Laying the foundation of “child health”—as opposed to only “child survival”—is seen by this Regional Office as a key approach to child care (see also IMCI).

This applies to most settings, whether under-five mortality is high or low: in fact, promoting child health helps not only foster healthy growth and development but also reduce child vulnerability to illness—and eventually disability and deaths.

The aim should be to build “stronger” children and prevent their illness rather than just wait for them to get sick in order to treat them. Also, children should be helped to develop to their best potential.

For example, nutrition and psychosocial interventions, especially when started early in life, can have a significant impact on child physical growth and cognitive and motor development also in disadvantaged children who live in a poor environment and are at higher risk of malnutrition, illness and poor development.

A number of key family practices contribute to these aims, e.g. exclusive breastfeeding, complementary feeding, personal hygiene, immunization, use of insecticide-treated bednets, caring for psychosocial development, and, before the child is born, antenatal care.

This principle has led to an evolution of the IMCI strategy in the Eastern Mediterranean Region, re-named “Integrated Management of Child Health”, to address both the healthy and sick child.

The Regional Office Child Health and Development programme has assisted a few countries in pursuing this objective by helping “revitalize” well child clinics and standardize the approach to child care at primary health care level.

Two countries, namely Syrian Arab Republic and Tunisia, have developed a training module on the healthy child and included it in the standard IMCI training course.

The module includes such aspects of child care as checking the child vaccination status, growth monitoring, early screening of eye refractory errors and other impairments, counselling on feeding—including breastfeeding and complementary feeding, and oral health. An attempt has also been made to strengthen the link with maternal care.

Another country which has recently included the healthy child component in its IMCI training for nurses for children aged from birth up to 5 years is Morocco.

Click on the hyperlink to see an exemplification of the flow of children taken to a primary health care facility according to the new approach.