Process

The final product of the adaptation process of the IMCI (Integrated Management of Childhood Illness) guidelines must be the result of a large consensus achieved within the professional community in the country.

IMCI working group

The process therefore requires good coordination and a specific group established for this particular task, the adaptation sub-group, which reports to the main IMCI Working Group or Committee.

In some countries, this sub-group consists of several teams of experts, each working on the adaptation of specific issues. Resource persons from the country are consulted throughout the process, whether within or outside the adaptation sub-group.

In most countries in the Region, the Child and Adolescent Health and Development unit of the Regional office has provided direct technical support to the adaptation process.

Duration

The duration of the process varies from country to country, from a few months to a year or more.

This process is however very important, playing an advocacy role and giving a sense of ownership, and is therefore key to future implementation of the IMCI strategy. This is because it brings together representatives of the Ministry of health, professional societies and academe, including medical schools, international and bilateral organizations, to generate an output by broad consensus.

Consensus

This consensus promotes further collaboration during implementation and reinforces the foundation of the strategy in the country. For example, senior, highly respected paediatricians in countries have joined in-service IMCI training courses as facilitators, participated in follow-up visits after training and eventually played a leading role in the introduction of the IMCI approach in medical schools.

The adaptation process concerns not only the clinical guidelines, but also the feeding recommendations and the care-seeking process, by identifying local terminology used in communi¬ties to refer to illness entities and to be used in health communication initiatives.