Guide to planning for implementation of IMCI at district level now available
20 November 2008

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The "Guide to planning for implementation of IMCI at district level" is designed to assist health officials responsible for planning for the implementation of IMCI (Integrated Management of Child Health) at district level. Developed by the Regional Office and based on a rich country experience, the Guide describes in detail the steps of the preparatory phase (from data collection to situation analysis and capacity building at district level), the district planning workshop and monitoring of the implementation of the plans of action developed, including a list of key indicators. It covers the three components of IMCI, human resource development, health system strengthening and improving child care community practices. Emphasis is given also to planning for monitoring and documentation. As such, this document serves as a useful guide to planning for primary child health care related activities and even for other programme areas at district level. A library of tools, widely used and tested in some countries in the Region, is provided in the Guide. A companion CD comes with the printed publication, containing the orientation package, tools for data collection and templates used during the district planning workshop, as a resource for countries to adapt as needed and use. The Guide has been extensively reviewed by a group of experts with longstanding field experience from many countries in the Region and from WHO, who have served as regional resource persons in the area of IMCI. It has already been introduced to national coordinators from six countries in the Region (Egypt, Jordan, Morocco, Sudan, Tunisia and Yemen) in a planning workshop in Suez, Egypt, in February 2008. The electronic version of the Guide can be downloaded from here

New item on data and statistics
15 September 2008 

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The new item "Data and statistics" has been added to the CAH website. This new section currently contains information on under-five mortality and its causes and useful links to information on key child health indicators by country. It also shows the link to data on IMCI implementation in countries in the Region and presents on one page results of follow-up visits and surveys on health provider skills and health system support after IMCI training in countries of the Region.

News and events section
15 September 2008 
 

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The CAH homepage now shows the news posted during the current year and a link to previous news archived by year. The webpage "News and events" lists all the titles of the news posted on the website over the years to facilitate the search for specific news. Clicking on the title of each news displays the full text of the news.

Meeting of experts on the standardized IMCI pre-service education package, Tehran, Islamic Republic of Iran, 26 July - 1 August 2008
10 August 2008

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Senior academic staff of paediatrics departments of medical schools from countries in the Region together with national IMCI coordinators from ministries of health and WHO staff met in Tehran to review a set of draft materials developed by the Regional Office to guide the introduction of IMCI into the teaching programmes of medical schools. The development of this package, which should become available early in 2009, had been strongly recommended by academic staff and child public health managers in the Second Regional Consultation on IMCI Pre-service Education, held in Cairo in August 2006. The draft package currently includes a facilitator guide to conduct in-depth orientation and planning workshops for teaching institutions, teaching sessions with student learning objectives, content and procedures, a guide on evaluation, a multiple-choice questions bank and electronic tools to support teaching and student learning. It is expected to assist interested teaching institutions to standardize teaching methodology and evaluate it. Click here to view information on the meeting.

Findings of the WHO EMRO Pediatric Insecticide Study Group on organophosphate / carbamate poisoning in children published
16 June 2008

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The results of the WHO EMRO Pediatric Insecticide Study Group’s study “A clinical decision aid for triage of children younger than 5 years and with organophosphate or carbamate insecticide exposure in developing countries”, supported by this Regional Office, have been published in the Annals of Emergency Medicine, Year 2008; vol.: (doi:10.1016/ j.annemergmed.2008.03.026). The study aim was to develop a clinical decision aid that could guide early triage at primary health care level of children exposed to organophosphates / carbamates, identifying those requiring referral to higher level facilities. The decision aid for referral, which is in line with the principles of IMCI guidelines, is based on the presence of any of two clinical signs (pinpoint pupils and diarrhea), requires no X-ray or laboratory facilities and has a sensitivity of 100% and a specificity of 77%. The paper can be accessed on the Journal’s website at www.annemergmed.com  (click “Articles in Press”). This publication follows that of the results of the WHO EMRO Pediatric Hydrocarbon Study Group’s study “A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries”, also supported by this Regional Office, which have been published in Clinical Toxicology, Volume 46, Issue 3 March 2008, pages 222 – 229. As the decision aids have initially been derived from cases seen only in one poison control centre in one country, they can not be extrapolated to, and need to be validated in, other settings before they can be recommended for use. This information is provided for scientists of research institutions interested in validating the rule in their settings under strict research conditions. Protocols and instruments used in the study are available from the Child and Adolescent Health and Development (CAH) unit of this Regional Office.

2008 Countdown to 2015 Conference - Maternal, newborn and child survival
19 April 2008

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The 2nd Countdown Conference was held in Cape Town, South Africa, from 17 to 19 April 2008. It ended with a “Call for G8 leaders and other donors to champion maternal, newborn and child health”. The website of Countdown 2015 contains much information on the Countdown initiative and the Conference, including the 2008 Report (Countdown to 2015 MNCH: The 2008 Report – Tracking Progress in Maternal, Newborn and Child Survival), the Lancet special issue launched in April 2008 and country profiles on progress towards the 2015 Millennium Development Goals related to maternal, newborn and child health prepared for the 68 countries which account for 97% of global maternal, newborn and child deaths. The list includes the following 9 countries in the Region: Afghanistan, Djibouti, Egypt, Iraq, Morocco, Pakistan, Somalia, Sudan and Yemen. As stated on its website, the mission of The Countdown to 2015 is “to track progress made towards the achievement of the United Nations Millennium Development Goals 1, 4 and 5 and promote evidence-based information for better health investments and decisions by policy-makers regarding health needs at the county level.”
 

Findings of the WHO EMRO Pediatric Hydrocarbon Study Group’s study on hydrocarbon (kerosene) poisoning in children published
1 April 2008

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The results of the WHO EMRO Pediatric Hydrocarbon Study Group’s study “A clinical decision rule for triage of children under 5 years of age with hydrocarbon (kerosene) aspiration in developing countries”, supported by this Regional Office, have been published in Clinical Toxicology, Volume 46, Issue 3 March 2008, pages 222 – 229. The study aimed to develop a clinical decision instrument to identify at primary health care facilities in developing countries children under-five exposed to hydrocarbon (kerosene) requiring referral to higher level facilities. The decision aid for referral decision is based on the presence of any of three clinical signs—which health providers trained in IMCI are able to assess—and requires no X-ray or laboratory facilities. It has a high sensitivity of 98% and specificity of 42%. The abstract of the paper can be accessed on the journal’s website. As the decision aid has initially been derived from cases seen only in one poison control centre in one country, it can not be extrapolated to, and needs to be validated in, other settings before it can be recommended for use. This information is provided for scientists of research institutions interested in validating the rule in their settings under strict research conditions. Protocols and instruments used in the study are available from the Child and Adolescent Health and Development (CAH) unit of this Regional Office.
 

Planning for IMCI implementation at district level: a capacity building workshop, Suez, Egypt, 16-19 February 2008
26 February 2008

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A workshop to build capacity of national IMCI coordinators and district staff in planning for IMCI implementation at district level was conducted in Suez, Egypt, from 16 to 19 February 2008. Technically and financially supported by the WHO Regional Office for the Eastern Mediterranean (EMRO) and conducted in Arabic, the four-day workshop was an opportunity not only to introduce the newly developed WHO/EMRO “Regional Guide on Planning for IMCI implementation at District level” to national coordinators from six countries (Egypt, Jordan, Morocco, Sudan, Tunisia and Yemen), but also to use it at the same time with 49 staff of six districts and with the participation of high-level officials of their respective governorates in Egypt. The outcome of the workshop was one-year plans of action for IMCI implementation developed for each district, including human resource development, health system support elements and community component.
 

Home-based treatment for children with severe pneumonia with oral antibiotics as effective and safe as hospital treatment with injectable antibiotics
13 February 2008

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A randomized clinical trial carried out in Pakistan, with support from Boston University School of Public Health and WHO and published in The Lancet, shows that home treatment for children (age 3 to 59 months) with severe pneumonia with oral antibiotics (high dose amoxicillin) is just as effective and safe as hospital treatment with injectable antibiotics (ampicillin), confirming earlier findings from three trials conducted in hospitalized children comparing oral Vs injectable antibiotics. These conclusions do not apply to very severe pneumonia and settings with high HIV prevalence. The implications of these findings are substantial, as they may improve access of children with severe pneumonia to effective treatment while reducing referral, admission, risk of needle-borne infections and treatment and other related costs also for the family. More information is provided here, including the link to the article from The Lancet (371:49-56, 2008).