Background: One of the efforts in the health sector for programs to reduce infant and under-five mortality and morbidity rates is by the competence-based integrated management childhood illness (CB-IMCI) program. However, the program has been poorly implemented by health workers at the health center. Thus, the involvement of cadres is needed and their competency remains important to be improved.
Objective: To quantitatively analyze cadre knowledge and competencies in the CB-IMCI program, and its relationship with the implementation of CB-IMCI, as well as to qualitatively explore and analyze the responses of cadres, health workers, and the community to the addition of cadre roles to the management of sick children.
Methods: This was a mixed methods study with randomized controlled trials and qualitative method. For randomized controlled trials, 100 cadres were selected, which 50 randomly assigned in the intervention and control group. And for quantitative methods, informants included 10 cadres, 4 health workers, and 20 mothers. Paired t-test and independent t-test were employed for quantitative analysis, and triangulation was used for qualitative analysis.
Results: The improvement of knowledge in the intervention group was better (I=14.42/C=4.44/p-value 0.00). The intervention group was more competent in the management of child illness (p-value 0.00). In addition, the cadres have additional competencies assisted by health workers to confidently detect cases earlier, and health center services reach a wider coverage in the community.
Conclusion: The addition of cadres’ roles and competencies in the management of child illness in the community can be implemented in Banyumas District. It is suggested that the implementation of this program should be followed up in other health centers by the Health Department of Indonesia.
Copyright (c) 2018 Umi Solikhah, Hari Kusnanto, Fitri Haryanti, Yayi Suryo Prabandari
This work is licensed under a Creative Commons Attribution 4.0 International License.
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Agha, A., Younus, M., Kadir, M. M., Ali, S., & Fatmi, Z. (2007). Eight key household practices of Integrated Management of Childhood Illnesses (IMCI) amongst mothers of children aged 6 to 59 months in Gambat, Sindh, Pakistan. Journal of Pakistan Medical Association, 57(6), 288.
Albert, J. R. G. (2015). Sustainable goals: From the MDGs to the SDGs Albert Jose Ramon. Retrieved from https://www.rappler.com/thought-leaders/87791-sustainable-development-mdg-sdg
Andrew, S., & Halcomb, E. J. (2009). Mixed methods research for nursing and the health sciences. United States: John Wiley & Sons.
Banyumas District Health Office. (2014). Health profile of Banyumas. Banyumas: Banyumas District Health Office.
Bappenas. (2015). Agenda pembangunan global pasca - 2015: dari MDGs menuju SDGs [Agenda of pasca global building 2015: from MDGs to SDGs]. Jakarta: Badan Pembangunan Nasional Indonesia.
Bhutta, Z. A., Lassi, Z. S., Pariyo, G., & Huicho, L. (2010). Global experience of community health workers for delivery of health related millennium development goals: A systematic review, country case studies, and recommendations for integration into national health systems. Global health Workforce Alliance, 1(249), 61.
Campbell, M. K., Piaggio, G., Elbourne, D. R., & Altman, D. G. (2012). Consort 2010 statement: extension to cluster randomised trials. BMJ (Clinical Research Ed.), 345, e5661.
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. United States: Sage publications.
Horwood, C., Vermaak, K., Rollins, N., Haskins, L., Nkosi, P., & Qazi, S. (2009). An evaluation of the quality of IMCI assessments among IMCI trained health workers in South Africa. PLoS One, 4(6), e5937.
MOH. (2011). Health profile of Indonesia Retrieved from Jakarta. http://www.depkes.go.id/resources/ download/pusdatin/profil-kesehatan-indonesia
MOH. (2013). Community based integrated management of childhood illness. Jakarta: Ministry of Health of the Republic of Indonesia.
Nettle, R., McKenzie, J., Coutts, J., Boehm, R., Saunders, D., Wythes, C., . . . Kelly, S. (2010). Making capacity building theory practical: The'on the fast track'project. Extension Farming Systems Journal, 6(1), 73.
Nguyen, D. T. K., Leung, K. K., McIntyre, L., Ghali, W. A., & Sauve, R. (2013). Does integrated management of childhood illness (IMCI) training improve the skills of health workers? A systematic review and meta-analysis. PLoS ONE, 8(6), e66030.
Pranata, S., Pratiwi, N. L., & Rahanto, S. (2011). Pemberdayaan masyarakat di bidang kesehatan, gambaran peran kader posyandu dalam upaya penurunan angka kematian ibu dan bayi di kota Manado dan Palangkaraya [Community health empowerment, the role of posyandu cadres in lowering mortality rates of mothers and children at Manado and Palangkaraya]. Buletin Penelitian Sistem Kesehatan, 14(2 Apr).
Presiden Republik Indonesia. (2014). Undang-undang Republik Indonesia No. 38 tentang keperawatan [Law of the Republic of Indonesia No .38 on nursing]. Jakarta: Presiden Republik Indonesia.
Priyadi, S. (2003). Beberapa Karakter Orang Banyumas. Jurnal Bahasa dan Seni, 31(1), 14-36.
Sihombing, K., Kandarina, B. I., & Sumarni, S. (2016). Peran lurah, petugas kesehatan, dan kader dalam partisipasi ibu balita ke posyandu di wilayah cakupan D/S terendah dan tertinggi di Kota Jambi [Role of head of village, healthcare workers, and cadres on the participation of mothers of under-five children to posyandu in the lowest and highest area of Jambi City]. Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), 3(2), 87-97.
Speziale, H. S., Streubert, H. J., & Carpenter, D. R. (2011). Qualitative research in nursing: Advancing the humanistic imperative. Philadelphia: Lippincott Williams & Wilkins.
UNICEF. (2016). Integrated Management of Childhood Illness (IMCI) in the 21st century: Integration into health systems. USA: UNICEF.
Wijaya, M. (2014). Pengembangan model pelatihan partisipatif berbasis gender dalam meningkatkan kompetensi kader tentang kesehatan ibu dan anak [Development of training participative model based on gender in developing competency of cadres in mothers' and children's health]. Retrieved from repository.unpad.ac.id