IMAI (Integrated Management of Adult and Adolescent Illness)

Fact sheet

What is IMAI?

IMAI is a health strategy that addresses the overall health of the patient. One of its most distinctive elements is its focus on the management of chronic disease and prevention rather than just the treatment of acute illness. This supports the shift from an exclusively acute care model of health service delivery to a chronic care model. IMAI also integrates important but neglected areas into the overall care model for HIV/AIDS such as prevention and mental health. The strategy streamlines existing services so that, even where resources are scarce, the health system can function more efficiently by simplifying and standardizing health care delivery.

Key features

  • An integrated service delivery approach—a coherent & consistent package for the district
  • Balances attention to acute and chronic care
  • Integrated clinical management of TB and HIV
  • Integrated patient monitoring with care and treatment
  • Links prevention interventions with acute care and chronic HIV care
  • Helps alleviate human resource limitations through task shifting
  • Involves PHLAs to train health workers and in the clinical team
  • Increases the efficiency of training

How can it be used?

IMAI is an integrated, flexible set of interventions in several compatible formats. It is not a fixed package.

Key tools to implement IMAI include four outpatient guideline modules: Chronic HIV Care with ARV Therapy, General Principles of Good Chronic Care, Acute Care, and Palliative Care. These guideline modules can be used by doctors in district hospitals; nurses and general health workers in first-line health facilities; and people living with HIV/AIDS (PLHA) or lay providers working in the community. Training materials have been developed appropriate to the clinical background of each of these groups.

The IMAI guidelines are based on key clinical symptoms, thus making it a "syndromic" approach. They need little laboratory support, can be used where resources are scarce, and are designed for adaptation to different conditions.

Country adaptation is an essential step before use. Adaptation involves the choice of interventions to address the priority needs of the country and modification of the guideline content to take account of culture difference, local disease conditions, the health system, the essential drug use, etc. It is important that these training materials become "owned" by the health ministry and thoroughly adapted locally.