Plan for the Introduction of IMCI Teaching

In most academic programmes, elements of IMCI will be integrated across different teaching units and subunits, as well as throughout several terms or years of the programme. Key staff at a teaching institution should create a written plan of action that identifies the academic programme or programmes where IMCI will be incorporated. The plan should describe when and where elements of IMCI should be placed within a relevant academic programme. In addition, the plan should describe

1.2 TEACHING INSTITUTION(S)

I[ Analyse the situation*

I[ Orient decision-makers*

I[ Create an IMCI Working Group*

I[ Train key planners*

I[ Plan for the introduction of IMCIteaching*

D Request endorsement of the plan

how the teaching institution will: orient decision-makers; train teachers and relevantclinical staff; develop or adapt materials for teaching, learning and student assessment; prepare clinical practice sites; coordinate IMCI teaching between different units and subunits; and monitor and review teaching.

Objectives

The objectives of planning for the introduction of IMCI teaching are to:

• Confirm the commitment of administration and staff to introducing IMCI into relevant academic programmes;

• Identify into what academic programme(s) IMCI should be incorporated; and

• Prepare a written plan of action (including a budget and timeline) to guide the incorporation of IMCI into each relevant academic programme.

Timing

Planning for the introduction of IMCI teaching may begin at any time. However, experience has shown that it is generally more effective to orient and train key decision-makers and planners before they finalize a written plan of action. For more information, see the tasks called Analyse the Situation, Orient Decision- Makers and Train Key Planners in section 1.2 of this guide.

W ho Should Develop the Pla n ?

Key representatives of relevant teaching units, subunits and clinical practice sites should prepare a plan of action for introducing IMCI teaching. Key planners

should involve students, as well as representatives of the Department of Education and the Department of Staff Development. They may also request assistance from national or state authorities, or from the National Working Group for IMCI Pre- Service Training. For certain categories of teaching institutions, a curriculum development group may develop a single plan of action at national or state level for several institutions with similar certificate, diploma or degree programme.

For more information, see the tasks called Create a National Working Group and Assist Teaching Institutions with Staff Orientation and Planning in section 1.1 of this guide. See also Analyse the Situation and Create an IMCI Working Group in section 1.2 of this guide.

Description

The purpose of this task is to plan for the introduction of IMCI teaching. The outcome should be a written plan of action (including a budget and timeline) for incorporating IMCI into a relevant academic programme. When developing a plan of action for the introduction of IMCI, administrators and staff should discuss where IMCI might fit within existing teaching agendas. Normally, theintroduction of IMCI into a relevant academic programme does not require arevision of the existing written curriculum. Instead, it should encourage a revision of teaching content and methods to foster a more holistic view of the child, better communication with the caretakers of sick children, and clinical practice in outpatient health facilities.

The planning process may be completed in stages. The first stage would consist of a small group that develops a preliminary plan of action. This preliminary plan of action should be reviewed by representatives of relevant teaching units, subunits and clinical practice sites and subsequently revised, as needed, to produce a final plan of action.

Experience has shown that the plan for introducing IMCI teaching should:

• Be tailored to the needs and resources of teaching institutions;

• Include learning objectives related to all three components of the IMCIstrategy;

• List the key teaching units, subunits and clinical practice sites that should be involved in IMCI teaching;

• Identify feasible entry points for IMCI within a relevant academic programme;

• Ensure that IMCI is recognizable to students as both a public health strategy and as a clinical approach to the management of sick children;

• Strive to integrate different subjects within an existing academic programme, rather than fragment IMCI into different subjects;

• Identify opportunities for students to practise the full process of “integrated” case management, including assessment of feeding problems and counselling of caretakers;

• Describe how students will be assessed for IMCI knowledge and skills, including both formative and summative assessment.

• Identify how teachers and relevant clinical staff will be trained in IMCI;

• Indicate how materials for teaching, learning and student assessment will be developed or adapted;

• Identify mechanisms for creating a sustainable supply of materials and trained teachers;

• Outline how the implementation of the plan will be monitored and reviewed;

• Indicate whether or not the formal written curriculum should be revised, and if so, when and how; and

• Include a budget, timeline and possible funding sources.

Sug g ested A c tivities and Materials

Three types of activities are suggested in planning for the introduction of IMCIteaching:

• Conduct a planning workshop. A planning workshop can help launch the process and add visibility to the critical task of planning. The workshop may be conducted at a teaching institution with representatives from relevant teaching units, subunits and clinical practice sites. Appropriate representatives from the national or state working group on IMCI pre-service training should participate in the workshop. During the workshop, participants should selectan academic programme where IMCI will be introduced. They also shouldidentify who will prepare for IMCI teaching, where IMCI clinical practice will take place, how teachers will be trained, and how materials for teaching, learning and student assessment will be developed or adapted. (See Annex 1 for a Sample Agenda of a Planning Workshop for IMCI Pre-Service Training, Outline of a Plan of Action for Introducing IMCI into an Academic Programme, List of Possible Materials for IMCI Teaching, Learning and Student Assessment and other useful planning materials.)

• Hold meetings to revise and finalize a written plan of action. Representatives from relevant teaching units, subunits and clinical practice sites should work together to review, revise and finalize a written plan of action for introducing IMCI into an academic programme or programmes. See Annex 1 for an

Outline of a Plan of Action for Introducing IMCI into an AcademicProgramme and a sample timeline.

The plan of action should specify learning objectives for all three components of the IMCI strategy. The following materials may be consulted when defining learning objectives for IMCI:

Component 1 - Improving the case management skills of health staff to prevent and manage common serious childhood conditions. Refer tothe List of Possible Learning Objectives for IMCI in Annex 1 of this guide.

Component 2 - Improving the health system to support the effective management of common serious childhood conditions. This component covers subjects such as: the availability of drugs, vaccines and other essential supplies and equipment; referral pathways; the organization of work at health facilities; supervision of health staff; health information systems (HIS); patient satisfaction; and cost of care (i.e. insurance). Materials that may help planners identify possible learning objectives related to this component include the IMCIplanning guide17 and the IMCI information sheet titled Planning national implementation of IMCI (WHO/CHS/CAH/98.1C REV.11999).18

Component 3 - Strengthening practices within families and communities to support the prevention and management of common serious childhood illnesses. Materials that may help identify possible learning objectives for this component include: Improving family and community practices: A component of the IMCI strategy (WHO/CAH/98.2)19 and the IMCI information sheet titled, The role ofIMCI in improving family and community practices to support child health and development (WHO/CHS/CAH/98.1G, REV.1 1999).20

17 IMCI planning guide: Gaining experience with the IMCI strategy in a country. Geneva, World Health

Organization, 1999 (unpublished document WHO/CHS/CAH/99.1, p. 5; available on request from Department of Child and Adolescent Health and Development, World Health Organization, 1211 Geneva 27, Switzerland – Fax:+41 22 791 4853, email: CAH@who.int).

18 Planning national implementation of IMCI. Geneva, World Health Organization, 1999 (unpublished document

WHO/CHS/CAH/98.1C, REV.1 1999; available on request from Department of Child and Adolescent Health and Development, World Health Organization, 1211 Geneva 27, Switzerland – Fax: +41 22 791 4853, email: CAH@who.int).

19 Improving family and community practices: A component of the IMCI strategy. Geneva, World Health

Organization, 1998. (unpublished document WHO/CAH/98.2; available on request from Department of Child and Adolescent Health and Development, World Health Organization, 1211 Geneva 27, Switzerland – Fax: +41 22 7914853, email: CAH@who.int).

20 The role of IMCI in improving family and community practices to support child health and development,

Geneva, World Health Organization, 1999 (unpublished document WHO/CHS/CAH/98.1G, REV.1 1999;

The plan of action should include a description of the specific activities needed to: train teachers; orient decision-makers; develop or adapt materials for teaching, learning and student assessment; prepare clinical practice sites; coordinate IMCI teaching between departments and sub-departments; and monitor and review teaching. The plan should specify the time period over which the activities will take place (e.g. 12 months, 18 months, etc.). It should also include a timeline and budget.

. Submit the written plan to national or state authorities (e.g. the National Working Group for IMCI Pre-Service Training) and to relevant technical and donor agencies.

Before developing a plan of action, it will be helpful to review the Report of an intercountry workshop on IMCI pre-service training: Geneva, 2.5, November1999 (WHO/FCH/CAH/00.11).21 This document summarizes experiences and lessons learned with the introduction of IMCI in more than 13 teachinginstitutions.

Request Endorsement of the Plan

Once the plan of action is finalized, the IMCI focal person at a teaching institution should circulate the plan to request agreement or endorsement from persons and groups who will be critical to the implementation of the plan. It is particularly important for directors of relevant teaching units, subunits and clinical practice sites to endorse the plan. It is also important to request agreement and support from: relevant national academic associations (e.g. Association of Medical Schools, Association of Nursing Schools,

1.2 TEACHING INSTITUTION(S)

I[ Analyse the situation*

I[ Orient decision-makers*

I[ Create an IMCI Working Group*

I[ Train key planners*

I[ Plan for the introduction of IMCIteaching*

I[ Request endorsement of the plan

etc.); technical and donor agencies; and relevant national authorities such as theMinistry of Health and the Commission on Higher Education.

available on request from the Department of Child and Adolescent Health and Development, World HealthOrganization, 1211 Geneva 27, Switzerland – Fax: +41 22 791 4853, email: CAH@who.int).

21 Report of an intercountry workshop on IMCI pre-service training: Geneva, 2.5, November 1999. Geneva, World Health

Organization, 2000 (unpublished document WHO/FCH/CAH/00.11; available on request from the Department of Child and Adolescent Health and Development, World Health Organization, 1211 Geneva 27, Switzerland – Fax: +41 22 791 4853, email: CAH@who.int).