Evaluation of Integrated Management of Childhood Illness (IMCI) Implementation at Primary Healthcare Centres in Oyo State, South West Nigeria

The Integrated Management of Childhood Illness (IMCI) strategy remains a cornerstone of child health policy in Nigeria, targeting the most common causes of under-five mortality. Despite national adoption, implementation fidelity at the primary healthcare level remains inconsistent. This study evaluates the quality of IMCI implementation at selected primary healthcare centres (PHCs) in Oyo State, South West Nigeria. A mixed-methods design was employed, combining facility assessments using standardised WHO observation checklists, structured interviews with 84 healthcare workers, and review of clinic records across 12 PHCs in Oyo East, Ibadan North, and Ogbomosho South local government areas. Findings revealed that only 41.7% of PHCs had at least 80% of required IMCI materials and drugs consistently available. Healthcare worker IMCI training coverage was 52.4%, and correct case classification was achieved in 58.3% of observed consultations. Common deficiencies included incomplete assessment of all danger signs, inadequate nutritional counselling, and poor documentation. Facilities with dedicated IMCI-trained staff demonstrated significantly better classification accuracy and treatment adherence. Caregiver satisfaction was highest in facilities where counselling cards were used. The study recommends refresher training cycles, drug supply chain strengthening, and integration of IMCI performance metrics into routine PHC supervision visits. Keywords: IMCI, primary healthcare, child health, Oyo State, South West Nigeria.