This paper presents the first published report of a national-level effort to implement the integrated management of childhood illness (IMCI) strategy at scale. IMCI was introduced in Peru in late 1996, the early implementation phase started in 1997, with the expansion phase starting in 1998. Here we report on a retrospective evaluation designed to describe and analyze the process of taking IMCI to scale in Peru, conducted as one of five studies within the multicountry evaluation of IMCI effectiveness, cost and impact (MCE) coordinated by the World Health Organization. Trained surveyors visited each of Peru’s 34 districts, interviewed district health staff and reviewed district records. Findings show that IMCI was not institutionalized in Peru; it was implemented parallel to existing programmes to address acute respiratory infections and diarrhoea, sharing budget lines and management st...

Objectives: (1) To document trends in integrated management of childhood illnesses (IMCI) implementation in the 24 departments of Peru from 1996 to 2000. (2) To documenttrends in indicators of health services coverage and impact(mortality and nutritional status) for the same period. (3) To correlate changes in these two sets of indicators. And (4)to attempt to rule out contextual factors that may affect the observed trends and correlations. Materials and Methods: An ecological analysis was performed in which the units of study were the 24 departments.Results: By 2000, 10,2% of clinical health workers were trained in IMCI,but some districts showed considerably higher rates. There were no significant associations between clinical IMCI training coverageand indicators of outpatient utilization, vaccine coverage, mortality or malnutrition. The lack of association persisted after adjustment fo...