Barriers and Enablers of Integrated Management of Childhood Illness Implementation: Desk Review Report

While IMCI has been widely accepted as a strategy, not enough attention has been placed on the complicated health system challenges that impede IMCI implementation, including complex factors such as human resources, supply chain, health information systems, governance, and financing. While these health system challenges are widespread across programs, IMCI programs specifically lack governance and leadership, making these issues more pronounced. Understanding the root causes of why IMCI is not functioning well—at national, district, and facility health systems levels—is important to maximize the great potential that IMCI has to further decrease newborn and child mortality and increase quality of life for children. The vast majority of reviews of the issues with IMCI implementation have focused on adherence to the IMCI protocol and challenges at the facility level. This desk review is unique in that it looks at IMCI implementation from a health systems perspective and explores challenges and facilitators at various levels of the health system, with a focus on governance and management.