The IMAI guidelines are aimed at first-level facility health workers and lay providers in low-
resource settings. These health workers and lay providers may be working in a health centre
or as part of a clinical team at the district clinic. The clinical guidelines have been simplified
and systematized so that they can be used by nurses, clinical aids, and other multi-purpose
health workers, working in good communication with a supervising MD/MO at the district
clinic. Acute Care presents a syndromic approach to the most common adult illnesses
including most opportunistic infections. Instructions are provided so the health worker
knows which patients can be managed at the first-level facility and which require referral
to the district hospital or further assessment by a more senior clinician. Preparing first-level
facility health workers to treat the common, less severe opportunistic infections will allow
them to stabilize many clinical stage 3 and 4 patients prior to ARV therapy without referral to
the district.
