Update on the regional review of IMCI strategy implementation
The review of progress on the Integrated Management of Childhood Illness (IMCI) strategy in the WHO European Region aims to define factors facilitating or hindering implementation for the improvement of child care access and quality in 16 countries. The overall objectives of the process are to:
- review and synthesize the status of IMCI implementation as well as its relevance, efficiency and effectiveness in providing quality care;
- gain a deep understanding of factors leading to the adoption of IMCI and its sustainability in countries, or why IMCI was not scaled up and sustained; and
- collate lessons learned and inform future steps for providing primary and referral care to children in Europe.
Investigators tested and adjusted the review tools for the first time in Uzbekistan and Kyrgyzstan. They used the IMCI impact model to enquire into IMCI implementation status, barriers and shortcomings within the specific country contexts. In the preparatory phase, they compiled background information from available technical documentation; national partners then validated this information during country visits.
Interviews with key informants and focus groups took place on 10–12 October in Uzbekistan, on 13–14 and 17–18 October in Kyrgyzstan, on 17–18 November in the Russian Federation and on 22–25 November in Ukraine. Key informants included stakeholders from ministries of health, national maternal and child health centres, universities, colleges, and international and partner organizations, as well as district health facility managers and health workers such as doctors and nurses.
At the end of the visits, debriefing meetings took place in Uzbekistan with Deputy Minister of Health Dr Laziz Tulchiev and key national experts in maternal and child health; in Kyrgyzstan with Chief Paediatrician of the Ministry of Health Dr Elnura Boronbaeva; and in Ukraine with Deputy Minister of Health Dr Oleksandr Linchevsky and staff from the department of maternal and child health.
The constraints and enabling factors revealed by the country reviews can be grouped into 3 major domains: socioeconomic and policy issues; health system issues; and individual/organizational behaviours. The findings in Kyrgyzstan, the Russian Federation, Ukraine and Uzbekistan will contribute to the final regional report.