More than half of all LMICs with high rates of child mortality have reported use and substantial implementation activities, a considerable achievement given minimal resources available for implementation. Improving the accessibility of the Pocket Book and its implementation tools to health workers, and developing a strategic approach to implementation in each country could improve quality of hospital care for children and support efforts towards achieving the Millennium Development Goal 4 targets.
There was encouraging evidence of uptake of the Pocket Book in Indonesia following local adaptation, nationwide mailing distribution and small-scale local implementation activities.
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