The overall score of adherence of HCWs to IMCI guidelines was 57.8% (95% CI, 42.6–73.0). The mean adherence score of the evaluation of danger signs was 71.9% (95% CI, 58.7–85.1). The mean adherence score of following IMCI guidelines was signiﬁcantly greater in boys (54.2%) compared with girls (44.6%; P &amp;lt; 0.001). The same trend was observed in rural areas (57.8%) compared with urban areas (43.6%; P &amp;lt; 0.001). Adherence scores of the performance of different IMCI tasks were signiﬁcantly different across HCW categories.