Factors influencing the implementation of Integrated Management of Neonatal and Childhood Illness (IMNCI) by nurses in Bhutan: A predictive correlational study

Abstract

Background: Integrated Management of Neonatal and Childhood Illness (IMNCI) is a critical strategy aimed at improving child health outcomes. In Bhutan, nurses play a frontline role in implementing IMNCI guidelines, yet factors influencing their implementation remain underexplored. Objective: This study aimed to identify the predictors of IMNCI implementation among nurses in selected hospitals in Bhutan. Methods: A correlational predictive design was used, involving 107 nurses from nine hospitals across Bhutan. Data on demographics, supplies/resources, supervision, attitude, workload, nurse management skills, and IMNCI implementation were collected between November and December 2023 through structured questionnaires. Multiple linear regression analysis was conducted to determine factors predicting IMNCI implementation. Results: Nurse management skill was the only significant predictor of IMNCI implementation (β = 0.321, p <0.001), while other variables such as supplies/resources, supervision, attitude, years of service, training, and workload showed no significant predictive value. The model explained 16.8% of the variance in IMNCI implementation. Conclusion: Nurse management skills play a pivotal role in effective IMNCI implementation in Bhutanese hospitals. However, the modest explanatory power suggests other factors may influence implementation, warranting further research to enhance child healthcare delivery through strengthened nurse leadership and systemic support.