2. IMCI Unit AFRO Going to scale: Experience with Community IMCI Meeting of RBM and IMCI Task Forces 24 th –26 th September 2002 Harare, Zimbabwe Presentation by IMCI AFRO

3. IMCI Unit AFRO Community IMCI … is an integrated child care approach that aims at improving key family and community practices that are likely to have the greatest impact on child survival, growth and development

4. IMCI Unit AFRO WHY SHOULD WE FOCUS ON THE HOME? Healthy life style starts at home Home is where treatment of sick children start using locally purchased medicine A big segment of the population in developing countries do not have access to health facilities Even where access to health facilities is reasonably good, most children die at home without seeking any health care outside the home

5. IMCI Unit AFRO –documented/greatest impact on mortality –feasible to implement in countries –Cost-effective –address major problems on child health, nutrition and development –Focus on behavior change IMCI Key Family and Community Practices

6. IMCI Unit AFRO Key Family Practices Growth Promotion &Development Exclusive breastfeeding for 6m Appropriate complementary feeding from 6m whilst continuing BF up to 24m Adequate micronutrients through diet or supplementation Promote mental and psychosocial development Home Management Continue to feed and offer more food & fluids when child sick Give child appropriate home treatment for infections Take appropriate actions to prevent and manage child injuries and accidents

7. IMCI Unit AFRO Key Family Practices.. contd. Care Seeking & Compliance Take child to complete full course of immunization before 1 st birthday Recognize when child needs treatment outside home and take to HW Follow HW advice about treatment, FU and referral ANC attendance and TT vaccination during pregnancy Active participation of men in childcare and reproductive health activities Disease Prevention Proper disposal of faeces, hand washing etc Child sleeps under ITN Prevention and care of HIV/AIDS Prevent child abuse/neglect & taking appropriate action

8. IMCI Unit AFRO Countries with c-IMCI Orientation Meeting IMCI Unit AFRO Common understanding Share information Identify stake holders Consensus on way forward

9. IMCI Unit AFRO COUNTRIES WITH PLAN FOR C-IMCI Planning at national and district levels Partners collaboration in planning

10. IMCI Unit AFRO C-IMCI SITUATION ANALYSIS (11 countries) To understand the current situation at district and national levels Sharing of experience Identifying the various partners and planning together Revise policy and guidelines

11. IMCI Unit AFRO Breastfeeding Indicators (%) Source Uganda DHS 2000 Tanzania MCE HH Survey 1999 DRC Situational Analysis 2002

12. IMCI Unit AFRO Use of mosquito nets Source Uganda DHS 2000 Tanzania MCE HH Survey 1999 DRC Situational Analysis 2002

13. IMCI Unit AFRO Management of sick children at home

14. IMCI Unit AFRO Regional level support Development of Briefing Package for planning of C-IMCI Developed for use by facilitators/ consultants who would assist countries in the planning for c-IMCI Pre tested in Benin in February 2002 Field test conducted, 15 countries (10 Anglophone and 5 francophone) involved Revision to be done in early October Manual on the recommendation for home care CHWs training manual Other materials to be developed

15. IMCI Unit AFRO Opportunities Constraints Selection of priority practices: -Effective -Feasible -Pertinent -Acceptable -Cost effective Community and community interventions What are the community needs? What does the community know? -Information -Knowledge What does the community have? -Practices -Community health services -Resources -Previous/existing interventions -Others sectors -Links with the health system IMCI/Child Health Strategy Document Strategic Plan for IMCI/Child Health Recommendations on Priority practices Strategy Document for the C-IMCI Situation analysis C-IMCI Briefing Package

16. IMCI Unit AFRO Community IMCI : Implementation Status Countries with child health related community interventions IMCI Unit AFRO Countries with C-IMCI in more than 3 Districts

17. IMCI Unit AFRO KEY FACTORS FOR SCALING UP C-IMCI : LESSONS LEARNT Advocacy and Resource Mobilization Showing Impact Partnership Documentation and sharing of experience Building on existing structures (and not substituting community resources )