In 2022, MOMENTUM Country and Global Leadership undertook a multi-country qualitative assessment of the successes of, challenges to, and opportunities for effective implementation of Integrated Management of Childhood Illness (IMCI) through multi-level consultations and interviews with health workers, facility and district administrators, and health system leaders in Ghana, Malawi, and Sierra Leone. This comprehensive report of results from all three countries will help critically inform a global reinvigoration of the IMCI strategy which, despite having been launched more than 25 years ago, still has not reached programmatic scale in many of the countries where this proven approach could have a big impact on child survival.