In summary, results of the study found a clear association between training in IMNCI case management of the participants and knowledge score obtained. Moreover, knowledge score association was also found based on nationality, country of graduation, year of graduation and duration of working experience in children ward. Results did not show any association of knowledge score with sector of work, age, gender, title of appointment, level of qualification, service duration in KSA and participation in other courses on child health. The study results seemed to support the fact that training in IMNCI case management program upgrade the knowledge of healthcare staff.
Low response rate was a weakness of the study. However, this data on knowledge of clinical case management of IMNCI from two sectors in KSA has advantage of convenience census sample. Anonymous self-administered nature of questionnaire survey did not allow investigators to look at non-responders. For better illustration of the survey experience, other sectors in KSA involving non-respondents of this study need to be investigated to better corroborate the results.
Depending on these survey results, it is recommended that clinical case management of IMNCI trainings should be implemented and strengthened in KSA. Healthcare students and working professionals should be trained for IMNCI case management which may improve the childhood survival, growth and development.
Further research should be done including PHCCs in other regions, higher level healthcare facilities and private sector healthcare facilities of KSA.
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Appendix I Survey Questionnaire
IMNCI Cross-Sectional Survey in Saudi Arabia 2011
Information for the Participants Dear Participant,
This survey is about the knowledge of primary health care staff of Sabya sector regarding clinical case management of Integrated Management of Neonatal and Childhood Illness (IMNCI) program of World Health Organization. You have been selected as representative of primary health care staff. The information you will give may serve as tool to better implement IMNCI strategy to better serve the neonates and children in Saudi Arabia.
Participation in this questionnaire survey is ABSOLUTELY VOLUNTARY. The questionnaire is prepared in a way that no participant will be recognized after the survey so please DO NOT write your name on any paper.
Please read the question carefully and answer them sincerely. Answer the questions after reading the answering instructions carefully. Answer the questions based on your own knowledge. Write your answer in the space given on the questionnaire. If you have problems in understanding any of the questions call the attention of the person who distributed the questionnaire to you.
Your participation in this survey will be highly appreciated.
Thanks for your participation.
For further details:
Dr. Muhammad Safdar
Principal Researcher (Sabya sector) Mobile: 0597328916
Email: drsafdarj@hotmail.com
Dr. Rizwan Ahmad Khan Co-researcher (Tathleeth sector) Mobile: 0557314405
Email: pediatric.professionals@gmail.com
Questionnaire for IMNCI Cross-Sectional Survey Tathleeth / Sabya 2011
Questionnaire is based on WHO/UNICEF guidelines for clinical case management of IMNCI
Participant # Date of Survey
INSTRUCTIONS:
1. Please circle the appropriate option / answer or fill in the blank where applicable.
2. Choose only one option from each question.
BACKGROUND INFORMATION 7. From which country did you graduate
in Medicine / nursing?
………
8. In which year did you graduate?
………
9. Did you go through IMNCI training during undergraduate studies in medical / nursing college?
a. No = 0 b. Yes = 1
If yes, what was the duration of IMNCI training you attended?--- days
10. Have you ever worked in a Pediatric / Children ward of any hospital after graduation?
a. No = 0 b. Yes = 1
If yes then for how long? --- months
11. For how long you are serving in primary health care in KSA?
a. Less than 3 years = 1 b. Three to ten years = 2
12. Have you attended on-job clinical case management of IMNCI training in KSA or elsewhere?
a. No = 0 b. Yes = 1
c. More than ten years = 3 If yes, what was the duration of IMNCI training?
--- days 13. Have you ever attended any other
training /course for neonatal and / or child health?
a. No = 0 b. Yes = 1 If yes name them
(i) (ii) (iii)
14. Do you think courses on neonatal and child health may help in improving your services?
a. No = 0 b. Yes = 1
15. Do you think ministry of health KSA should conduct such courses to train health care personnel for neonatal and child healtha. No = 0 b. Yes = 1
Questionnaire for IMNCI Cross-Sectional Survey Tathleeth / Sabya 2011
Questionnaire is based on WHO/UNICEF guidelines for clinical case management of IMNCI
Questionnaire
# QUESTION
Q1. Enumerate/write signs of possible serious bacterial infection in a young infant?
Q2. Enumerate/write danger signs in a sick child?
Q3. Define following:
a) Stridor?
b) Wheeze?
c) Chest in-drawing?
Q4. What are the signs of severe dehydration
Q5. a) What is fast breathing? Define.
Definition:
i) What are cut-off values of fast breathing in Less than 2 months old? ---/min
ii) What are cut-off values of fast breathing in 2 months to 12 months old? ---/min
iii) What are cut-off values of fast breathing in 12 months to 5 years? ---/min
Q6. Classify dehydration?
Q7. What is low birth weight baby (LBW)? Define
Questionnaire for IMNCI Cross-Sectional Survey Tathleeth / Sabya 2011
Questionnaire is based on WHO/UNICEF guidelines for clinical case management of IMNCI
# QUESTION
Q9. What do you mean by Acute and Chronic diarrhea (define)?
Acute Diarrhea:
Chronic Diarrhea:
Q10. Describe KSA Immunization schedule for a child (from birth to entry in first class)?
Visit At age Vaccines to be given
Q11. What do you mean by ORS? (ORS stands for ???)
Q12. What is safe remedy? Give two examples.
Definition:
Examples:
Q13. What is good positioning for breast feeding (write signs of good positioning)?
Q14. What is good attachment for breast feeding (write signs of good attachment)?
Q15. In case of Vitamin – A deficiency, what is the dose of Vitamin – A (i) In a baby of age 3 months old? --- IU (ii) In a baby of age 8 months old? --- IU (iii) In a baby of age 15 months old? --- IU
Appendix 2, Univariate Analysis of Variance Tables
UNIANOVA ObtainedScore BY Gender Designation
Countryofgraduation Graduation IMNCItrainingduringstudies WITH Age
/METHOD=SSTYPE(3) /INTERCEPT=INCLUDE /PRINT=PARAMETER
/CRITERIA=ALPHA(0.05)
/DESIGN=Age Gender Designation Countryofgraduation Graduation IMNCItrainingduringstudies.
Univariate Analysis of Variance
[DataSet1] C:\Users\osalmens\AppData\Local\Temp\SAFDAR 2016.sav
Between-Subjects Factors
Value Label N
Gender 1 Male 45
2 Female 54
Designation 1 Doctor 60
2 Nurse 39
Country of graduation 1 Bangladesh 4
Tests of Between-Subjects Effects Dependent Variable: Obtained Score
Source
Countryofgraduation 33,928 7 4,847 1,365 ,231
Graduation 20,976 3 6,992 1,969 ,125
IMNCItrainingduringstudies 159,470 1 159,470 44,898 ,000
Error 298,357 84 3,552
Total 5456,758 99
Corrected Total 562,401 98
a. R Squared = .469 (Adjusted R Squared = .381)
Parameter Estimates Dependent Variable: Obtained Score
Parameter B Std. Error T Sig.
95% Confidence Interval Lower
Bound
Upper Bound
Intercept 11,411 2,121 5,380 ,000 7,193 15,629
Age -,052 ,057 -,916 ,362 -,165 ,061
[Gender=1] -,757 ,620 -1,222 ,225 -1,990 ,475
[Gender=2] 0a . . . . .
[Designation=1] 1,403 ,838 1,674 ,098 -,264 3,070
[Designation=2] 0a . . . . .
[Countryofgraduation=1] -1,662 1,355 -1,227 ,223 -4,357 1,033 [Countryofgraduation=2] -1,699 1,110 -1,530 ,130 -3,907 ,509 [Countryofgraduation=3] -1,614 1,477 -1,093 ,278 -4,552 1,324 [Countryofgraduation=4] -1,182 1,171 -1,010 ,316 -3,511 1,146
[Countryofgraduation=5] -,186 1,126 -,165 ,869 -2,425 2,053
[Countryofgraduation=6] -2,418 1,475 -1,639 ,105 -5,352 ,516 [Countryofgraduation=7] -1,856 1,141 -1,626 ,108 -4,125 ,414
[Countryofgraduation=8] 0a . . . . .
[Graduation=1] 4,591 1,967 2,333 ,022 ,678 8,503
[Graduation=2] 1,513 1,219 1,240 ,218 -,912 3,938
[Graduation=3] ,841 ,765 1,100 ,275 -,680 2,361
[Graduation=4] 0a . . . . .
[IMNCItrainingduringstudies=1] -3,369 ,503 -6,701 ,000 -4,368 -2,369
[IMNCItrainingduringstudies=2] 0a . . . . .
a. This parameter is set to zero because it is redundant.