Management structure

IMCI (Integrated Management of Childhood Illness) brought about many significant changes compared with the vertical programmes from which it evolved. It was meant to be managed by a committee or working group, rather than a programme manager, cutting across key child health-related and health system programmes.

The committee was to be chaired by a senior official of the ministry of health with decision-making authority, and to be supported in its work by a focal point acting as its secretariat.

The committee also oversaw and coordinated a technical process of adaptation of the IMCI guidelines to the country, bringing in the best expertise available in the country to build a consensus in the scientific and public health community. Although time consuming as a process, this created a strong foundation for partnerships within the ministry of health and with academia in many countries in the Region.

A potential constraint of the management approach proposed was the lack of visibility of a specific management structure such as that developed for vertical programmes that could be allocated also a budget line for its operations. Some countries therefore appointed a ‘programme manager’ also for IMCI (e.g. Egypt, Sudan, Syrian Arab Republic and Tunisia), while establishing their IMCI steering committees and working groups.

In countries in the Region, IMCI was usually placed in the Primary Health Care department.