo(3)

(1) Bantul District Health Office; Yogyakarta; Indonesia
(2) Departement of Family and Community Medicine; Faculty Medicine, Public Health and Nursing; Universitas Gadjah Mada; Indonesia
(3) Neonatology Division; Department of Child Health; Sardjito General Hospital; Indonesia
(*) Corresponding Author


Background: At the Community and Primary Health Care Center in Bantul, the number of paramedics receiving Integrated Management of Childhood Illness (IMCI) training is very limited and not evenly distributed. With the low number of IMCI trained officers, this affects the skill of the officers in conducting the IMCI. Fewer skills affect the handling of sick children including the recognition of general danger signs, classification, designing appropriate action, as well as providing treatment and counseling. Objective: This study aimed to know the effectiveness of IMCI Mini Training intervention to improve health workers’ skills in handling sick children with IMCI. Methods: This research was a quasi-experimental study with a non-equivalent pre-post control group design. The sample of this study was a group of health workers who implement IMCI in daily work at 20 Community and Primary Health Care Centers in Bantul. Data were collected by observing 20 health workers in the control group and 20 health workers in IMCI treatment group before and after receiving IMCI Mini Training. Data results were analyzed using univariate, bivariate and multivariate statistical tests. Results: Using t-test analysis the mean value of health worker’s pretest and posttest skill scores in implementing IMCI in control group showed no significant difference (p=0.857) while in the treatment group, the mean value of pretest and posttest score showed a significant difference (p=0.000). In the treatment group, the improvement of sign recognition skills was significant (p=0.000) compared with the classification (p=0.148), treatment (p=0.009), communication and counseling (p=0.005). Multivariate analysis of linear regression showed that IMCI Mini Training was significant in improving the skill of health workers (p=0.000) compared with variables: age (p=0.970), duty (p=0.425), IMCI training history (p=0.686), category of Community and Primary Health Care Center (p=0.409) and education (p= 0.474). IMCI Mini Training improved significantly the sign recognition skills (p=0.000), classification (p=0.001) as well as communication and counseling (p=0.011) but was not significant in treatment skill (p=0.093). IMCI Mini Training can be done in a shorter time and more interactive method by using ICATT. Conclusion: This study showed that IMCI Mini Training increased health workers’ skills in IMCI implementation with the advantages of shorter course time, lower cost, and more interactive methods. The IMCI skills were enhanced by the provision of IMCI Mini Training which includes skills in the recognition of common signs, classifications as well as providing appropriate communication and counseling.


IMCI; health worker’s skill; IMCI Training; Primary Care Center

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1. Amaral J, Gouws E, Bryce J, Leite ÁJ, Cunha AL, Victora CG. Effect of Integrated Management of Childhood Illness (IMCI) on health worker performance in Northeast-Brazil. Cadernos de Saúde Pública. 2004 Jan;20:S209-19.

2. Naimoli JF, Rowe AK, Lyaghfouri A, Larbi R, Lamrani LA. Effect of the Integrated Management of Childhood Illness strategy on health care quality in Morocco. International Journal for Quality in Health Care. 2006 Jan 19;18(2):134-44.

3. World Health Organization. Department of Child, Adolescent Health, World Health Organization, UNICEF. Handbook IMCI: Integrated management of childhood illness. geneva: World Health Organization. 2005.

4. Mullei K, Wafula F, Goodman C. A case study of Integrated Management of Childhood Illness (IMCI) implementation in Kenya. 2008.

5. Kesanak. Integrated Management of Childhood Illness (IMCI) In: MOH RI (ed). Jakarta: November 21, 2011.

6. Patel H, Nayak A, Bhalani K, Kotecha I, Singh MP. Rapid Assessment of IMNCI Programme in Bhavnagar District, Gujarat. National Journal of Integrated Research in Medicine. 2013 Nov 1;4(6):54-8.

7. Were W. Pre-service and in-service capacity building: Lessons learned from Integrated Management of Childhood Illness (IMCI). 2014.

8. Armstrong-Schellenberg J, Bryce J, Savigny D, Lambrechts T, Mbuya C, Mgalula L, et al. The effect of Integrated Management of Childhood Illness on observed quality of care of under-fives rural Tanzania. Health Policy Plan 2004;19:1-10.

9. Kolstad, PR, Burnham G, Kalter HD, Kenya-Mugisha N, Black RE. The integrated management of childhood illness in western Uganda. Bull World Health Organ 1997; 75 Suppl 1:77-85.

10. Horwood C, Vermaak K, Rollins N, Haskins L, Nkosi P, Qazi S. An evaluation of the quality of IMCI assessments among IMCI trained health workers in South Africa. PloS One. 2009 Jun 17;4(6):e5937.

11. Smet B. Health Psychology. Jakarta; PT Gramedia Widiasarana Indonesia. 1994.

12. Adnan DS, Sitaresmi MN. Evaluation of the implementation of Integrated Management of Childhood Illness (IMCI) in Health Officers in the Management of Pneumonia in Toddlers in Aceh Besar District [Doctoral dissertation]. Yogyakarta: Gadjah Mada University. 2013.

13. Hafizah R, Ismail D. Factors that influence health worker compliance to IMCI algorithm in Pontianak City Health Center [Doctoral dissertation]. Yogyakarta: Gadjah Mada University. 2007.

14. Mayhew M, Ickx P, Newbrander W, Stanekzai H, Alawi SA. Long and short Integrated Management of Childhood Illness (IMCI) training courses in Afghanistan: a cross-sectional cohort comparison of post-course knowledge and performance. International Journal of Health Policy and Management. 2015 Mar;4(3):143.

15. Khayati FN, Haryanti F, Laksnawati IS. The impact of training on the management of children with cough of the health workers’ knowledge, attitude and skills in the management of children with cough and breathing difficulties. International Journal of Research in Medical Sciences. 2017 Jan 26; 3:47-52.

16. Chaudhary N, Mohanty PN, Sharma M. Integrated management of childhood illness (IMCI) follow-up of basic health workers. The Indian Journal of Pediatrics. 2005 Sep 1;72(9):735-9.

17. Mahanta TG, Trakroo A, Gogoi MP, Bhuyan P, Nirmolia N, Baruah R, Jyotinagar D. Comparison of IMNCI activities amongs frontline workers of health and ICDs sectors in Dibrugarh District of Assam and effect of monitoring and supervision- a process evaluation. Journal of Evolution of Medical and Dental Sciences. 2012;1:29-37.

18. Gove S. Integrated Management of Childhood Illness by outpatient health workers: technical basis and overview. The WHO Working Group on Guidelines for Integrated Management of the Sick Child. Bull World Health Organ. 1997;75(Suppl. 1):7–24


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