Non-compliance is defined as any deviation by a patient from health workers instructions. Non-compliance with medications is particularly important in clinical practice. This form of non-compliance has been found to be associated with treatment failure and all its consequences, namely: deterioration of patients’ health, the need for additional consultations, and the use of extra drugs, additional hospital admissions and increases in direct and indirect costs of management.
Care takers compliance towards breast feeding/feeding was 56%. This is higher than the study conducted in Hawassa town which has compliance towards counseling 28.2%. Reason for noncompliance regarding to recommend action majority (43.9%) were did not know the importance of breast feeding and additional feeding practice and 21.3% were said that I have no money. The study conducted in Hawassa town indicate that the reasons given by care takers for giving less fluids were: did not know importance of giving more fluid 26.6%, unable to suck 22.5% and child did not want to suck 21.7%. This is relatively similar to the present finding (5).
Care takers compliance towards follow up was 38.6%. The study conducted in Afghanistan shows that most caretakers 75% complied with referral advice. This is different from the findings of this study because compliance to follow-up higher than the present finding 38.6%. The study conducted in Sudan shows that compliance with a follow-up recommendation was 44.5%. This is relatively higher than the findings of this study. The study conducted in Hawassa shows that compliance to recommend follow-up visit was 19.7%, which lower than the findings of this study. The study conducted in KwaZulu Natal, South Africa compliance with the primary referral was reported by less than half (45%) of care givers which is higher than the findings of this study (6, 7,5, 8). The difference may be due to socio-demographic difference between the study area.
Reason for non compliance of follow up majority 41.6% of the respondent said that the child was improved and 19% were said that I forgot follow up date. This is relatively similar to the study conducted in Hawassa health center which has 39.0% of care takers who did not attend follow up said because their child had improved, 22.9% said that they had forgotten the appointment (24).
Compliance towards IMNCI counseling is low (27.3%) in this study. It was affected by age categories, educational status, and trust on health workers, care takers knowledge and availability of health center nearby place of residence.
Knowledgeable care takers were 2.574 times more likely significantly associated with compliance to IMNCI counseling than non-knowledgeable care takers. The result of this study may suggest care takers compliance to IMNCI counseling increase when knowledge increases. Care taker knowledge is important since when the care takers implement the counseling practice incorrectly the child nutritional status may be decreased and the child health status becomes worse, the final result may be death. In order to avoid such condition knowledgeable care takers were more compliance than non-knowledgeable care takers.
Care takers those satisfied by the service delivered by health workers were 2.781 times more likely significantly associated with compliance to IMNCI counseling than those do not satisfied by the service delivered by health workers. The result of this study may suggest care takers compliance towards IMNCI counseling increase when the health works delivered quality health services. Quality health service is important since when the care takers satisfied by the service implement the counseling practice correctly the child nutritional status improved and the child health status becomes good.
Those care takers travel from home to health center with less than or equal to one hours were 2.214 times more likely significantly associated with compliance to IMNCI counseling than those travel more than one hours. This indicate that when care takers live nearby health center the probability of getting information regarding to IMNCI increase and the health workers get the care takers easily. This give chance that the health workers do easily close supervision and give counseling.
Post secondary educated care takers were 2.959 times more likely significantly associated with compliance to IMNCI counseling than illiterate care takers. The result of this study may suggest care takers compliance to counseling increase when educational status increases. Care taker education is important since when care takers give care for their child based on the counseling the child health status becomes well and produce productive future generation. In order to create productive future generation educated care takers were important than non educated care takers. When educational status increase other associated factors like knowledge and job opportunity also improved.
Age categories between 25-34 years were 2.118 times more likely significantly associated with compliance to IMNCI counseling. The result of this study may suggest care takers compliance to counseling decrease when care takers age increase and very young age care takers. This is may be due to when the care taker is very young there is no experience regarding to child caring practice and when care takers age becomes old the capacity that give care according to the instruction decrease.