• Youssef M Tawfik, Stephane Legros, and Colette Geslin.
• Senior Child Survival Advisor, Support for Analysis and Research in Africa (SARA) Project, Academy for Educational Development, 1875 Connecticut Avenue, NW, Washington DC, 20009 USA. ytawfik@aed.org
• BMC Int Health Hum Rights. 2001 Jan 1; 1 (1): 1.

BackgroundWHO and UNICEF have recently developed the "Integrated Management of Childhood Illness" (IMCI) as an efficient strategy to assist developing countries reduce childhood mortality. Early experience with IMCI implementation suggests that clinical training is essential but not sufficient for the success of the strategy. Attention needs to be given to strengthening health systems, such as supervision and drug supply. ResultsThis paper presents results of evaluating an innovative approach for implementing IMCI in Niger. It starts with strengthening district level supervision and improving the availability of child survival drugs through cost recovery well before the beginning of IMCI clinical training. The evaluation documented the effectiveness of the initial IMCI clinical training and referral. ConclusionsStrengthening supervision and assuring the availability of essential drugs need to precede the initiation of IMCI Clinical training. Longer term follow up is necessary to confirm the impact of the approach on IMCI preparation and implementation.

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