Regional IMCI coordinators' meeting
Amman, Jordan
2 - 6 September 2007

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Conclusions and recommendations (unedited)

Conclusions 

1. 10 years of IMCI implementation in the region and at global level have shown that IMCI is a cost-effective strategy that responds well to the needs of children under-five.

2. IMCI is acknowledged in the region as a broad primary child health care strategy for children under-five.

3. IMCI is a dynamic and flexible strategy that brings quality to under-five child health care and is able to adapt to evolving country needs. In the region, many countries have adapted IMCI to include care for the newborn at first level, healthy children and psychosocial development.

4. Improving infant and young child feeding  practices (including breastfeeding) has been recognized as an essential intervention to protect, promote and improve child health and development (including newborns)

5. Experience in the region has showed that scaling up the IMCI strategy is feasible with adequate political commitment and matching resources.

6. The lack of national child health policies strongly contributes to the lack of commitment to child health and adversely affects the harmonization and coordination of actions between relevant stakeholders.

7. Country experiences have pointed out that child health related efforts are fragmented and dispersed among different programme areas and partners. This makes the use of available resources less effective and adversely affects the rate of scaling-up.

8. Partnerships between child health related programmes, academia, community and other relevant partners, including NGOs and the private sector, are being built and expanded.

9. Progress of scaling up IMCI in the region has been uneven. Essential conditions and ways to accelerate progress in implementation in order to achieve MDG4 were identified during the meeting.

10. The region has been pioneering the implementation of IMCI pre-service education. The growing interest of countries in the initiative shows that IMCI pre-service education is recognized as an essential pre-requisite for IMCI sustainability and scaling-up. 

11. The IMCI community component has been moving at a slower pace than the other two components but there are encouraging country experiences that may guide future work in this area.

12. The identification and measurement of key indicators are essential to assess progress, plan and advocate for increased commitment and resources.

13. WHO technical support has been highly valued by countries and recognized as a key factor in accelerating progress of IMCI implementation.

14. The collaboration with other partners, in particular UNICEF, was recognized as a major factor for the progress made.

15. Participants expressed clear appreciation for the opportunity that this meeting created to share experiences with other countries, discuss issues of common interest and jointly identify ways to move forward.

Recommendations

To countries

Countries should: 

1. Develop a comprehensive child health policy, with emphasis on children under-five that specifies all child health elements, which should serve as a basis for all relevant stakeholders to develop strategy and work plans.

2. Plan to expand the scope of the IMCI strategy to address under-five child health rather than only illness.

3. Increase emphasis on newborn care within the three IMCI components and strengthen linkages with maternal health and other relevant programmes to ensure continuum of care.

4. Plan for scaling up the IMCI strategy to achieve universal coverage, while keeping quality, following a systematic approach.

5. Develop and fully own one national plan for all IMCI components, with clear indicators, timely-bound targets and adequate allocation of human and financial resources, to which all partners will contribute.

6. Include actions to promote infant and young child feeding practices using available tools as an integral part of the IMCI plans of action.

7. Include IMCI pre-service education as an integral part of their national IMCI plans, intensify efforts to scale up its implementation and evaluate it.

8. Regularly monitor progress, including inputs, outputs and outcomes of IMCI implementation, complemented by periodic evaluations to measure impact.

9. Carefully document their experiences and use the successes and lessons learnt to advocate for increased commitment, support and resources (financial and human).

10. Regularly report to WHO information on IMCI progress.

To WHO

Who should: 

1. Continue providing all possible technical support to countries, including the development of tools adapted to the needs of the region.

2. Develop a framework for monitoring and evaluation and agree with countries on key indicators and standardized procedures for reporting.

3. Ensure that within the regular budget adequate resources are allocated to child health at country and regional levels.

4. Continue to fulfill its coordinating role to build partnerships for child health in the region.

5. Convene periodic inter-country meetings on child health (IMCI) to discuss technical and programmatic issues and review overall progress in countries in the region.