Primary Health Care Physicians’ Adherence and Attitude Towards Integrated Management of Childhood Illness Guidelines in Alexandria Governorate in Egypt

BACKGROUND Integrated Management of Childhood Illness (IMCI) is a cost-effective strategy that improves the quality of care provided to under - five children. Alexandria was the first governorate that applied the Integrated Management of Childhood Illness guidelines in Egypt. The aim of this study was to assess the degree of primary health care physicians' adherence and attitude towards those guidelines after 17 years of application. METHODS This cross-sectional study was carried out on a representative sample from the primary health care facilities in Alexandria from which physicians using IMCI guidelines were included in the study. The sample units were chosen randomly from all districts of Alexandria. Observational checklists were developed to assess the degree of adherence of physicians based on the guidelines booklet. RESULTS The highest adherence score reported was that of writing disease classification (100%). As regards infants aged up to 2 months, the highest physicians' adherence score reported was that of jaundice and possible bacterial infection assessment (100 % and 95% respectively). And in spite of its importance, only 85.7% of physicians were complied with weight assessment and its plotting in the growth curve. For children aged from 2 months up to 5 years physicians were generally well complied with the guidelines especially for assessment of dangerous signs and possible bacterial infection. CONCLUSION Despite being applied for years, IMCI guidelines still show certain areas of poor adherence, an issue that need further investigation in order to maximize physicians' adherence and achieve the best of their performance.