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History of IMAI

History of IMAI. 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.

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History of IMAI

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  1. History of IMAI

  2. 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. • 2001: Grant from the Rockefeller Foundation for the development of syndromic management of HIV; international IMAI working group created

  3. History of IMAI: Acute Care • 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. • 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 new expert groups—"Skin problem or lump" was particularly difficult; mental health working group still in existence.

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

  5. 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) October 2003: ART added and reviewed by expert group Training materials tested in Uganda in early 2004; paediatrics added History of IMAI: Chronic HIV Care

  6. History of IMAI: Palliative Care • 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: Reviewed at an international consultation on palliative care in Botswana

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