Enabling medical professionals to respond effectively and with sensitivity to the needs of adolescents.

Adolescence is a period when important changes occur in an individual's life. It is a period of both risk to health and well-being, and of opportunity to set the stage for healthy adulthood. Most adolescents are healthy, but a small (and in some places not so small) proportion of them face health (including both physical and psychological) problems as well as social problems. Many individuals and institutions have important contributions to make in ensuring the health of adolescents. Medical professionals have crucial contributions to make--both as service providers and as community-change agents. Studies from many places show that adolescents value medical professionals as credible sources of help, and reach out to them for health information and services, albeit in small numbers. However, studies from many parts of the world suggest that medical professionals are unable and/or unwilling to respond to the needs of adolescents effectively and with sensitivity. There is growing recognition of the public-health benefits of strengthening the technical as well as the inter-personal competencies of medical professionals, and of helping them clarify their attitudes so that they could deal with adolescents with understanding and respect. Initiatives in this area are under way in many countries. WHO strongly supports these capacity-building initiatives, and urges that orientation and training programmes be followed up with ongoing support to enable medical professionals to perform to the best of their abilities. WHO also stresses the importance of informing and engaging families and communities to support the provision of health information and services to young people.

Integrated Management of Childhood Illness (IMCI): a robust strategy.

Integrated Management of Childhood Illness (IMCI), a strategy fostering holistic approach to child health and development, is built upon successful experiences gained from effective child health interventions like immunization, oral rehydration therapy, management of acute respiratory infections and improved infant feeding. The core intervention of IMCI is integrated management of the five most important causes of childhood deaths-acute respiratory infections, diarrheal diseases, measles, malaria and malnutrition. Using a set of interventions for the integrated treatment and prevention of major childhood illnesses, the IMCI strategy aims to reduce death as well as the frequency and severity of illness and disability, thus contributing to improved growth and development. In health facilities, the IMCI strategy promotes the accurate identification of childhood illness (es) in the outpatient settings, ensures appropriate combined treatment of all major illnesses, strengthens the counselling of caretakers and the provision of preventive services, and speeds up the referral of severely ill children. The strategy also aims to improve the quality of care of sick children at the referral level. It also creates a scientifically sound link between the management guidelines at the community level and the management approach in a referral centre. The strategy also envisages actual situations when referral is not possible and offers the best possible options in such circumstances. In the home setting, it promotes appropriate early home care and care-seeking, improved nutrition and prevention, and the correct implementation of prescribed care. In addition to its focus on treatment of illness in the health facility as well as at home, it also provides an opportunity for important preventive interventions such as immunization and improved infant and child nutrition including breastfeeding. The IMCI strategy reduces wastage of resources and avoids duplication of efforts that may occur in a series of separate disease control programs. The essential pillars include improvement in the case management skills of health personnel, improvement in health systems, and improvement in family and community practices. IMCI has been introduced in more than 80 countries and 19 of them have already scaled up IMCI implementation Even though it is too early to relate the decrease in childhood mortality with the introduction of IMCI in these countries, there are several indirect indicators which endorse its validity as a comprehensive and effective strategy. IMCI has helped countries to revise and update their child health policies, streamline the essential drug lists for children, increase service utilization, improve quality of care and nutritional counselling, improve health systems and improved family and community practices.