OBJECTIVES: In 1996 PAHO / WHO and UNICEF developed the IMCI strategy with the aim of improving the health workers’ performance, strengthening the health system support and improving the knowledge about the children care best practices at home and in the community. The objective of this study is to evaluate the IMCI strategy through the health managers’ perceptions. METHODS: Qualitative design using semi-structured interview. Population Study: key persons, governmental and nongovernmental health organizations managers who participated in the IMCI strategy in the State of Ceará (Northeast Brazil) and in Peru. The interviews were conducted during May-June 2011. They were tape recorded and transcribed later. For the analysis, a triangulation method was carried out with another researcher, reviewing the literature and other documents. RESULTS: An important reduction in infant mortality rate was observed in Ceará (from 32 per 1000 live births in 1997 to 15.6 in 2009) and in Peru (from 43 per 1000 live births in 1996 to 17 in 2008) by the decrease in post-neonatal mortality due to diarrhea and pneumonia. In both places at the beginning there was a large-scale training for the health staff, doctors and nurses, and less for the community health agents. The evolution of the strategy has been different. In Ceará there was a decrease of the interest and a lack of support from governments. In Peru, the government adopted the strategy; likewise there was a greater incorporation into the university teaching, distance learning and the addition incorporation of new content (perinatal / neonatal, asthma and broncho-obstructive syndrome, child development, oral health, abuse, violence and accidents, diabetes and obesity).  CONCLUSIONS: The IMCI strategy has been developed differently in the studied countries. This information can be used to evaluate the strategy and the participation of the different sectors responsible for the child health.