Original Research Article
Year: 2017 | Month: May | Volume: 7 | Issue: 5 | Pages: 1-10
Integrated Management of Neonatal and Childhood Illnesses (IMNCI) Training Enhanced Child-Survival Knowledge of Anganwadi Workers in Odisha, India
Meena Som1, Krushna Chandra Sahoo2, Rojalin Swain2, Ashirbad Pradhan2, Sandeep Kumar Panigrahi1, Pinaki Panigrahi3, Ambarish Dutta2,4
1UNICEF, Odisha, India
2Asian Institute of Public Health, Bhubaneswar, India
3Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Nebraska, United States of America
4Indian Institute of Public Health, Bhubaneswar, India
Corresponding Author: Ambarish Dutta
ABSTRACT
Integrated management of neonatal and childhood illness (IMNCI), a universally acclaimed community-based child-survival programme was rolled out in Odisha during 2006 and the Anganwadi workers (AWWs) were trained to be the frontline implementers. It was perceived that IMNCI has developed operational weakness that led to the decision of discontinuing its implementation through AWWs, hence, withdrawing state support from their training. Alternatively, Accredited Social Health Activists (ASHA), the village-based health volunteers, were to be engaged through a re-packaged programme – Home-based Newborn Care (HBNC). But, neither HBNC has provision for children beyond 42 days, nor the relatively less-educated ASHAs are trained as intensely. This study aims to assess the influence of IMNCI training on the AWW’s knowledge regarding childhood illnesses. A cross-sectional study was conducted in 10 districts of Odisha that recruited a probability sample of AWWs (n=443) among both trained and untrained AWWs. During interviews, the AWWs were asked of various aspects of IMNCI-related knowledge. The trained AWWs, as compared to untrained, possessed substantially more IMNCI knowledge. Knowledge of possible serious bacterial infection and nutrition in children aged 0-2 months was almost twice and 1.2 times higher about diarrhoea respectively among trained (p<0.0001). Knowledge for age-group of 2–59 months had modest association with training. IMNCI training is associated with significantly higher knowledge levels among the AWWs, despite operational lacunae in IMNCI. This may provide evidence for the Odisha policy-makers to continue the training of AWWs and continuation of IMNCI implementation, to complement ASHA-led HBNC.
Key words: IMNCI training, Anganwadi Worker, child survival