INTERSECT and the World Health Organization – IMAI

Integrated Management of Adolescent and Adult Illness

In an effort to provide guidance on an integrated approach to the management of patients in resource-limited settings, the World Health Organization has coordinated the development of Integrated Management tools.

These tools, comprised of guidelines and health worker training modules, include the following programs:

  • the Integrated Management of Childhood Illness (IMCI)
  • the Integrated Management of Pregnancy and Childbirth (IMPAC)
  • the Integrated Management of Adolescent and Adult Illness (IMAI)

INTERSECT members have worked intensively with WHO on this initiative, playing critical roles in the development of guidelines and training programs for IMAI.

Guidelines and Training Programs

Since 2009, several INTERSECT team members have contributed to the development of consensus-based algorithms for the management of severe sepsis and respiratory failure without shock in resource-constrained settings. Involved in this project were:

  • Dr. Satish Bhagwanjee (UW Department of Anesthesiology and Pain Medicine)
  • Dr. Len Hudson (UW Department of Medicine, Division of Pulmonary and Critical Care, retired)
  • Dr. Shevin Jacob (UW Department of Medicine, Division of Allergy and Infectious Diseases)
  • Dr. Eoin West (UW Department of Medicine, Division of Pulmonary and Critical Care)

WHO adapted INTERSECT’s guidelines for use during the H1N1 global pandemic. INTERSECT members and other collaborators subsequently developed a protocol for a multi-country evaluation of the efficacy and effectiveness of the algorithms in austere settings.

IMAI District Clinician Manual

WHO incorporated INTERSECT’s guidelines into the soon-to-be-published, two-volume IMAI District Clinician Manual. This manual will be distributed to ministries of health in low and middle income countries. The goal of the manual is to provide health workers with guidance and reference materials to standardize management of severely ill hospitalized patients.

Dr. Jacob, one of INTERSECT’s founding directors, is one of seven technical editors for the manual.

In addition, Drs. Bhagwanjee and Jacob, along with INTERSECT founding directors Dr. Justin Ortiz (UW Department of Medicine, Division of Pulmonary and Critical Care), and Dr. Eoin West, have contributed to the reference materials comprising the manual.

Training Modules

To complement the District Clinician Manual, WHO has developed, with contributions from INTERSECT founding directors Drs. Jacob and West, training modules for the triage and management of severely ill hospitalized patients in resource-limited settings.

To date, WHO has piloted these training modules in Malawi, Ethiopia and Uganda, with plans for expansion into Sierra Leone and other countries in 2012.

Technical Assistance

Implementation of the guidelines provided in the Integrated Management tools requires technical assistance from various global organizations. The IMAI-IMCI Alliance ( was conceived in order to leverage the varying expertise that can be provided from these institutions, particularly those already involved in the development of the Integrated Management tools.

Because of its role in the development of the IMAI materials, INTERSECT is a member of the IMAI-IMCI Alliance and provides technical assistance to alliance member organizations on topics related to the management of severe illness in resource-limited settings.