WHO EMRO - CHILD AND ADOLESCENT HEALTH


23 October 2011 - Study to validate hydrocarbon poisoning algorithm to start soon at Allied Hospital / Punjab Medical College, Faisalabad, Pakistan	\| Français \|
WHO staff from the Regional office trained a team from the Paediatric Department and Poison Control Centre of Allied Hospital / Punjab Medical College, Faisalabad, Pakistan, from 10 to 14 October 2011 on research methodology on a study to validate a clinical decision rule on hydrocarbon poisoning. The rule had been derived earlier in a study at Ain Shams Hospital, Cairo, where it had a sensitivity of 98%, and needed to be validated in another setting. Unintentional ingestion of kerosene in children is common in developing countries. The rule, for use at primary health care facilities and following the algorithm approach of IMCI, relies only on a few clinical signs and aims at predicting within two hours of the accident which children below five years old will have a more severe course requiring referral to a higher level facility and which ones will have a milder course and could be sent home. Analysis of the data from this prospective study is expected to start in 2012.
31 July 2011 \| Yemen prepares background document for IMCI programme review, Cairo, 24–27 July 2011
A small team from Yemen worked with the staff of the Child and Adolescent Health (CAH) programme of the WHO Regional Office in Cairo to prepare a document to serve as a background to a programme review of the Integrated Management of Childhood Illness strategy (IMCI) in the country. The team was composed of the national IMCI programme director, the WHO country office focal point for child health and the UNICEF country office child health medical officer. The draft document includes three main sections: 1) an introductory section with country demographic, socio-economic and health system information; 2) a section on child health, describing policies, indicators and progress towards the millennium development goal 4 on under-five mortality reduction and child health-related programmes; and 3) a detailed section on IMCI and its three components, including implementation at the health system (e.g., planning, management, organization of work at health facilities, drug supply, referral, monitoring and supervision) and community level (e.g. community child care by community health workers), financial support, pre-service education, challenges and recommendations. Every country implementing the IMCI strategy reviews implementation after the early implementation phase, when the adapted guidelines are tested in a limited number of districts in order to finalize the approach. The Regional Office has recommended that countries periodically review programme implementation also during the expansion phase, especially when a substantial proportion of health facilities has been covered. It has proposed for this purpose an approach which includes the preparation of a background document followed by the conduct of a workshop. The document is a key document which is reviewed in detail and discussed throughout the workshop by the participants divided into groups by document section. The workshop convenes representatives of various programmes of the ministry of health, public health officials from governorates, teaching institutions, professional associations, other national and international partners and interested parties. The main objective of the review is to recommend actions to address issues identified in the review which hamper expansion and provision of quality child care. Yemen started IMCI expansion in January 2003 and has since trained staff from 61% of its primary health care facilities. It has also adopted initiatives to increase access to quality child health care services such as integrated primary health care mobile teams and, more recently, community health workers. It has also started introducing IMCI into teaching programmes of a few teaching institutions. According to the UN interagency child mortality estimation group, under-five mortality has declined in Yemen by 47% between 1990 and 2009.
20 July 2011 \| Report on 2010 IMCI Coordinators’ meeting now available online	\| Français \|
The report on the Regional IMCI Coordinator’s meeting held in Sana’a, Yemen, 6–9 December 2010 is now available for downloading. The report covers progress in under-five mortality reduction and implementation of IMCI in countries in the Region, work on child health country profiles, interventions to increase access to quality child health care, especially through community-based health providers and mobile teams, progress in IMCI pre-service education, updates on regional work and on the “Countdown to 2015: Tracking progress in maternal, newborn and child survival” initiative, indicators on infant and child feeding practices and the child health financial situation. A news item summarizing the meeting was also posted on this web site in December 2010.
17 July 2011 - Priorities for implementation research in neonatal and child health, Cairo, Egypt, 11–12 July 2011	\| Français \|
Priorities for “implementation research” to reduce neonatal and child mortality in Egypt were proposed in a WHO-supported consultation in Cairo, Egypt, on 11–12 July 2011, following the systematic Child Health and Nutrition Research Initiative (CHNRI) methodology. Thirty-one participants from the ministry of health, teaching and research institutions and international agencies (UNICEF and WHO) first reviewed and prioritized the barriers to implementation of public health interventions aimed at reducing deaths in neonates and children in the country. Next, they listed research questions to address those priority barriers. Finally, each participant individually scored each research question based on six criteria according to the CHNRI methodology. Ten top-ranking research issues with the highest agreement were identified in this way among all those listed in the previous step. A call for letters of intent for implementation research in the identified research priority areas will be made in two weeks’ time and widely disseminated in the country, including on this web site. The call will be open to any interested party in the country. See details on consultation
21 June 2011 - Achieving MDG 4 on under-five mortality reduction is a challenge for priority countries in the Region	\| Français \|
Under-five mortality in the Eastern Mediterranean Region fell to 72 per 1000 live births in 2009, a 31% reduction from the 1990 level, based on the World Health Statistics Report 2011. Three countries (Egypt, Lebanon and Oman) have already achieved a percentage reduction greater than the two third reduction set as the Millennium Development Goal (MDG) 4 for 2015; this is a remarkable accomplishment. Seven more countries have seen over a 50% reduction in the same period, substantially increasing the future chances of survival of their children. The causes of mortality have gradually been shifting pattern in this decade, with such traditional causes as infectious diseases (postneonatal pneumonia and diarrhoea, malaria and measles) decreasing to about 35% of all causes and newborn deaths increasing to 45%. Despite this progress, an estimated 1.150 million under-five children still died in the Region in 2009, with 83% of these deaths occurring in just five countries (Afghanistan, Pakistan, Somalia, Sudan and Yemen). An analysis of the under-five mortality rates and average annual rate of reduction (AARR) by five-year periods by country recently conducted by the Regional Office gives an indication about not only trends over time but also the level of effort required to achieve MDG 4 in the next five years and, thus, its feasibility at this stage. The analysis suggests that the five priority countries with very high under-five mortality rates (Afghanistan, Djibouti, Pakistan, Somalia and Sudan) are not on track to achieve MDG 4. These countries are mostly in complex emergencies and have an AARR of less than 2% per year (except for Pakistan which has a 2.1%), which is much lower than the 12%–18% required by them to achieve the Goal in the remaining next few years. The “Data and statistics” section on “Under-5 mortality and its causes” contains detailed information on mortality rates, trends and AARR by country.
16 January 2011 – IMCI pre-service education package now available for downloading	\| Français \|
The IMCI pre-service education package has been developed by the Regional Office in close collaboration with medical schools in the Region to assist teaching institutions in introducing, implementing and assessing undergraduate teaching programmes that include the IMCI approach. Over 50 medical schools have to date introduced the Integrated Management of Child Health (IMCI) approach into their teaching programmes. The package comprises the following publications. 1. IMCI pre-service education: orientation and planning workshop: facilitator guide is designed to assist in the conduct of in-depth participatory workshops for teaching institutions to develop plans to introduce IMCI into the teaching programmes. The guide, tested in an intercountry workshop in July 2009, includes detailed guidelines, presentations and tools to support this task. 2. IMCI pre-service education: teaching sessions, with lesson plans to support planning and conduct of IMCI-related teaching sessions within the paediatric and community medicine teaching programmes, describes the student learning objectives, content and procedures of each session. The content was thoroughly reviewed by an expert group in 2008. 3. IMCI pre-service education: guide to evaluation is a comprehensive tool to assess whether IMCI pre-service education as a public health intervention improves students’ competencies in managing main childhood health problems in outpatient settings. Extensively reviewed through expert consultations and tested in four medical schools, this guide comes with a user guide to data entry and analysis and a CD with the relevant e-forms and programme files. 4. IMCI pre-service education: question bank is a resource library of multiple-choice questions and case scenarios suitable for evaluations of IMCI pre-service education and student formative and summative assessments. It has already been used to develop student knowledge tests for evaluations in two medical schools, in 2009. 5. IMCI pre-service education: e-lectures on CD provides standard technical content as a resource to support IMCI-related teaching. 6. IMCI pre-service education: e-learning material for students on DVD is designed to support students’ learning at their own pace through an electronic, interactive medium. Items 1, 2, 3 and 4 above are available in English language for downloading from our website.