ObjectiveTo assess the extent to which Integrated Management of Childhood Illness (IMCI) has been adopted and scaled up in countries.SettingThe 95 countries that participated in the survey are home to 82% of the global under-five population and account for 95% of the 5.9 million deaths that occurred among children less than 5 years of age in 2015; 93 of them are low-income and middle-income countries (LMICs).MethodsWe conducted a cross-sectional self-administered survey. Questionnaires and data analysis focused on (1) giving a general overview of current organisation and financing of IMCI at country level, (2) describing implementation of IMCI’s three original components and (3) reporting on innovations, barriers and opportunities for expanding access to care for children. A single data file was created using all information collected. Analysis was performed using STATA V.11.ParticipantsIn-country teams consisting of representatives of the ministry of health and country offices of WHO and Unicef.ResultsEighty-one per cent of countries reported that IMCI implementation encompassed all three components. Almost half (46%; 44 countries) reported implementation in 90% or more districts as well as all three components in place (full implementation). These full-implementer countries were 3.6 (95% CI 1.5 to 8.9) times more likely to achieve Millennium Development Goal 4 than other (not full implementer) countries. Despite these high reported implementation rates, the strategy is not reaching the children who need it most, as implementation is lowest in high mortality countries (39%; 7/18).ConclusionThis survey provides a unique opportunity to better understand how implementation of IMCI has evolved in the 20 years since its inception. Results can be used to assist in formulating strategies, policies and activities to support improvements in the health and survival of children and to help achieve the health-related, post-2015 Sustainable Development Goals.

Objective.To describe the prevalence of recent physical, sexual, and emotional violence against children 0 – 19 years of age in Latin America and the Caribbean (LAC) by age, sex, and perpetrator.Methods.A systematic review and analysis of published literature and large international datasets was conducted. Eligible sources from first record to December 2015 contained age-, sex-, and perpetrator-specific data from LAC. Random effects meta-regressions were performed, adjusting for relevant quality covariates and differences in violence definitions.Results.Seventy-two surveys (2 publications and 70 datasets) met inclusion criteria, representing 1 449 estimates from 34 countries. Prevalence of physical and emotional violence by caregivers ranged from 30% – 60%, and decreased with increasing age. Prevalence of physical violence by students (17% – 61%) declined with age, while emotional violence remained constant (60% – 92%). Prevalence of physical intimate partner violence (IPV) ranged from 13% – 18% for girls aged 15 – 19 years. Few or no eligible past-year estimates were available for any violence against children less than 9 years and boys 16 – 19 years of age; sexual violence against boys (any age) and girls (under 15 years); IPV except for girls aged 15 – 19 years; and violence by authority figures (e.g., teachers) or via gangs/organized crime.Conclusion.Past-year physical and emotional violence by caregivers and students is widespread in LAC across all ages in childhood, as is IPV against girls aged 15 – 19 years. Data collection must be expanded in LAC to monitor progress towards the sustainable development goals, develop effective prevention and response strategies, and shed light on violence relating to organized crime/gangs.

The World Health Organization (WHO) has collected information on policies on sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) over many years. Creating a global survey that works for every country context is a well-recognized challenge. A comprehensive SRMNCAH policy survey was conducted by WHO from August 2018 through May 2019. WHO regional and country offices coordinated with Ministries of Health and/or national institutions who completed the questionnaire. The survey was completed by 150 of 194 WHO Member States using an online platform that allowed for submission of national source documents. A validation of the responses for selected survey questions against content of the national source documents was conducted for 101 countries (67%) for the first time in the administration of the survey. Data validation draws attention to survey questions that may have been misunderstood or where there was a lot of missing data, but varying methods for validating survey responses against source documents and separate analysis of laws from policies and guidelines may have hindered the overall conclusions of this process. The SRMNCAH policy survey both provided a platform for countries to track their progress in adopting WHO recommendations in national SRMNCAH-related legislation, policies, guidelines and strategies and was used to create a global database and searchable document repository. The outputs of the SRMNCAH policy survey are resources whose importance will be enriched through policy dialogues and wide utilization. Lessons learned from the methodology used for this survey can help to improve future updates and inform similar efforts.

The last menstrual period is used to estimate gestational age. This paper examines sources of measurement error related to the recall of last menstrual period among Mexican immigrant women living in the United States. Qualitative analyses (focus groups and cognitive interviews) suggest that last menstrual period recall does not seem to be a large source of measurement error in the calculation of gestational age and the impact of this type of error on the misclassification of preterm births appears to be minimal. Questions for querying about last menstrual period in this population are offered.