Background: Between 1991 and 2011, the under-five mortality rate in Cameroon has made very little progress, slightly dropping from 126 to 122 deaths per 1,000 live births. As developing countries around the world renew their efforts to reach Millennium Development Goal 4 – Reduce under-five mortality by two thirds from 2000 to 2015 – Cameroon recently adopted the Integrated Management of Childhood Illness as a strategy to accelerate the reduction of under- five mortality.
Objective: This paper examines the effect of the Integrated Management of Childhood Illness (IMCI) program implemented by local organization Tockem, in the Menoua Department, to reduce under-five mortality in the department and provide a model to be replicated in other provinces of the country in an effort to achieve Millennium Development Goal 4.
Methods: Data on the knowledge and practices of mothers of children under the age of two were gathered in three IMCI intervention groups to determine the impact of the IMCI strategy on the health of children, and health behaviors of caretakers. A Knowledge, Practice and Coverage survey was performed using a 30x10 complex sampling method in each IMCI group to measure coverage of thirteen key health practices.
Results: There is no evidence that the IMCI strategy procured an advantage to the population served compared to the population living in non IMCI areas. In fact, coverage of child illness home-based management was found to be significantly lower in the IMCI area than in the two other areas. Overall, coverage of births assisted by a qualified attendant and of mothers who received at least two tetanus toxoid shots during their last pregnancy reached program goals.
Discussion: The full potential of the IMCI strategy implemented in the Menoua Department is not being met. Areas of weakness identified as priority areas are for the most part dependent on the work and performance of Community Health Workers acting as health messages relays for the community. Improved health behaviors and practices will necessitate continued supervision and evaluation of community health workers’ performance by Tockem, along with supervision of
health facility personnel by local health districts through a more efficient health system.