IMCI and Primary Health Care

The conceptual framework of IMCI (Integrated Management of Childhood Illness) is very close to the ideology of primary health care, as defined in the Alma-Ata Declaration on Primary Health Care, to the extent that in many countries in which it has been introduced IMCI has been seen as “primary child health care”. It is currently promoted in the Region as such.

IMCI is public child health: it is “essential health care” in that it aims to address the “main health problems” of under-five children in a country, based on epidemiological evidence.

While leading causes of under-five mortality have been targeted as a priority and reduction of under-five morbidity and disability have remained key objectives of the strategy, attention has increasingly been placed also on child development.

IMCI is based on “scientifically sound methods”, following a thorough process which relies on expert opinion and research.

It promotes a technology that is affordable and does not require sophisticated laboratory facilities, equipment and supplies.

It proposes an “integrated” approach, to bring together the main elements of child care instead of vertical programmes.

The IMCI community component advocates for community participation, in line with the PHC principles, as a means of achieving sustainability.

IMCI focuses on “the first level of contact of the community with the national health system”.

It promotes a close-to-client approach to provide access to quality child health care, especially for those who need it most—the poor and most disadvantaged.

The child health interventions that are promoted under the IMCI umbrella include those that have widely been recognized as most effective by the international scientific community. These interventions aim not only at curing illness, but also at preventing it and promoting health.

In the same way as PHC has developed differently in different countries, IMCI experiences have differed in different countries and evolved according to country capacity and needs in our Region (e.g. going beyond illness to promote healthy growth and development in children in countries in which under-5 deaths have been decreasing steadily over the years).

The critical role played by policies has been recognized and an initiative has been launched in the Region to support countries in developing national child health policies.

IMCI strives to promote a public health response that provides cost-effective and evidence-based child health care services.

“Child health care” is one of the core activities included in the Alma-Ata definition of primary health care.

Many challenges remain, including the achievement of universal access and coverage, financing and closer collaboration with partners and the private sector.