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Technical updates of the guidelines on Integrated Management of Childhood Illness (IMCI): evidence and recommendations for further adaptations.
Geneva, Switzerland, WHO, 2005.  p.It is over seven years since IMCI has been introduced and much has been learnt through the adaptation and implementation processes in countries. The Department of Child and Adolescent Health and Development (CAH) and other institutions have undertaken work to evaluate the evidence base for the technical guidelines of the IMCI strategy. Research results are emerging with potential implications for updating the technical guidelines of IMCI. In 2001 CAH, jointly with Roll Back Malaria, organized a technical consultation to examine the evidence base for the IMCI strategy for the management of malaria and other febrile illnesses including measles and dengue haemorrhagic disease. This international consultation came up with recommendations to improve the guidelines, as well as specific recommendations for operational research. Following the technical consultation, CAH held a series of meetings within the Department at HQ in addition to consultations with regional office staff where the updating process was discussed. In 2004 it was recommended that CAH finalize the IMCI updates on the basis of the best available evidence and country programme feedback, prioritizing those updates most likely to reduce child mortality. (excerpt)
Washington, D.C., Pan American Health Organization [PAHO], Division of Health Promotion and Protection, Food and Nutrition Program, . 37 p.Adequate nutrition during infancy and early childhood is fundamental to the development of each child’s full human potential. It is well recognized that the period from birth to two years of age is a “critical window” for the promotion of optimal growth, health and behavioral development. Longitudinal studies have consistently shown that this is the peak age for growth faltering, deficiencies of certain micronutrients, and common childhood illnesses such as diarrhea. After a child reaches 2 years of age, it is very difficult to reverse stunting that has occurred earlier. The immediate consequences of poor nutrition during these formative years include significant morbidity and mortality and delayed mental and motor development. In the long-term, early nutritional deficits are linked to impairments in intellectual performance, work capacity, reproductive outcomes and overall health during adolescence and adulthood. Thus, the cycle of malnutrition continues, as the malnourished girl child faces greater odds of giving birth to a malnourished, low birth weight infant when she grows up. Poor breastfeeding and complementary feeding practices, coupled with high rates of infectious diseases, are the principal proximate causes of malnutrition during the first two years of life. For this reason, it is essential to ensure that caregivers are provided with appropriate guidance regarding optimal feeding of infants and young children. (excerpt)