2nd Inter-Regional Integrated Management of Childhood Illness (IMCI) Case Management Course for Consultants
A Report to CORE Members from Larry Casazza (World Vision)
On behalf of CORE, Larry Casazza (World Vision) attended the WHO course held at El Shatby Children's Hospital, Alexandria, Egypt from July 28 - August 08, 2000 to experience the course first hand, to assess opportunities to integrate the community components of IMCI with this training, and to acquire skills that will be useful to CORE participants who might become engaged in IMCI Healthworker Case Management Training.
Under the direction of Dr. Suzanne Farhoud, WHO EMRO, 27 participants from eleven countries were involved. There were adequate well-trained instructors and facilitators to allow for thorough, individual interaction. The hospital facility is a major pediatric referral point and was able to provide sufficient number of patients for clinical observation and management by the participants throughout the course.
The community component of IMCI is only beginning to be designed and considered as an integral part of Egypt's national IMCI Initiative. Dr. Farhoud has keen interest in strengthening the community component and is seeking collaboration with CORE partners. She has issued an invitation to CORE to participate in the upcoming WHO-EMRO IMCI Consultation in November 2000.
The course represents WHO's latest attempt to improve the skills of health workers in IMCI. While this course is considered "self taught," it adheres to a strict format as laid out in the modules with little room for interaction. No longer are there class oral readings or homework assignments. While the degree of skill acquisition that results from the intense training is high, there was little room for consideration of operational program compliance issues. Those practitioners who have successfully completed the course are fully trained in all the counseling messages, such as nutritional instruction, when to return for follow up, medication to be administered at home, etc. But they are not challenged during the course to grapple with compliance issues they might expect in their clientele after a successful visit to the health facility. While these realities are fully acknowledged by the participants, yet brainstorming around possible ways of addressing constraints due to geographic access, economic limitations, cultural barriers between health worker and client are left un-addressed. Thus, a practitioner might leave the course fully confident in his newly acquired clinical skills, but unprepared to meet the operational realities on his return home.
For a full report on the training, including many interesting specific course observation and recommendations, contact The CORE Group.