Lessons from the past

The IMCI (Integrated Management of Child Health) pre-service training initiative is not a new undertaking. In fact, it much relies on the experience gained with the introduction of other public health programmes in pre-service education and builds on the lessons learnt from that.

Past experiences

This experience especially includes the Expanded Programme on Immunization—or EPI (especially for health professional allied schools), the Control of Diarrhoeal Diseases—or CDD—and promotion of breastfeeding, and the Acute Respiratory Infection control programme—or ARI—.

Lessons

From those past experiences on pre-service training, positive lessons have been drawn, concerning:

the closer collaboration between ministries of health and academic institutions;

the setting up of national IMCI task forces;

the structured format of the high quality orientation workshops held for medical and paramedical schools;

the introduction of standardized clinical protocols and increased attention paid to priority public child health problems in undergraduate teaching; and

interest in research oriented to solve implementation issues.

Issues

At the same time, many factors have been identified which were inadequately addressed and thus adversely affected the impact and long-term sustainability of those initiatives. Most of the emphasis was placed on the orientation workshop, with less attention given to the setting up of a coordinating structure within the concerned teaching institutions. Only one or two representatives from each concerned school participated in the orientation workshops, too few to bring about major changes and receive adequate support when they returned to their schools. The lack of a standard approach to institutionalizing the innovative teaching approach within each school had an adverse impact on its long-term sustainability.

The need

However, the need for a pre-service approach in child health was so logically and strongly felt by ministries of health in the Region that the WHO Regional Office involvement was a natural response to this call, despite the lack of global guidelines and scepticism among some partners. A similar demand followed also in other Regions.

A new approach

The lessons learnt from the past were carefully reviewed in the Region to develop the IMCI pre-service education initiative, leading to a regional framework, a recommended step-by-step approach and an IMCI pre-service education package. This approach is described in “Phases of IMCI pre-service training”.

Related link:

IMCI pre-service education package