John Nkum

This paper addresses community-based Integrated Management of Childhood Illness (IMCI), the strategy initiated by WHO and UNICEF to address the large number of young children (10 million) in developing countries who die before age five because of vaccine preventable diseases (VPD), malnutrition, and/or AIDS. This strategy involves improving the case management skills of health workers, the health system, and family and community practices. Community IMCI, more specifically, focusses on preventing and managing childhood diseases and fostering children's development in the home and community by involving those at national, district, and community levels.

The paper begins with an introduction that explores this approach to childhood illness. This opening section explores the meaning of communication in this context, with a special focus on countries in sub-Saharan Africa. A central theme is introduced here: communication is not only a right in itself, but also a means of enabling access to other human rights. This human rights approach to programming (HRAP) features community capacity development (CCD), and "operates on the premise that the social norms and relationships in households and communities heavily influence sustainable behaviour change in individuals." The next section explores the means of implementing community-based IMCI through a proposed communication model. In essence, this model involves including families, care institutions, support agencies, and NGOs in the effort to participate in the definition of key strategies and cooperative actions to attain their goal of reducing infant and early childhood mortality. For example, skilled health workers counsel mothers in an effort to improve their awareness of management at home when a child is sick. Various figures and tables are provided to clarify means of implementing this approach and to explain the role of community-level facilitators in this context.

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