History of IMAI

1998: in response to interest from countries and donors that something comparable to IMCI needed to be developed for adults; first concept paper to the DG and other WHO departments in Geneva. Attempts to get collaborative group started. 1998: in response to interest from countries and donors that something comparable to IMCI needed to be developed for adults; first concept paper to the DG and other WHO departments in Geneva. Attempts to get collaborative group started. 2001: Grant from the Rockefeller Foundation for the development of syndromic management of HIV; international IMAI working group created 2001: Grant from the Rockefeller Foundation for the development of syndromic management of HIV; international IMAI working group created

History of IMAI: Acute Care The syndromic algorithm was developed from a variety of sources: The syndromic algorithm was developed from a variety of sources: Existing protocols—the STI and diarrhoea protocol had been previously developed at WHO with extensive testing. Existing protocols—the STI and diarrhoea protocol had been previously developed at WHO with extensive testing. Based on other protocols—"Cough or difficult breathing" based on PAL, in development since 1998 by STB Department, with expert group. Based on other protocols—"Cough or difficult breathing" based on PAL, in development since 1998 by STB Department, with expert group. Review by existing expert groups—malaria-related protocols reviewed by RBM's expert group. Review by existing expert groups—malaria-related protocols reviewed by RBM's expert group. Review by new expert groups—"Skin problem or lump" was particularly difficult; mental health working group still in existence. Review by new expert groups—"Skin problem or lump" was particularly difficult; mental health working group still in existence.

History of IMAI: Acute Care Field testing Field testing Mouth or throat tested in Tanzania Mouth or throat tested in Tanzania Signs of acute bronchitis in Kenya Signs of acute bronchitis in Kenya Early draft of the algorithm tested in industrial clinics in Zimbabwe Early draft of the algorithm tested in industrial clinics in Zimbabwe Validation study of nurses vs. doctors with lab Validation study of nurses vs. doctors with lab 1000 patients in KZN; resulted in some adjustments to "cough or difficult breathing" and "fever" 1000 patients in KZN; resulted in some adjustments to "cough or difficult breathing" and "fever"

History of IMAI: Chronic HIV Care Developed out of review of literature and project experience; operationalizes the recommendations in Scaling Up ARV Therapy in Resource-limited Settings Developed out of review of literature and project experience; operationalizes the recommendations in Scaling Up ARV Therapy in Resource-limited Settings Approach reviewed at the Zambia consultation (11/03), by multiple WHO departments and international partners (ITM, Columbia MTCT+, etc) Approach reviewed at the Zambia consultation (11/03), by multiple WHO departments and international partners (ITM, Columbia MTCT+, etc) October 2003: ART added and reviewed by expert group October 2003: ART added and reviewed by expert group Training materials tested in Uganda in early 2004; paediatrics added Training materials tested in Uganda in early 2004; paediatrics added

History of IMAI: Palliative Care 2002: developed with Hospice Uganda and other palliative care experts based on evidence-based reviews 2002: developed with Hospice Uganda and other palliative care experts based on evidence-based reviews 2003: international review meeting in Uganda including 4-5 countries; training course also pretested. 2003: international review meeting in Uganda including 4-5 countries; training course also pretested. 2003: Reviewed at an international consultation on palliative care in Botswana 2003: Reviewed at an international consultation on palliative care in Botswana