TY - JOUR

T1 - ‘Better medicines for children’ within the Integrated Management of Childhood Illness framework

T2 - a qualitative inquiry in Uganda

AU - Nsabagasani, Xavier

AU - Ogwal-Okeng, Jasper

AU - Hansen, Ebba Holme

AU - Mbonye, Anthony

AU - Muyinda, Herbert

AU - Ssengooba, Freddie

PY - 2016

Y1 - 2016

N2 - Background: The Integrated Management of Childhood Illnesses is the main approach for treating children inmore than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate‘better medicines for children’ into their essential medicines lists and treatment guidelines. WHO regularly providesgeneric algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based onnew evidence for member countries to adopt. However, the status of ‘better medicines for children’ within theIntegrated Management of Childhood Illnesses approach in Uganda has not been studied.Methods: Qualitative interviews were conducted with: two officials from the ministry of health; two district healthofficials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed formanifest and latent content.Results: Child-appropriate dosage formulations were not included in the package for the Integrated Managementof Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance fromthe World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do supportsupervision and update treatment guidelines to reflect ‘better medicines for children’. Health workers reporteddifficulties in administering tablets and capsules to under-five children and that’s why they preferred liquid oraldosage formulations, suppositories and injections.Conclusions: The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations – amissed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle tothe integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for theIntegrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List ofUganda, the Uganda Clinical Guidelines and, the Treatment Charts for the Integrated Management of ChildhoodIllnesses to reflect child-appropriate dosage formulations.Keywords: IMCI, Better medicines for children, Dosage formulations and Uganda

AB - Background: The Integrated Management of Childhood Illnesses is the main approach for treating children inmore than 100 low income countries worldwide. In 2007, the World Health Assembly urged countries to integrate‘better medicines for children’ into their essential medicines lists and treatment guidelines. WHO regularly providesgeneric algorithms for IMCI and publishes the Model Essential Medicines List with child-friendly medicines based onnew evidence for member countries to adopt. However, the status of ‘better medicines for children’ within theIntegrated Management of Childhood Illnesses approach in Uganda has not been studied.Methods: Qualitative interviews were conducted with: two officials from the ministry of health; two district healthofficials and, 22 health workers from public health facilities. Interview transcripts were manually analyzed formanifest and latent content.Results: Child-appropriate dosage formulations were not included in the package for the Integrated Managementof Childhood Illnesses and ministry officials attributed this to resource constraints and lack of initial guidance fromthe World Health Organization. Underfunding reportedly undercut efforts to: orient health workers; do supportsupervision and update treatment guidelines to reflect ‘better medicines for children’. Health workers reporteddifficulties in administering tablets and capsules to under-five children and that’s why they preferred liquid oraldosage formulations, suppositories and injections.Conclusions: The IMCI strategy in Uganda was not revised to reflect child-appropriate dosage formulations – amissed opportunity for improving the quality of management of childhood illnesses. Funding was an obstacle tothe integration of child-appropriate dosage formulations. Ministry of health should prioritize funding for theIntegrated Management of Childhood Illnesses and revising the Essential Medicines and Health Supplies List ofUganda, the Uganda Clinical Guidelines and, the Treatment Charts for the Integrated Management of ChildhoodIllnesses to reflect child-appropriate dosage formulations.Keywords: IMCI, Better medicines for children, Dosage formulations and Uganda

U2 - 10.1186/s40545-016-0071-9

DO - 10.1186/s40545-016-0071-9

M3 - Journal article

C2 - 27280024

VL - 9

JO - Journal of Pharmaceutical Policy and Practice

JF - Journal of Pharmaceutical Policy and Practice

SN - 2052-3211

M1 - 22

ER -