Siti Nurmawan Sinaga
Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan, Sumatera Utara, Indonesia

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Determinants of the Implementation of Integrated Management of Childhood Illness (IMCI) by Midwives in Primary Health Care A Literature Review Oktaviani Zebua; Isyos Sari Sembiring; Astaria Ginting; Siti Nurmawan Sinaga
Jurnal Kebidanan Midwiferia Vol. 12 No. 2 (2026): October
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/midwiferia.v12i2.1822

Abstract

Introduction: Integrated Management of Childhood Illness (IMCI) is a strategy developed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to improve child healthcare quality and reduce morbidity and mortality among children under five years of age. However, IMCI implementation in primary healthcare settings remains influenced by various individual, organizational, resource-related, operational, and health system factors. This literature review aimed to identify and synthesize the determinants influencing IMCI implementation. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were conducted in Google Scholar, PubMed, Scopus, and ScienceDirect using keywords related to IMCI implementation and determinants. A total of 86 records were identified, with 72 records remaining after duplicate removal. Following title, abstract, and full-text screening, 34 articles met the eligibility criteria and were included in the review. Study selection was conducted by the primary reviewer and reviewed with research supervisors, with disagreements resolved through discussion and consensus. Methodological quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Twenty-eight studies were appraised and classified as high quality, while six non-primary research articles were excluded from JBI assessment. Result: Five determinant categories were identified: individual healthcare worker factors, organizational factors, resource availability factors, health system factors, and operational factors. Knowledge, IMCI training, clinical competence, supervision, leadership support, medicine availability, policy support, financing, workload, and digital health technologies were identified as key determinants. Conclusion: Strengthening these factors may improve IMCI implementation, service quality, and child health outcomes.