THE IMPACT OF INFORMATION ON INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS AT PRIMARY HEALTH CARE LEVEL IN NIGERIA
The Integrated Management of Childhood Illness (IMCI) is a child health strategy developed by
the World Health Organization and UNICEF aimed at reducing child morbidity and mortality. This study aimed
to assess the level of awareness and implementation of IMCI among nurses in paediatric settings and to re-
sensitize them about reduction of infant morbidity and mortality rates through IMCI implementation.
Methods:A random sampling technique was used for selecting 110 respondents and a self developed
questionnaire was used to collect data. Hypotheses were tested using Pearson chi-square.
Results:It was deduced from the findings that nurses’ years of experience in paediatric setting had little or no
influence on their knowledge and practice of IMCI; that nurses’ knowledge of IMCI affects their implementation
and that IMCI implementation is influenced by institutional support, nurses attitude and parents or guardians
Conclusion:The IMCI strategy is effective in the reduction of under- five’s morbidity and mortality if properly
and efficiently implemented and supervised. Nevertheless, the implementation of the IMCI strategy is not
optimal due to various factors that can otherwise be overcome by local/institutional interventions.
Keywords:Awareness, Implementation, Integrated management of childhood illnesses, Paediatric, Nurses
Information systems is collection of hardware, software, data, people and procedures that are designed to provide the right information the user needs to do their task more effectively, to the right person and at the right time (Davis and Yen, 1998).
Information system is important for any business because the business needs to have accurate information and need to have the technology as a tool for solving problems and at the same time increasing the productivity and the quality of doing business. Businesses today use information system and use the available technologies because they understand the importance of maintaining and updating data electronically (Davis and Yen, 1998).
Using information system for managing information in the health care such as patient record, patient appointment system, patients scheduling appointment, doctor schedule and medicine prescription is not only to save time or reduce cost, but also a way to support and improve the health care information to be more accessible and flexible (modifying, saving, deleting, updating etc) for system users and storing data efficiently. In addition, it improves the quality of data control (Liu and Zhu, 2007).
On the other hand, information system works to interact with the system databases, financial module, scheduling module and the entire system modules. Therefore, to get the best implementation, the health care system should be able to interact with several medical health care staff (physicians, nurses, medical device users, financial and the administrators),
which is the conducted way to get a good insight how health care system working and will be more effectively and efficiently for managing the information (Song et al., 2007).
Health care information system is looking at patients, in order to represent their health information history and provide the flexibility and accessibility for patient information to be more reachable by the authorized person (Rogers et al., 2006).
On the other hand, health care information system have user interface, that provides to the system user the ability to interact with the patient; Once the patient arrive at the medical center they must register their information and health history in the health care center system. The system automatically will update the patient information; then the patient will be under queue to have an appointment for medical check up by the physician. The physician will specify whether the patient case is an emergency case or not. If the case is an emergency, the physician will retrieve the relevant patient information from the system database. Nevertheless, in the general case, the system will request the examination queue for the patient. Finally, after the patient complete the medical check the system will place the prescription order to the pharmacy unit and update the information to the patient record (Tang et al., 2001).
The challenge here is how the information system can represent and manage the entire information in the health care such as patient information, patient consultation history, patient appointment, doctor’s schedule, payment, products and medicines, and document. In addition, how an integrated system can provide the accessibility to the right and accurate information for any patient in the health care center. Moreover, how the system can provide the accessibility for patients to allow them confirm their own appointment by themselves.
1.2 Research Project material Focus
The focus of this research is to study the following areas towards the development of an integrated health care management system:
- Patient information history, which include all the patient information such as consultation history, medication history, treatments history, appointments.
- Doctors schedule information, which include the doctor schedule status such as (available, on leave, oversea, operation day etc)
- Products, such as medicine information, which contains the products prices and the supplier for the product.
- Third party interest such as insurance companies and companies’ information. A patient can be a business client of an insurance company.
- Managing the patient appointment and giving the opportunity to the patient to
confirm their own appointment by themselves online.
The expected outcomes for focusing on those points in this research are:
- Providing an integrated health care system to the health care.
- Improving the quality of health care services.
- Keep tracking for all the patient information and patient consultation history.
- Managing the doctor schedule.
- Managing the patient appointment.
- Giving the patient the opportunity to confirm their appointment by themselves online, which help to:
- Reduce the working load of nurse.
- Reduce unnecessary waiting time for patients and staffs.
- Encouraging continuity of medical care.
1.3 Problem Statement
The current health care providers are using different ways and systems for managing information. Some health care providers are using only one system for managing the health information but it is not comprehensive for managing all the information, for instance the system can support only the patient information but cannot support the patient appointment or cannot support the doctor schedule.
Therefore Mazzi et al. (2006) reported results of study about current system use in the health care, which proved that there is a lack of software that fulfils the patient’s need for medical information and the doctor’s need to monitor patients.
Conversely, there are a health cares are using more than one health management system such as (patient information, doctor schedule, products and medicine suppliers, financial etc.) for managing the health information. Those system are dedicated to only one activity of the healthcare and this functionality is not integrated with other systems (Mazzi et al., 2006).
Furthermore, about the patient appointment, the patient can book an appointment through a different way such as (telephone, email, website etc); otherwise the patient needs to go to the health center personally to make an appointment.
Traditionally, the doctors’ time is more important than patient time. So an appointment system designed to minimize the doctor idle time only and considered that the patient can wait for more than one hour to be attended by a physician in a health care center, which make patients feel they are being disregarded and treated unfairly (Dexter, 1999).
On the other hand, the old appointment system designed to minimize the doctor idle time but current designing of an appointment system is based on decisive factors with respect to both the patient and doctor (Wijewickrama and Takakuwa, 2005).
Therefore, here is the necessity of developing an integrated health care system that can manage the entire health care information and provide a very sturdy interacting communication between the system component and system users.
1.4 Research Objectives
The objective of this research material is to:
- Identify and analyze the current system used for managing patient information and health care information.
- Design and Develop an integrated system for managing the patient information and the health care information.
- Develop the confirmation appointment system to allow patient to confirm their appointment by themselves online.
- To enhance the protection of patient health information history and provides the flexibility and accessibility of the information to be more reachable by authorized personnel.
- Observe and control the huge information of health care (diseases, finance, medication, treatment, out patients etc) to enhance the ability of evaluating the work in the health care, which provides the necessary information for future planning.
- Provide very secure communication between patients and physicians. In addition, incorporates services such as prescription renewal and appointment.
1.5 Research Significance
An integrated health care management system provides an electronic document instead of using the traditional method (paper document), which is not easy to retrieve patient information and can not accesses remotely.
Therefore, Zeng and Cimino, (2000) mentioned that because of the huge of patients information in the health care, it is not practical to keep going using the paper documents for tracking and managing the patient information , but information system in health care, systematically supports extensive manage for the of patients information in the health care and keep tracking for all medication details
Moreover, Wilcox et al., (2005) refer that the traditional method (paper documentation) it is limited aptitude for saving patient information, retrieving patient information etc and cannot access it remotely. From this issue, the importance of health care information system that can provide the flexibility and supports remote access to patient health information.
On the other hand, regarding to Brown et al. (2008) a health care management system provides an extensive patient record, which helps to make proper diagnoses and prescribe proper treatments and provides track crucial medical information, insurance data, consultation history, medications and special conditions, which means improve the quality of health care and enhance the health care performance by allowing the physician to diagnose diseases faster and more safely since historical information will be collected from numerous sources to present an obvious picture of a patient’s health at the point of care. Furthermore it provides consolidated reports for all patient records, and historical data.
1.6 Research Scope
- This research is for analyzing and developing a web based integrated system to manage the entire information in the health care such as:-
- Patient information: personal patient information, patient consultations history, patient treatments and diagnosis, patient medications history, patient appointments, confirming the appointment online, patient documents, and patient payments.
- Doctors’ schedule information.
- Products and medicine information.
- Health care client information such as insurance companies.
- This system can be used online through World Wide Web by the users, however the security need to be focused.
- The doctor and the nurse can observe the patient health based on the consultation history for each appointment.
- This system manages the patient appointment and allows the patient to use the system online and confirm their own appointment by themselves. However, the patient cannot change the appointment time or date, they have to see the nurse to do that and the patients are not allowed to booking the appointment by themselves.
- Before the patient can use the system, the patient must register through the nurse to create the user account.
THE IMPACT OF INFORMATION ON INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS AT PRIMARY HEALTH CARE LEVEL IN NIGERIA