To explore adherence to Integrated Management of Childhood Illness(IMCI)guidelines for assessment, classification, treatment, counselling and follow-upfor children under 5 years of age with acute diarrhoea. This descriptive study used both quantitative and quantitative methods together, specifically a retrospective review of children’s case files and interviews with health workers. Data were gathered using both methods concurrently. Quantitative data were analysed using descriptive statistics and interview data were incorporated in the findings to provide depth and explanations for interpreting the results. Health Services in one Municipality in Timor-Leste The IMCI trained heads of community health centresand IMCI facilitators in the municipality. Adherence to the IMCI algorithm and guidelines for assessment, classification, treatment, counselling and follow-up for children under five year with acute diarrhea. The study found high levels of adherence to the IMCI guidelines for assessment and classification of cases, but low levels of adherence to guidelines for treatment, counselling and follow-up of these children.Overall 61.7% of the case files showed adherence to guidelines. Explanations for non-adherence to guidelines were related to shortages of resources such as zinc tablets and a lack of mentoring, follow up training and supervision of health workers. The quality of IMCI case management for children with acute diarrhoea is hinderedby a lack of resources, increasing the risk of malnutrition and recurrence of diarrhoea in this already vulnerable population of children. System improvements can ensure appropriate resourcing and staff knowledge and skills for IMCI

Keywords : Children’s Health Services, East Timor, Diarrhoea, Guideline Adherence, Quality of Health Care. From the journal database:- Quality Management, guidelines, children, developing countries, primary care, digestive diseases