الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Acute respiratory infections (ARls) are one of the major causes of morbidity and mortality in developing countries. ARl mortality is ten times igher in developing countries than in developed countries. Reasons !dvanced for the consistently high ARl mortality rate in developing countries mclude poverty, overcrowding, air pollution, malnutrition, harmful ’aditional practices, delayed care-seeking and inappropriate case anagement at health facilities. Children under five years may suffer form 5-8 attacks of ARl annually. One fourth to one third of under-five mortality in developing countries has oeen shown to be attributable to ARl as an underlying or a contributing ause. Most of these deaths are due to pneumonia and are preventable with adequate antibiotic treatment. While many of children with ARl lack the loenefit of essential antibiotic treatment, others are victims of indiscriminate and inappropriate use of antibiotics. Research studies in Egypt and other developing countries have shown iliat training of physicians in the rational and effective management of ARl episodes can help to reduce mortality due to ARl in the community. Among the goals for achieving health for all (HF A) by the year 2000 was a one-third reduction in child deaths caused by ARl. The corner-stone of Itne strategy for reducing ARI mortality is standard case management using simple antimicrobial agents. Applying the case management strategy recommended by the WHO, trained physicians in various countries have 112 a hieved from 30 to 70 reduction in mOliality. There is limited data ailable on physicians KAP (knowledge, attitude and practice) regarding I management in children under five years of age. he aim of the present study is to assess the knowledge and performance of ysicians in l\1CH centers trained on ARI SCM program and their mpliance to the program guidelines. tudy setting and sample: The study was carried out on a sample of physicians working in MCH ~nters in Alexandria who received training on WHO standard case anagement of the young child with acute respiratory infection. Five MCH :enters reporting the highest recorded attendance rate of under 5 children during e last 5 years were selected. However, only one third of of trained physicians lin Bakous center accepted to participate, in Smouha and Elgomrok centers the lumber of trained physicians was small but nearly all of them participated in the d)’ (2 and 4 physicians respectively), whereas from Moharam bey and Imandra 7 and 6 physicians shared respectively. To conduct the present study the following techniques were used: ’J. An interview questionnaire (Appendix I) was designed to measure the owledge of physicians concerning ARl. The questionnaire used multiple ~oice questions to collect data about physician’s knowledge regarding sessment, classification and treatment of ARI cases. . An observation checklist (Appendix II) was designed to collect data about hysicians’ compliance with the steps that should be followed to examine and anage (diagnose and treat) a case of ARI according to the SCM. Each ] 1: Inysician was observed while examining 10 cases of ARI. Each case was en examined again by the researcher away from the physician. A total of 10 cases of ARI were included in this study through a period of time tended from ]/1/1997 to 1/11/1997. . Records review, regarding recording of main findings of history taking, ixamination and diagnosis. ala was subjected to statistical analysis and interpretation. ’he results obtained in the present study could be summarized as follows: .In history taking, physicians paid great attention for general questions as ge and presence of cough while they gave little attention for specific ARI luestions as feeding problems (whether breast feeding or ability to drink) and fesence of dangerous signs.