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Liquid, sanitation and health interventions need to be enhanced. © The Author(s). 2019.Background The Integrated handling of Childhood Illness (IMCI) method was adopted in Burundi in 2003. Our aim was to assess as to what extent the malnutrition element of the IMCI tips is implemented at health facilities level. Techniques We carried out direct observations of curative outpatient consultations for kids aged 6-59 months in 90 health centers chosen randomly. We considered both the child while the wellness work