• Description of adaptations made in IMCI case management guidelines
• Overview of IMCI implementation strategy and activities
• Availability of locally-adapted clinical guidelines for IMCI case management in first-level facilities.
• Availability of adequate minimum counselling aids for use by health workers.
• Policies on user fees, drug distribution, staff assignment, MIS/record keeping

Mapping (once, unless new facilities)

Basic description of health system: facilities, training, supervision, MIS/record keeping, staffing patterns, utilization patterns, EPI delivery system, financial systems and costs

Availability of locally-adapted clinical guidelines for IMCI case management in first-level facilities.

Availability of adequate minimum counselling aids for use by health workers.

Availability of breastfeeding counselling

Availability of referral services

IMCI included in district development plans

IMCI included in district budget

District health plan updated in previous year

Levels of budget allocations and expenditures at district level for child health activities

Availability of human resources for child health activities: trainers, supervisors, managers

Most recent year for which summary report from HIS/MIS on child mortality is available

Timeliness/completeness of district records on child mortality

Training coverage: health workers

District supervisors trained in IMCI

District supervisors trained in IMCI and follow-up after training

Description of any planned activities cancelled because of IMCI

All types of training conducted

Number of mother=s cards (nutrition counselling) distributed (will vary based on policy on distribution to caretakers)

Number of children immunized, by type and dose of vaccine

Number of micronutrient supplements distributed for pediatric use, by type (vitamin A, iron)

Number of drugs distributed for pediatric use, by categories (ORS packets, antibiotics, antimalarials, anthelminthic drugs)

Description of interventions other than IMCI that affect child health

Supervisory visits conducted by trained personnel

Availability of locally-adapted clinical guidelines for IMCI case management in first-level facilities.

Availability of adequate minimum counselling aids for use by health workers.

Staffing

Availability of locally-adapted clinical guidelines for IMCI case management in first-level facilities.

Availability of adequate minimum counselling aids for use by health workers.

Facility services available

Service hours (opening and closing) and days services provided

Type and strength of community organization

Child health interventions at community level (e.g., ITMs, IEC activities)

Links between communities and health facilities