Programs and Progress
Measles Partnership Fosters Resolve for Elimination (pdf)
IMCI
What is IMCI? Integrated Management of Childhood Illnesses (IMCI) -- basically Polio Plus Plus – focuses on the well being of the child. WHO, who runs IMCI describes it as:
- promoting the accurate identification of childhood illnesses in outpatient settings
- ensuring the appropriate combined treatment of all major childhood illnesses
- strengthening the counseling of caretakers, and
- speeding up the referral of severely ill children.
Early results of IMCI in Tanzania show that childhood mortality drops 43% and infant mortality drops 49%. The estimated number of children dying annually is 10.8 million. Cutting that rate by 43-49% would save over 5 million lives annually.
These results come from areas that have not yet completed implementation. For example, these areas have only 20-30% of children sleeping under Insecticide Treated Nets. Nor do these areas have adequate water and sanitation. Results typically improve over time as more health care workers are trained and as the healthy cycle strengthens.
Likewise, studies show that results improve as implementations are rolled out and strengthened. Furthermore, they show that improvement in health status is cumulative, that effects improve over time.
It is easier to improve the health of a sick child in a healthy community than to keep a healthy child healthy in a community where disease and death is commonplace, indeed rampant.
IMCI has been adapted in over 70 countries as of early 2004.
Cost of IMCI is estimated at 80 cents per person per year. Worst case. The worst case includes significant up-front training costs and downtime. According to "The Effect of Integrated Management of Childhood Illness on Observed Quality of Care of Under-Fives in Rural Tanzania . Health Policy Plan. 19:1-10":
The results [of the survey] indicate that children in IMCI districts received better care than children in comparison districts: their health problems were more thoroughly assessed, they were more likely to be diagnosed and treated correctly as determined through a gold-standard re-examination, and the caretakers of the children were more likely to receive appropriate counseling and reported higher levels of knowledge about how to take care of their sick children.
Management of Childhood Illness in Africa
BMJ Journal Editorial
The main steps, according the WHO, for implementation involve:
- Adopting an integrated approach to child health and development in the national health policy.
- Adapting the standard IMCI clinical guidelines to the country's needs, available drugs, policies, and to the local foods and language used by the population.
- Upgrading care in local clinics by training health workers in new methods to examine and treat children, and to effectively counsel parents.
- Making upgraded care possible by ensuring that enough of the right low-cost medicines and simple equipment are available.
- Strengthening care in hospitals for those children too sick to be treated in an outpatient clinic.
- Developing support mechanisms within communities for preventing disease, for helping families to care for sick children, and for getting children to clinics or hospitals when needed.
last updated 25 May 2006