The main method of providing feedback in the Uganda/MCE was through a workshop organized at the central level by the National IMCI Programme. A quarterly meeting of the advisory committee, which brought together the investigators, Ministry of Health and other key stakeholders and agencies supporting implementation of IMCI was another important means of dissemination of findings. On a smaller scale, the field team provided immediate feedback on critical observations made during a visit to the facility to all the staff present on the day of the visit after data collection was finished.

As a result of the findings of the study and feedback to the IMCI National Programme and other stakeholders, as well as to the districts (via the National Programme), the following actions have resulted either directly by the study, or have been greatly influenced by it:

• The community baseline demographic survey found that only 17% of people in the community used public (government and NGO) facilities as the first point of external contact with the health system for illness episodes. Partly on the basis of this finding, the Ministry of Health and partners in health have decided to design and accelerate plans for home management of fever. The strategy is now being implemented countrywide.

• Intervention districts received detailed results from the baseline (first round) survey and used these findings to submit plans to the National IMCI Programme to scale up implementation of IMCI.

• To try to increase coverage of health workers trained in IMCI, the Ministry of Health has introduced a "short interrupted course" for health workers who cannot spend a long time away from their stations. This has already been done in Luweero, Masindi and Masaka districts. The course is for six days (three days followed by a week when health workers go back to their work stations and then return for another three days).

• A placement programme has been introduced to permit districts to learn from one another. For instance, teams from Luweero, Masaka, Kiboga, Kumi and Masindi visited Ntungamo district to share Ntungamo’s experiences in implementation of the community component of IMCI. The plan is to do this regularly, with placements rotating through all the intervention districts.

• The Ministry of Health has decided to speed up the development of a national IMCI monitoring tool, modelled along the lines of the indicators used in the MCE/Impact study, but covering more extensive operational issues.

• The Ministry of Health has developed and is introducing a "referral care package" which seeks to improve compliance with referral for severe illness.

• The Ministry of Health and partners have adapted the household survey protocols developed by the Ugandan Impact Study team to monitor progress at community level of child health interventions.

The EPI Programme used findings from the study to plan for revitalization and restructuring of the immunization programme, e.g., through emphasizing daily immunizations, as a way of improving coverage.