What "I", "M", "C", "I" mean in I.M.C.I.

I. "Integrated" refers to a number of characteristics of the strategy, in addition to the proposed management approach.

The ultimate aim of this “integration” is for children under-5 to receive holistic care, whether at home, in the community or at the health facility. It is “integrated” because:

It is meant to bring together curative, preventive and development aspects of child care into one strategy;

It is supposed to be managed and coordinated by a committee that draws on managers and experts from different, key public health areas;

It enables the clinical management of priority public child health problems through a standardized, fully integrated approach based on clinical guidelines presented in just one training course package; and

It aims at creating a continuum of care between health system services and the care provided in the community.

M. "Management" here should be seen as having both a clinical and public health meaning.

The IMCI clinical management adopts a syndromic approach, where signs and symptoms are the entry point: cases are “classified” into defined categories of severity based on the presence or absence of a few key signs and symptoms.

The main emphasis is on the resulting action. The classifications have the purpose of enabling the primary health care provider to select a management plan rather than make a precise diagnosis, which would often be impossible at that level based only on clinical grounds and the assessment of a few signs.

Thus, a sick child is "classified" into one of three main categories, highlighted with a colour code:
 "red", indicating severe conditions which need urgent referral to an inpatient facility; "yellow", indicating situations that can be managed at the health centre—often with drugs—but that require definite follow-up; and"green", indicating mild conditions which require simple home care.

Apart from the clinical management of sick children, many things have to be in place to deliver child care, both in the health system and in the community. These aspects of health care represent the public health meaning of management.

C. "Childhood" here refers to children below 5 years of age, which is the child age group most vulnerable to illness and death.

Investing in this age group gives also great rewards for their future development and the society as a whole. They are the current targets of IMCI. It is the same age group that was originally targeted by such programmes as the control of diarrhoeal diseases and acute respiratory infections.

At the beginning, the global IMCI clinical guidelines did not cover the first week of life, but several countries in the Region decided to include this period also in their adapted guidelines. Much work is currently being undertaken to address the issue of neonatal health.

I. "Illness" is used in public health terms, to address conditions that are first of all a major cause of death, severe illness or disability in children under-5.

These conditions include:

acute respiratory infections—including pneumonia;diarrhoeal diseases, including dehydrating diarrhoea, dysentery and persistent diarrhoea; meningitis and sepsis;  malaria;  HIV/AIDS; measles;  ear infections; malnutrition; and  anaemia.

IMCI therefore is not comprehensive paediatrics but focuses on public child health priorities in under-fives.

In the Eastern Mediterranean Region, the acronym "IMCI" has remained but "illness" has been replaced with the more holistic concept of "health".