Linking the Integrated Management of Childhood Illness (IMCI) and Health Information System (HIS) classifications: issues and options

Differences in the terms used to classify diseases in the Integrated Manage ment of Childhood illness (IMCI) guidelines and for health information syst em (HIS) disease surveillance could easily create confusion among health ca re workers. If the equivalent terms in the two classifications are not clea r to health workers who are following the guidelines, they may have problem s in performing the dual activities of case management and disease surveill ance, These difficulties could adversely affect an individual's performance as well as the overall effectiveness of the IMCI strategy or HIS surveilla nce, or both. We interviewed key informants to determine the effect of thes e differences between the IMCI and HIS classifications on the countries tha t were implementing the IMCI guidelines. Four general approaches for addres sing the problem were identified: translating the IMCI classifications into HIS classifications; changing the HIS list to include the IMCI classificat ions; using both the IMCI and HIS classification systems at the time of con sultations; and doing nothing. No single approach can satisfy the needs of all countries. However, if the short-term or medium-term goal of IMCI plann ers is to find a solution that will reduce the problem for health workers a nd is also easy to implement, the approach most likely to succeed is transl ation of IMCI classifications into HIS classifications. Where feasible, a m odification of the health information system to include the IMCI classifica tions may also be considered.