WHO EMRO - Eastern Mediterranean Health Journal


Volume 11 No 4 May , 2005		Print this article	PDF

The publications listed here can be obtained from: Sales and Distribution, WHO Regional Office for the Eastern Mediterranean, PO Box 7608, Nasr City, Cairo 11371, Egypt (tel: +202 670 2535; fax: +202 670 2492; email: DSA@emro.who.int). They can also be obtained from Marketing and Dissemination, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; email: bookorders@who.int).

The world health report 2005 – make every mother and child count says that this year almost 11 million children under 5 years of age will die from causes that are largely preventable. Among them are 4 million babies who will not survive the first month of life. At the same time, more than half a million women will die in pregnancy, childbirth or soon after. The report examines why these deaths continue to occur on such a scale, and how the annual toll can be reduced. The report contains both an expert analysis of the obstacles to progress in maternal, neonatal and child health, and a comprehensive series of recommendations aimed at overcoming them. It says that today the interventions already exist to transform the lives of millions of mothers and children and to prevent millions of tragically premature deaths. To put an end to widespread exclusion, countries have to guarantee access to care for each and every mother and child – through a continuum that extends from pregnancy through childbirth, the neonatal period and childhood. The report makes detailed projections of the efforts – and the corresponding costs – needed to scale up towards universal access within the coming decade. Universal access for mothers and children requires health systems to be able to respond to the needs and demands of the population, and to offer them protection against the financial hardship that results from ill-health. To make this possible, investments in health systems and in the human resources for health need to be stepped up. The report argues that maternal, newborn and child health should constitute the core of the health entitlements protected and funded through public funds and social health insurance systems. The World Health Report 2005 “ is essential reading for everyone with an interest in improving the health of every mother, newborn and child, and making them count. The report is available on line in Arabic (http://www.emro.who.int/whd2005/worldhealthreport.htm), English (http://www.who.int/whr/2005/whr2005_en.pdf) and French (http://www.who.int/whr/2005/fr/index.html).

The maternal mortality ratio and the proportion of births attended by skilled health personnel are the two indicators selected for the Millennium Declaration to monitor the improvement of maternal health. Goal 5 of the Millennium Declaration aims at reducing the maternal mortality ratio by three-quarters between 1990 and 2015. Measuring maternal mortality accurately is notoriously difficult, except where there is comprehensive registration of deaths and causes of death. Several process indicators have been proposed for tracking progress in reduction of maternal mortality by focusing on professional care during pregnancy and childbirth. However, the most widely available and used indicator is the “proportion of births attended by skilled health personnel”. This document presents nationally representative data of births attended by skilled health workers available up to 2004 and include global, regional and subregional estimates. The document is available on line at: http://www.who.int/reproductive-health/global_monitoring/skilled_attendant_at_birth2005_estimates.pdf

Low birth weight has been defined by the World Health Organization (WHO) as weight at birth of less than 2500 g. This is based on epidemiological observations that infants weighing less than 2500 g are approximately 20 times more likely to die than heavier babies. In addition, a birth weight under 2500 g contributes to a range of poor health outcomes. The reduction of low birth weight forms an important contribution to the Millennium Development Goal for reducing child mortality. But more than half of the infants born in the developing world are not weighed, posing a major challenge to measuring the global incidence of low birth weight. This joint WHO/UNICEF publication uses recently revised estimates to report on this condition that affects more than 20 million infants worldwide; almost 96% of low birth weight infants are born in developing countries. Low birth weight: country, regional and global estimates is available free and can be accessed on line at: http://www.unicef.org/publications/files/low_birthweight_from_EY.pdf

Evidence-led obstetric care: report of a WHO meeting: Geneva, Switzerland, 28–30 January 2004

This report is based on a meeting entitled The RHL and beyond: influencing policy and changing practice. The meeting focused on ways of promoting evidence-based care in the area of pregnancy and childbirth, using the WHO Reproductive Health Library (RHL) as a source of systematic review of evidence. Researchers and clinicians attending this meeting analysed various approaches and projects which had been implemented to promote the RHL as a tool for policy-making and practice change. The meeting reviewed the lessons learnt from such experiences and strove to determine how they could be used to inform future strategy. The meeting had three objectives: i) to draw lessons from initiatives promoting evidence-based reproductive health in low- and middle-income countries; ii) to combine these lessons with existing knowledge on effective behaviour change to guide future implementation initiatives; and iii) to recommend strategies and tools for clinicians, administrators and policy-makers for introducing and sustaining evidence based approaches. This report is available on line at: http://www.who.int/reproductive-health/publications/evidence_led_obstetric_care/text.pdf

This publication is the companion guideline to WHO’s Medical eligibility criteria for contraceptive use. It aims to improve access to quality care in family planning by providing guidance on the safe and effective use of contraceptive methods once they are deemed to be medically appropriate. The book is intended to be used by policy- makers, programme managers and the scientific community, and aims to provide guidance to national family planning and reproductive health programmes in the preparation of guidelines for service delivery of contraceptives. It contains 33 specific questions with recommendations, including 10 new questions for this second edition. Recommendations are based on the latest clinical and epidemiological data, and developed through consensus at an International Expert Working Group meeting. The book covers the following family planning methods: combined oral contraceptives, combined injectable contraceptives, progestogen-only pills, DMPA, NET-EN, levonorgestrel implants, emergency contraceptive pills, copper-bearing IUDs, levonorgestrel-releasing IUDs, fertility awareness-based methods, and male & female sterilization. This publication is available on line at: http://www.who.int/reproductive-health/publications/spr/spr.pdf

Medical eligibility criteria for contraceptive use is one of WHO’s two evidence-based guidelines on contraceptive use. The document reviews the medical eligibility criteria for use of contraception, offering guidance on the safety of use of 19 different methods for women and men with specific characteristics or known medical conditions. The recommendations are based on systematic reviews of available clinical and epidemiological research. It is the companion guideline to WHO’s selected practice recommendations for contraceptive use. These documents are intended to be used by policy-makers, programme managers, and the scientific community, and aim to support national programmes in the preparation of service delivery guidelines. This 3rd edition updates the 2nd edition, entitled Improving access to quality care in family planning: medical eligibility criteria for contraceptive use, which was published in 2000. It contains over 1700 recommendations on different method/condition combinations. This publication is available on line in Arabic at: http://www.emro.who.int/rhrn/ and in English at: /http://www.who.int/reproductive-health/publications/mec/mec.pdf

Beyond the numbers. Reviewing maternal deaths and complications to make pregnancy safer

Every year some 8 million women suffer pregnancy-related complications and over half a million die. Most of these deaths can be averted even where resources are limited but, in order to do so, the right kind of information is needed upon which to base actions. Knowing the statistics on levels of maternal mortality is not enough – we need information that helps us identify what can be done to prevent such unnecessary deaths. Beyond the numbers presents ways of generating this kind of information. The approaches described go beyond just counting deaths to developing an understanding of why they happened and how they can be averted. It is directed at health professionals, health care planners and managers working in the area of maternal and newborn health who are striving to improve the quality of care provided. The publication includes a CD-ROM of sample data collection and analysis forms to serve as a basis for local adaptation. This document is available on line at: http://www.who.int/reproductive-health/publications/btn/text.pdf

Attention to both maternal and newborn health is central to the attainment of the Millennium Development Goals. In the MDG framework, two indicators are proposed for monitoring progress towards the maternal health goal namely, the maternal mortality ratio and the proportion of deliveries with a skilled health care provider. WHO is calling for a global movement to ensure that every pregnant woman and her newborn has access to a skilled attendant. This document puts forward WHO’s global advocacy and action for skilled attendants for pregnant women. Recognizing that there is a need for accountability, WHO has outlined a framework that defines its own roles and responsibilities and those of other key stakeholders in this global action movement. The framework also identifies key actions needed at different levels by the different actors. This document is available on line at: http://www.who.int/reproductive-health/publications/global_action_for_skilled_attendants/mpr_global_action.pdf

Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets

The strategy presented in this document is the World Health Organization’s first global strategy on reproductive health. It was adopted by the 57th World Health Assembly (WHA) in May 2004. The strategy is intended for a broad audience of policy-makers within governments, international agencies, professional associations, nongovernmental organizations and other institutions. Part I sets out the major discrepancies between global goals and global realities, and describes the principal barriers to progress, noting in particular the inequities related to gender and poverty and the exposure to risk of adolescents. Part II lays out the strategy, which is guided by principles based on international human rights. It highlights the core aspects of reproductive and sexual health services and proposes ways for countries and WHO to take innovative approaches. It concludes by reaffirming WHO’s corporate commitment to collaboration with its partners in order to encourage and support Member States in their efforts to attain the United Nations Millennium Development Goals and other internationally agreed goals and targets relating to reproductive and sexual health. This document is available on line at: http://www.who.int/reproductive-health/publications/strategy.pdf

Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO

Skilled care refers to the care provided to a woman and her newborn during pregnancy, childbirth and immediately after birth by an accredited and competent health care provider who has at her/his disposal the necessary equipment and the support of a functioning health system, including transport and referral facilities for emergency obstetric care. Since skilled care as defined above can be provided by a range of health professionals, whose titles may vary according to specific country contexts, it has been agreed to refer to this health care provider as the “skilled attendant” or “skilled birth attendant” so as to avoid confusion over titles. In issuing this statement, WHO, ICM and FIGO are advocating for skilled care during pregnancy, childbirth and the immediate postnatal period. This statement is especially aimed at countries in which the coverage of skilled attendance at birth is below 85%. The statement defines clearly who is a skilled attendant, what skills she/he should have and how she/he should be trained and supported. This document is available on line at: http://www.who.int/reproductive-health/publications/2004/skilled_attendant.pdf

Reduction of maternal mortality is one of the major goals of several recent international conferences and has been included within the Millennium Development Goals. However, because measuring maternal mortality is difficult and complex, reliable estimates of the dimensions of the problem are not generally available and assessing progress towards the goal is difficult. In response to these challenges and in order to improve the information base, WHO, UNICEF and UNFPA developed an approach to estimating maternal mortality that seeks both to generate estimates for countries with no data and to correct available data for underreporting and misclassification. The approach, with some variations, was used to develop estimates for maternal mortality in 1990 and 1995 and has been used again for generating these estimates for the year 2000. The purpose of these estimates is to draw attention to the existence and likely dimensions of the problem of maternal mortality. They are indicative of orders of magnitude and are not intended to serve as precise estimates. In addition, these estimates can help to stimulate greater awareness of and attention to the challenge of measuring maternal mortality. The document is available on line at: http://www.who.int/reproductive-health/publications/maternal_mortality_2000/executive_summary.html

Pregnancy, childbirth, postpartum and newborn care: a guide for essential practice

This guide provides a full range of updated, evidence-based norms and standards that will enable health care providers to give high quality care during pregnancy, delivery and in the postpartum period, considering the needs of the mother and her newborn baby. All recommendations are for skilled attendants working at the primary level of health care, either at the facility or in the community. They apply to all women attending antenatal care, in delivery, postpartum or post abortion care, or who come for emergency care, and to all newborns at birth and during the first week of life (or later) for routine and emergency care. This publication is a guide for clinical decision-making. It facilitates the collection, analysis, classification and use of relevant information by suggesting key questions, essential observations and/or examinations, and recommending appropriate research-based interventions. It promotes the early detection of complications and the initiation of early and appropriate treatment, including time referral, if necessary. This document is available on line in Arabic at: http://www.emro.who.int/rhrn/ and in English at: http://www.who.int/reproductive-health/publications/pcpnc/pcpnc.pdf

Managing complications in pregnancy and childbirth. A guide for midwives and doctors

This manual is written for midwives and doctors at the district hospital who are responsible for the care of women with complications of pregnancy, childbirth or the immediate postpartum period including immediate problems of the newborn. The emphasis of the manual is on rapid assessment and decision-making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings (e.g. district hospital or health centre). This publication is available on line at http://www.who.int/reproductive-health/impac/mcpc.pdf. This publication is also available in Arabic.

Antenatal care in developing countries: promises, achievements and missed opportunities

Today we have better evidence about what works and what does not work to reduce maternal mortality, and the role that antenatal care can play. It has become clear that antenatal care interventions, in and of themselves, cannot be expected to have significant impact on maternal mortality. Yet there is ample evidence that care during the antenatal period represents an opportunity to deliver interventions that will improve maternal health, perinatal health and, more than likely, perinatal survival. This document presents an analysis of antenatal care use patterns and trends, using data drawn from household surveys carried out in developing countries during the 1990s and 2000-2001. This document is available free of charge and can be accessed on line at: http://www.who.int/reproductive-health/docs/antenatal_care.pdf

Working with individuals, families and communities to improve maternal and newborn health

This document examines lessons learned from more than two decades of experience in applying information, education and communication (IEC) interventions in support of public health. It represents an attempt to gather and synthesize experiences in IEC for public health, and to succinctly analyse and share these experiences so that IEC can be effectively integrated into, and support, improved reproductive health programmes and service delivery. The document proposes a framework for the development of interventions at the individuals, families and communities (IFC) level to improve maternal and newborn health. It is a first step for the Making Pregnancy Safer initiative towards the elaboration of a consistent and validated IFC approach. This document is available on line at: http://www.who.int/reproductive-health/publications/RHR_03_11/ifc.pdf

A systematic review of the health complications of female genital mutilation including sequelae in childbirth

The immediate aim of this systematic review was to identify primary data on health complications of female genital mutilation (FGM), with particular emphasis on sequelae in childbirth, including psychosexual outcomes. The longer term aim of the systematic review was to use this information for a number of purposes, including identification of outcome measures of complications of FGM for studies to quantify the risk attributable to FGM at each stage in the life cycle; identification of country specific and ethnic group specific outcome measures of FGM that can be used to provide focus to optimize health care provision for care of such complications; and identification of sites world-wide where opportunities exist for research into the health sequelae of FGM. This document is available on line at: http://www.who.int/reproductive-health/docs/systematic_review_ health_complications_fgm.pdf

Female genital mutilation. The prevention and the management of the health complications. Policy guidelines for nurses and midwives

It is estimated that 100–140 million girls and women worldwide have undergone female genital mutilation (FGM). At the current rates of population increase and with the slow decline in these procedures, it is estimated that each year a further 2 million girls are at risk from the practice. These guidelines are intended for use primarily by those responsible for developing policies and directing the working practices of nurses, midwives and other frontline health care providers. They are also intended to complement the training materials for nurses and midwives in the management of girls and women with FGM. The purpose of the policy guidelines is: to promote and strengthen the case against the medicalization of FGM; to support and protect nurses, midwives and other health personnel in adhering to WHO guidelines not to close an opened up infibulation; to empower nurses and midwives to carry out functions in relation to FGM which are outside their current legal scope of practice; and to encourage appropriate documentation of FGM in clinical records and health information system. This document is available on line at: http://www.who.int/reproductive-health/publications/rhr_01_18_fgm_policy_guidelines/fgm_policy_guidelines.pdf

Strategic directions for accelerating the reduction of maternal mortality in the Eastern Mediterranean Region. A Regional Framework

Reduction of maternal mortality has been endorsed as a key development target by countries and is included in consensus documents emanating from several international conferences. In the Eastern Mediterranean Region, around 53 000 women of childbearing age die every year as a result of pregnancy-related complications. This document provides a background on the current situation of maternal health in the Eastern Mediterranean Region, including underlying causes and contributing factors, and describes strategic directions aimed at accelerating the reduction of maternal mortality in the Region and moving closer to the achievement of the Millennium Development Goals.

Making Pregnancy Safer in the Eastern Mediterranean Region. Report of an Intercountry Consultation, Casablanca, Morocco, 14–17 June 2005

The objectives of the consultation were to: discuss the existing opportunities and challenges in addressing maternal health as a priority component of reproductive health, with specific focus on making pregnancy safer strategy; identify appropriate mechanisms to develop and operationalize the existing and new strategies for making pregnancy safer through multisectoral collaboration and translate them into action; share information and experiences on existing national programmes, strategies and approaches designed to address safe motherhood issues in countries of the Region; and identify training, programmatic and resource needs to better address maternal health in specific settings. The report includes technical and country presentations together with final conclusions and recommendations.

Use of guidelines for making pregnancy safer and family planning. Report of a joint UNFPA/WHO regional workshop. Cairo, Egypt 14–18 January 2005

This document presents the report of a workshop on the use of guidelines for making pregnancy safer. The objectives of the workshop were to: familiarize regional and national counterparts with making pregnancy safer and family planning guidelines; share information and experiences on existing national programmes, strategies and approaches designed to address safe motherhood issues, including family planning in countries of the Region; discuss and identify technical backstopping needs of participating countries; develop a framework for action to improve maternal health and family planning services, using the evidence based guideline; initiate the next steps for implementation through the development of country plans of action.

Total quality management guidelines in maternal and perinatal care. A training manual

The above-mentioned manual for (total quality management) TQM in maternal and perinatal care is designed to provide the necessary information to countries of the WHO Eastern Mediterranean Region to help them manage maternal and prenatal health care problems, acting on evidence-based decisions and using scientific methods to solve problems. The manual comprises 2 sections: the first describes the vision, objectives, schedule, expectations and steps of a model TQM workshop. The second section describes how to apply the principles of TQM through a series of practical sessions.

Using data for decision-making in maternal and perinatal health Report of a training course Cairo, Egypt 16–22 January 2001

Recognizing that many countries in the Region lacked the analytical tools and the appropriate maternal and perinatal surveillance systems in order to effectively monitor the impact of programmes and activities and their progress in achieving the goals set by the Safe Motherhood Initiative, the WHO Regional Office for the Eastern Mediterranean, in collaboration with the Centers for Disease Control and Prevention (CDC) in Atlanta, USA, and the University of Nebraska Medical Center in Omaha, USA, designed a training course on using data for decision-making in maternal and perinatal health. This training course is aimed at identifying and screening appropriate data sources, managing the limitations of the data and translating the analysis results into programme and policy recommendations for maternal and perinatal health. The course concludes with formulating national learning field projects to be implemented by the trained national health staff. The above-mentioned document is the report of the second training course held in Cairo in 2001.

The safe motherhood initiative, a decade after Nairobi. Achievements in the WHO Eastern Mediterranean Region: Report of an intercountry meeting, Sana’a, Republic of Yemen, 3–6 May 1998

Since its inception, WHO has worked closely with Member States to reduce morbidity and mortality among women and children. While infant and young child mortality was being significantly reduced, maternal mortality did not show the same decline in many countries. Thus there was a need to critically review the underlying reasons for this and to strengthen the overall strategy for safe motherhood. It was against this background that the above-mentioned meeting was convened in order to review achievements in the post-Nairobi decade, to identify major causes where responses to interventions had not been satisfactory, to select more cost-effective measures and finally to strengthen the safe motherhood strategy, not only to bring maternal mortality under control but also to upgrade the quality of life for women through socioeconomic measures.

Family and community practices that promote child survival, growth and development: A review of the evidence

This document presents the evidence for 12 family and community practices identified by UNICEF and WHO to be of key importance in providing good home-care for the child, and particularly for preventing or treating the common serious conditions included in IMCI. It is a technical review that can be used by health professionals, researchers and policy advisers to inform policy discussions and investment for programme action and research. It can also be used as a basis for advocacy to and by decision-makers in government ministries and partner agencies. The document has three objectives. The first is to summarize the evidence available on the potential impact on child survival, growth and development of each of the 12 key family and community practices, and the evidence concerning the feasibility of interventions to improve them. The second is to identify gaps in knowledge that either hamper the assessment of impact, or that need to be filled in order to develop effective interventions, and to make recommendations for future research. The third objective is to make recommendations concerning next steps and priority-setting for both programme action and research. This document is available on line at: http://www.who.int/child-adolescent-health/New_Publications/CHILD_HEALTH/ISBN_92_4_159150_1.pdf

Strategic directions for improving the health and development of children and adolescents

This document summarizes priority areas for WHO action based on global evidence. Improving the health and development of children and adolescents means that WHO will need to shape its implementation of the strategy to the epidemiological needs of specific regions and countries. This strategy document proposes a flexible, country-specific approach that reflects and respects differences in epidemiology. In addition, it outlines a strategic framework that is based on equity, the life course, and a public health approach. It is intended to contribute to the definition of a new and common agenda for children and adolescents with Member States and partners, and guide the work of the Organization with Member States. The document is available on line at: http://www.who.int/child-adolescent-health/New_Publications/Overview/CAH_Strategy/CAH_strategy_EN.pdf

Worldwide about 30% of children under five are stunted as a consequence of poor feeding and repeated infections. Even in resource-poor settings, improved feeding practices can lead to improved intakes of energy and nutrients, leading to better nutritional status. Over the past decades, the evidence of biological requirements for appropriate nutrition, recommended feeding practices and factors impeding appropriate feeding has grown steadily. The global strategy aims to revitalize efforts to promote, protect and support appropriate infant and young child feeding. It builds upon past initiatives, in particular the Innocenti Declaration and the Baby-friendly hospital initiative and addresses the needs of all children including those living in difficult circumstances. The strategy specifies not only responsibilities of governments, but also of international organizations, nongovernmental organizations and other concerned parties. It engages all relevant stakeholders and provides a framework for accelerated action. This document is available on line at: http://www.who.int/nut/documents/gs_infant_feeding_text_eng.pdf

Breastfeeding is normally the best way to feed an infant. A woman infected with human immunodeficiency virus (HIV), however, can transmit the virus to her child during pregnancy, labour or delivery, or through breastfeeding. The Global strategy on infant and young child feeding lays down the optimal feeding pattern for survival in the general population. At the same time, the strategy recognizes the situation of children in exceptionally difficult circumstances, including those born to HIV-positive women. This framework for priority action was developed within the context of the Global Strategy. The purpose is to recommend to governments key priority actions related to infant and young child feeding, that cover the special circumstances associated with HIV/AIDS. The aim should be to create and sustain an environment that encourages appropriate feeding practices for all infants, while scaling-up interventions to reduce HIV transmission. The document is available on line at: http://www.who.int/child-adolescent-health/New_Publications/NUTRITION/HIV_IF_Framework_pp.pdf

The purpose of the World health report 2003: shaping the future is to encourage action for health improvement, especially for the poor and disadvantaged. In an increasingly interdependent world, collaboration across political/ and sectoral boundaries is more vital than ever. This report urges every reader, whether inside or outside public health institutions, to share in the task of shaping a healthy, equitable and sustainable future for all. For every child born today to have a good chance of a long and healthy life, there are minimum requirements which every health care system should meet equitably. These are: access to quality services for acute and chronic health needs; effective health promotion and disease prevention services; and appropriate responses to new threats as they emerge. This report argues that the key to success is health systems strengthening, centred on the strategies and principles of primary health care, constructing responses that support integrated, long-term health systems development on behalf of the entire population. This requires both effective use of existing knowledge and technologies and innovation to create new health tools, along with appropriate structures and strategies to apply them. This report is available on line at:

A national child health policy is an important instrument for bringing together in one document all the main elements and maternal and child health care need to be integrated at all levels, within strong health systems, to deliver quality services to all children in a revived primary child health care initiative. It was with this aim that the WHO Regional Office for the Eastern Mediterranean launched the child health policy initiative in October 2003. Five countries, Egypt, Morocco, Sudan, Syrian Arab Republic and Tunisia, joined the first phase, during which a thorough situation analysis was carried out to identify key policy issues to be addressed in the national child health policy document. The above-mentioned document describes the management and coordination structure recommended for the process, giving examples of its composition in the 5 countries. The document proposes a 10-step approach to the situation analysis, and provides an outline of the proposed 8 main sections of the situation analysis report. Finally, some information is also given on the other 2 phases of the development of a national child health policy: the “policy document development” phase and “official adoption of the policy document” phase. This document is available on line in English, Arabic and French at: http://www.emro.who.int/cah/ChildHealthPolicy-situationanalysis.htm

The integrated management of childhood illness (IMCI) strategy was developed to reduce mortality and morbidity in children under 5 years and improve children’s growth and development. The strategy represents a major shift toward a more integrated approach focusing on the whole child and the environment in which it is living. The family and the community in which a child is living play a major role in child development and they need to be actively involved in child care. This document proposes a framework for integrated community child care to guide national public health managers in planning community actions in the context of the IMCI strategy. This document is available on line in Arabic (http://www.emro.who.int/cah/PDF/IMCICommunityComponent_Framework_ Ar.pdf), English (http://www.emro.who.int/cah/PDF/IMCICommunityComponent_ Framework_En.pdf) and French (http://www. emro.who.int/cah/PDF/IMCICommunity Component_Framework_Fr.pdf0.

This unedited, working document has been prepared to guide the planning process for the community component of the IMCI strategy. The steps highlighted in the process are based on the Framework for the community component of the integrated childcare strategy developed by the World Health Organization Regional Office for the Eastern Mediterranean. The document has already been used by many countries in the Region to plan for the IMCI community component. The document is available on line at: http://www.emro.who.int/cah/PDF/IMCI-PlanningSteps.pdf

This document presents the contribution of the WHO Regional Office for the Eastern Mediterranean to the report for the high level Arab conference in preparation for the Arab participation in the UN general assembly special session on children, September 2001. The document is available on line at: http://www.emro.who.int/cah/pdf/childhealth-arabcountries.pdf

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