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. 2018 Jul 30;8(7):e019079.
doi: 10.1136/bmjopen-2017-019079.

Global implementation survey of Integrated Management of Childhood Illness (IMCI): 20 years on

Cynthia Boschi-Pinto  1   2 , Guilhem Labadie  1 , Thandassery Ramachandran Dilip  1 , Nicholas Oliphant  3   4 , Sarah L Dalglish  1 , Samira Aboubaker  1 , Olga Adjoa Agbodjan-Prince  5 , Teshome Desta  6 , Phanuel Habimana  7 , Betzabe Butron-Riveros  8 , Jamela Al-Raiby  9 , Khalid Siddeeg  9 , Aigul Kuttumuratova  10 , Martin Weber  10 , Rajesh Mehta  11 , Neena Raina  11 , Bernadette Daelmans  1 , Theresa Diaz  1
Affiliations

Global implementation survey of Integrated Management of Childhood Illness (IMCI): 20 years on

Cynthia Boschi-Pinto et al. BMJ Open. .

Abstract

Objective: To assess the extent to which Integrated Management of Childhood Illness (IMCI) has been adopted and scaled up in countries.

Setting: The 95 countries that participated in the survey are home to 82% of the global under-five population and account for 95% of the 5.9 million deaths that occurred among children less than 5 years of age in 2015; 93 of them are low-income and middle-income countries (LMICs).

Methods: We conducted a cross-sectional self-administered survey. Questionnaires and data analysis focused on (1) giving a general overview of current organisation and financing of IMCI at country level, (2) describing implementation of IMCI's three original components and (3) reporting on innovations, barriers and opportunities for expanding access to care for children. A single data file was created using all information collected. Analysis was performed using STATA V.11.

Participants: In-country teams consisting of representatives of the ministry of health and country offices of WHO and Unicef.

Results: Eighty-one per cent of countries reported that IMCI implementation encompassed all three components. Almost half (46%; 44 countries) reported implementation in 90% or more districts as well as all three components in place (full implementation). These full-implementer countries were 3.6 (95% CI 1.5 to 8.9) times more likely to achieve Millennium Development Goal 4 than other (not full implementer) countries. Despite these high reported implementation rates, the strategy is not reaching the children who need it most, as implementation is lowest in high mortality countries (39%; 7/18).

Conclusion: This survey provides a unique opportunity to better understand how implementation of IMCI has evolved in the 20 years since its inception. Results can be used to assist in formulating strategies, policies and activities to support improvements in the health and survival of children and to help achieve the health-related, post-2015 Sustainable Development Goals.

Keywords: IMCI; IMCI global survey; child health; strategic review.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Survey summary map. IMCI, Integrated Management of Childhood Illness.
Figure 2
Figure 2
Proportion of countries reporting government as primary funder of various elements of Integrated Management of Childhood Illness in first-level health facility by under-five mortality level.
Figure 3
Figure 3
Implementation of the three IMCI components. IMCI, Integrated Management of Childhood Illness.
Figure 4
Figure 4
Main delivery mechanisms used for the promotion of key family practices related to child health.
See this image and copyright information in PMC

References

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