Skip to main content Skip to main navigation menu Skip to site footer
Published: 2024-04-30

Assessment of factors related to caregivers and children on the IMCI program outcomes in Baghdad City in 2021

Department of Family and Community Medicine, Faculty of Medicine, Anbar University, Anbar, Iraq
Department of Family and Community Medicine, Faculty of Medicine, Al- Nahrain University, Baghdad, Iraq
IMCI, IMNCI, IMNCH, Child Morbidity, PHC, Iraq


Background: The implementation of the Integrated Management of Childhood Illness (IMCI) program has led to enhancement in outcomes for many treatable childhood diseases. This study aims to assess how implementing IMCI affects child mortality and morbidity in Iraq.

Methods: A cross-sectional study spanning from January to December 2021 was carried out at primary healthcare centers (PHCCs) with IMCI units in Baghdad, Iraq. Using a lottery sampling method, 40 PHCCs were randomly chosen from a total of 235 centers across both sides of the city. A universal sampling technique was adopted to select all children attending these PHCCs regularly. With a p-value below 5%, multiple logistic regression analyses were performed to identify the significant independent predictors at a 95% confidence interval.

Results: The majority of caregivers were mothers (97.8%), aged 20 to 30 years (75.8%), and housewives (59.2%). Sixty percent of children (6 to 35 months) had normal anthropometric measurements. Bottle feeding was common (44.2%), and most children had a normal neonatal history (82.9%). In bivariate analysis, the severity of illness, severe cases of diarrhea, and acute respiratory infection (ARI) showed significant associations with worsened or not improved outcomes (χ2 = 18.900, p < 0.001; χ2 = 6.265, p= 0.016; and χ2 = 7.549, p= 0.003, respectively). However, multiple logistic regression analysis indicated that mild and moderate illness severity (OR = 10.634, 95% CI: 6.985 to 16.192, p < 0.001), strict breastfeeding (OR = 3.307, 95% CI: 1.703 to 6.421, p < 0.001), and completing treatment at home (OR = 6.190, 95% CI: 4.115 to 9.311, p < 0.001) significantly improved outcomes through IMCI services.

Conclusion: Severe illness, especially in diarrhea and ARI, correlates with poorer outcomes. Conversely, exclusive breastfeeding, prompt medical attention within a day of illness onset, and completing home treatment are associated with improved outcomes.


Download data is not yet available.


  1. World Health Organization. Child Health and Development Unit, Integrated Management of Childhood Illness. [Internet]. Available from: Accessed on 11th January 2024.
  2. World Health Organization Child and Adolescent Health, Integrated Management of Childhood Health. [Internet]. Available from: Accessed on 11th January 2024.
  3. World Health Organization (WHO). Regional Health Observatory Data Repository, Implementation of IMCI: Iraq. [Internet]. Available from: Accessed 11 February 2024.
  4. World Health Organization (WHO). Media Centre, Iraq scales up efforts to improve maternal and child health in line with Dubai Declaration commitments. [Internet]. Available from: Accessed 12 February 2024.
  5. Tawfiq WA. Integrated management of childhood illnesses "IMCI": the situation in Iraq (Abstract, Al Nahrain University website), 2009. [Internet]. Available from: Accessed 25 February 2024.
  6. Yasin EA, Abd-Al Ghafoor AH, Mustafa MA. Knowledge of health providers in Salahuddin towards integrated management of neonate & child health in year 2014. Med J Tikrit Univ. 2016;21(1):148-59.
  7. Al-Samarrai MA, Jadoo SA. Impact of training on practical skills of Iraqi health providers towards integrated management of neonatal and childhood illness: A multicenter cross-sectional study. J Ideas Health. 2018;1(1):1-6. doi: 10.47108/jidhealth.vol1.iss1.2.
  8. Abdulrahman A, et al. Implementation of Integrated Management of Childhood Illness Strategy's in Al Hadbaa Primary Health Care Center in Mosul City. Ann Coll Med Mosul 2019;41(1):75-80. doi:10.33899/MMED.2019.161297. Available from: doi: 10.33899/mmed.2019.161297.
  9. Raoof SM, Raoof RD, Ibraheem MA. Evaluation of application of nutritional status assessment for children under 5 years by using IMCI program in a sample of primary health care centers in Baghdad City. Al-Kindy Coll Med J. 2018;14(2):1-7.
  10. Hussein SS, Farhood HF. 2019. Assessment of knowledge and practical skills among integrated management of neonatal and childhood illness program healthcare personnel in primary healthcare centers. Med J Babylon 16(4):351. doi: 10.4103/MJBL.MJBL_50_19.
  11. Mazin Khalid Abdullah et al. "Evaluation of the performance, knowledge among IMCI Trained Health Workers in Primary Health Care Centers in Baquba City." Dwight's Journal of Music, 13 (2017): 37-45.
  12. Sharhan MA, Ali MG. Evaluation of Health Care Professional Knowledge toward Integrated Management of Childhood Illness at the First Health Sector of Amara. Kufa J Nurs Sci. 2021;11(1):206-211.
  13. UN Joint Programme (UNFPA/ UNICEF/WHO). Assessment of the Integrated Management of Newborn and Childhood Illnesses Lao PDR, 27 March – 7 April 2017. [Internet]. Available from: Accessed 15 February 2024.
  14. Getachew A, Tadie A, G.Hiwot M, et al. Environmental factors of diarrhea prevalence among under five children in rural area of North Gondar zone, Ethiopia. Ital J Pediatr. 2018;44:95.
  15. Chari S, Mbonane TP, Van Wyk RH. Social and Environmental Determinants of Diarrheal Diseases among Children under Five Years in Epworth Township, Harare. Children (Basel). 2023 Jul 6;10(7):1173.
  16. Paul P. Socio-demographic and environmental factors associated with diarrhoeal disease among children under five in India. BMC Public Health. 2020 Dec 7;20(1):1886.
  17. Ali Jadoo SA. The second wave of COVID-19 is knocking at the doors: have we learned the lesson? Journal of Ideas in Health. 2020 Oct. 8;3(Special1):183-4.
  18. Ali Jadoo SA, Alhusseiny AH, Yaseen SM, Al-Samarrai MAM, Mahmood AS. Evaluation of health system in Iraq from people’s point of view: a comparative study of two different eras. Journal of Ideas in Health. 2021 May 20;4(2):380-8.
  19. Ali Jadoo SA, Yaseen SM, Al-Samarrai MAM, Mahmood AS. Patient satisfaction in outpatient medical care: the case of Iraq. Journal of Ideas in Health. 2020 Aug. 26 ;3(2):176-82.
  20. World Health Organization. Global Strategy for Infant and Young Child Feeding. Geneva, Switzerland: WHO and UNICEF; 2003.
  21. Dieterich CM, Felice JP, O'Sullivan E, Rasmussen KM. Breastfeeding and health outcomes for the mother-infant dyad. Pediatr Clin North Am. 2013 Feb;60(1):31-48.
  22. Al-Samarrai MAM, Al-Rawi RA, Yaseen SM, Ali Jadoo SA. Knowledge, attitude, and practice of mothers about complementary feeding for infants aged 6-12 months in Anbar Province, Iraq. Journal of Ideas in Health. 2020 May 9;3(1):125-9.
  23. Larson E, Hermosilla S, Kimweri A, Mbaruku GM, Kruk ME. Determinants of perceived quality of obstetric care in rural Tanzania: a cross-sectional study. BMC Health Serv Res. 2014;14:483.
  24. Boskabadi H, Maamouri G, Sadeghian MH, Ghayour-Mobarhan M, Heidarzadeh M, Shakeri MT. Early detection of developmental problems in children with a history of neonatal icterus. Child Care Health Dev. 2010;36(1):20-24.
  25. Abdulraheem IS, Parakoyi DB. Factors affecting mothers' healthcare-seeking behaviour for childhood illnesses in a rural Nigerian setting. Early Child Dev Care. 2009;179(5):671-683.
  26. Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on determinants. Soc Sci Med. 2003;57(4):733-744.

How to Cite

Al-Samarrai M, Sahib A. Assessment of factors related to caregivers and children on the IMCI program outcomes in Baghdad City in 2021. jidhealth [Internet]. 2024 Apr. 30 [cited 2024 Jun. 15];7(2):1042-8. Available from: