Development of a strategy of Integrated Management of Childhood Illness (IMCI) was started by WHO and UNICEF in 1992. Its main objective was reduction of the mortality and morbidity associated with the major causes of childhood illness. Every year, about 10 million children die before reaching their fifth birthday. Over 70% of these deaths, the vast majority occurring in the developing world, are due to acute respiratory infections, diarrhoeal diseases, malaria, measles and malnutrition, often in combination. It was decided to initially focus on improving care at the first level health facilities where millions of children arrive sick each day, most of them with one or more of the major causes of illness and death.
IMCI strategy seeks to reduce childhood mortality and morbidity by adopting a broad and cross-cutting three-pronged approach:
- Improving case management skills of health-care staff
- Improving overall health systems
- Improving family and community health practices
A cornerstone of IMCI strategy remains a set of clinical guidelines for management of childhood illness at first level health facilities. The first version of these guidelines was completed in 1995.
Since its introduction in 1996 IMCI strategy was accepted by many countries in the world and as of today more than 100 countries are being implementing IMCI strategy at large scale. Global implementation of IMCI is coordinated and supported by WHO and UNICEF.
The implementation of the strategy and guidelines has achieved impressive results both in reducing childhood mortality and in improving the quality of life of children all over the world.
Nevertheless a number of challenges related to IMCI implementation remain.
The key challenges are:
- Need to ensure availability of scientific evidence to support global IMCI guidelines
- Ensuring periodical updates of national and sub-national IMCI guidelines
- Need to respond to new and emerging threats to child health
- Translate the latest technical information into knowledge and skills of thousands and thousands of health care providers (training and performance maintenance)
IMCI Computerized Adaptation and Training Tool (ICATT) was developed by WHO Child and Adolescent Health and Development department (CAH) and the Novartis Foundation for Sustainable Development (NFSD) to address some of these challenges.