Knowledge of clinical case management of IMNCI among trained and untrained primary health care personnel in two districts of province Punjab in Pakistan

Reduction in child and neonatal mortality is a major global health challenge. Pakistan, a developing country, occupies third highest place in the under five mortality rate (97/1000 live births) in Asia. To improve the child survival, government of Pakistan has adopted Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy. Health care personnel have been trained for clinical case management of IMNCI but over the years slow progress has been noticed. This study aimed to assess and compare the knowledge of clinical case management of IMNCI among trained and untrained first level rural health care staff of district Lahore and Sheikhupura in Pakistan. For the purpose, an anonymous questionnaire based cross-sectional survey with convienence sampling (response rate 75.2%) was conducted; 131 participants from Lahore and 136 from Sheikhupura were studied. Maximum possible score in the study questionnaire was 15. Mean knowledge score with 95% confidience intervals (CI) were calculated. Independent sample t-test and one way ANOVA test with Tukey’s post-hoc contrast were used to analyze and compare the mean difference in knowledge score between the groups by training status and to test the hypothsis in the sample. On knowledge scale, the trained personnel scored almost twice than untrained [9.7 vs 5.1; CI 4.6 (5.4, 3.7); p=<0.001]. Statistically significant knowledge score differences were noted among medical officers (p=<0.001), lady health visitors (p=0.001), and dispensers (p=0.02) depending upon their training status. Likewise, trained personnel working at Basic Health Units (p=<0.001) and Rural Health Centers (p=