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World Health Organization, 2001This document is not a formal publication of the World Health Organization (WHO), and all rights are reservedby the Organization. The document may, however, be freely reviewed, abstracted, reproduced and translated,in part or in whole, but not for sale nor for use in conjunction with commercial purposes.The views expressed in document by named authors are solely the responsibility of those authors.

Contents

Integrated Management of Childhood Illness...................................................................1The inequities of child health......................................................................................1Rationale for an evidence-based syndromic approach to case management.............2Components of the integrated approach.....................................................................3The principles of integrated care................................................................................4Adapting the guidelines to a country’s situation..........................................................5The IMCI case management process.........................................................................5Outpatient health facility.......................................................................................5Referral health facility...........................................................................................5Appropriate home management...........................................................................5Outpatient management of children age 2 months up to 5 years.....................................7Assessment of sick children.......................................................................................7Communicating with the caretaker........................................................................7Checking for general danger signs.......................................................................8Checking main symptoms.................................................................................... 9Cough or difficult breathing............................................................................ 9Diarrhoea......................................................................................................11Fever............................................................................................................16Ear problems................................................................................................20Checking nutritional status - malnutrition and anaemia.......................................22Assessing the child's feeding..............................................................................24Checking immunization status............................................................................24Assessing other problems..................................................................................25Treatment procedures for sick children.....................................................................25Referral of children age 2 months up to 5 years.................................................26Treatment in outpatient clinics............................................................................28Oral drugs.....................................................................................................28Treatment of local infections.........................................................................29Counselling a mother or caretaker................................................................32Follow-up care..............................................................................................34

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