Summary of Country presentations Group 1: Template

2 BANBHUDPRKINOSRL Number and Proportion of districts implementing IMCI 54 (84%) 20 (100%) 97 counties 8 province No dataNo full IMCI Proportion of districts (out of IMCI districts) with 60 % or more health providers trained na100%22,500 staff trained 12,556 staff ?Standard guideline s develope d IMCI supervisory checklists introduced YES (rev) Proportion of first-level health facilities that had at least one supervisory visit over a period of 6 month during previous year na100% biannua l 22,500 staff trained No dataTrained estate medical assistant s Proportion of districts (out of IMCI districts) covered with Follow-up IMCI training na100%No data IMCI Review done (If yes, year) June 2008 IMCI Implementation

3 BANBHUDPRKINOSRL IMCI implementation review conducted (If yes, year; National or sub-national) 2003 subnati onal 2011 June , 2009 subnational IMCI Health Facility Survey conducted (If yes, year; National or sub-national) 2008NO 2008, districts Proportion of first-level health facilities with at least one health worker who cares for children trained in IMCI >90%100%4,118? Pre-Service IMCI teaching / training NA Number and proportion of Medical Schools teaching IMCI 48 (88%) All 100% > 70 schools Number and proportion of Nursing Schools teaching IMCI nil1 (100%) All government schools? IMCI Implementation

4 Key factors that helped scaling up 1. Conducive policy environment (BAN) 2. Continued commitment and support (BAN) 3. Strong partnership with NGOs, academics (BAN) 4. Long-term posting programme office (BHU) 5. Core team of trainers (BHU) 6. Standard recording forms available in HF (BHU) 7. Implementation of regular supervision (BHU) 8. Formation of child health advisory group (BHU) 9. Responsible IMCI management teams at national and provincial level (DPRK) 10. IMCI well integrated with nutrition activities. Newborn and maternal care (DPRK) 11. Part of national strategy (INO) 12. Budget from multiple sources (INO) 13. Inclusion IMCI in curriculum medical doctors and midwives (INO) 14. Strong health system organization (SRL)

5 IMCI Implementation Key challenges to scaling up: 1. Lack/continuity of supervision and monitoring (BAN) (BHU) (INO) 2. Utilization of pooled funds (BAN) 3. Weak health system to scale-up integrated approach (BAN) 4. Rapid turn-over of health workers (BHU) 5. Decentralization (INO) 6: Inadequate programme coordination (province, districts) (INO) 7. High turn-over programme staff (INO) 8. Scaling up (INO) 9. Malnutrition in spite of low mortality – need to strengthen focus on family behaviours and community practices (SRL)

6 BANBHUDPRKINOSRL ENC Course: Number / Proportion of Healthcare providers trained Pocket book for newborn 2007 MOs222 (34%) 64.8% Nurses247 (17%) mostly 21.5% CHW / CHV12,000 out of 80,000 Pocket book No training 19.6% Referral Care: Number / proportion of Healthcare providers trained ETAT Pocket book all hospita ls NO MOsna Nursesna Proportion of hospitals providing pediatric care having oxygen: 483 (82%) 31 hospita ls (all) Sample:100% cylinder, 77% concentrators Hospital assessment using WHO tools: Number of Hospitals covered 6 DH 12 UCH (2009 ) Done on sample Newborn care and Referral Care

7 Number and Proportion of districts implementing CHW approach BAN 71 BHUDPRKINOSRL Home based newborn care 25 (39%) 0%CMAM 25 counties Sick child package 35 (55%) 9 (45%) 5 pilot districts Healthy child package (ECD) NA0 C-IMCI promotive, preventive 6 districts 68% Children with special needs program CHW approach for care of sick newborns and children

8 BANBHUDPRKINOSRL CH Short Programme Review introduced: Yes / No 2010 nation al 2010 Programme Management Course introduced: Yes / No 2010 nation al NO2010 Programme Review and Management

9 BANBHUDPRKINOMAVMAV SRL IMCI FIMCI 100% All hospitals ExpandPreservice, inservice ICATT use introduce d nointroducedIn pre-service Study CHW Packages ExpandIndoor airpollution Home Based NB Care 35 districts Scale- up Sick child package: 35 districts All districts Expand10 – 15 % villages without health staff Healthy Child (ECD) package Nonutrition Scale- up Strengthen Referral (Hospital) Care Distribute materials Neonatal care and NRUs ExpandYes Neonatal care Programme Review and evaluation plans Operational workplan Integration Nationl strategi c plan CH Short Programme Review 2014No plan yes Programme Managers Course naNo plan yes Scale up plans for Next 2 years