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Fimnci

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  • 1. F-IMNCI Presented By: Nikhil Bansal(2006)
  • 2. IMNCI: WHO/UNICEF have developed a new approach totackling the major diseases of early childhoodcalled the Integrated Management of ChildhoodIllnesses (IMCI)
  • 3. Why IMNCIReduce infant and child mortality ratesImproving child health & survivalIMR reduced from 114 to 53Malnutrition and low birth weight (LBW) are contributors to the about 50% deaths
  • 4. Attention to counselling skills to promote exclusive breastfeeding, complementary feeding & micronutrient supplementation is a key strength of IMNCI Malaria* 5% Measles* Other 7% 32% Diarrhoea* 19% Malnutrition* 54% Acute Respiratory Perinatal Infections* 18% 19%* Based on data taken from The Global Burden of Disease 1996, edited by Murray CJL and Lopez AD, andEpidemiologic evidence for a potentiating effect of malnutrition on child mortality, Pelletier DL, FrongilloEA and Habicht JP, AmJ Public Health 1993;83:1130-1133
  • 5. THE INTEGRATED CASE MANAGEMENT Out Patient Health Facility (up to 5 yrs) Check for Danger Signs Ask about main symptoms Assess Nutrition & Immunization Status Check for other ProblemsClassify Conditions & Identify Management Strategy
  • 6. Case management strategyPINK CLASSIFICATION: Child needs referral ( Inpatient care)YELLOW CLASSIFICATION:Child needs specific treatment, provide it at home (e.g.Antibiotics, ORS)GREEN CLASSIFICATION: Child needs no medicine, give home care
  • 7. IMNCI Beneficiaries• Care of Newborns and Young Infants (infants under 2 months)• Care of Infants (2 months to 5 years)
  • 8. Care of Newborns and Young Infants (infants under 2 months)• Keeping the child warm• Initiation of breastfeeding• Counseling for exclusive breastfeeding• Cord, skin and eye care• Recognition of illness in newborn and management and/or referral• Immunization• Home visits in the postnatal period
  • 9. Care of Infants (2 months to 5 years)• Management of diarrhoea, ARI malaria, measles, acute ear infection, malnutrition and anemia• Recognition of illness and risk• Prevention and management of Iron and Vitamin A deficiency• Counseling on feeding for all children below 2 years• Counseling on feeding for malnourished• Immunization
  • 10. IMNCI Components and Intervention areas• Improve health • Improve • Improve worker skills health family & systems community practices• Case • District & • Appropriate management Block Care seeking standards & planning guidelines and managemen t• Training of • Availability • Nutrition facility-based of IMNCI public health drugs care providers
  • 11. IMNCI Components and Intervention areasImprove health Improve health Improve familyworker skills systems & community practicesIMNCI roles for Quality Home caseprivate providers improvement management & and supervision adherence to at health recommended facilities – treatment public & private
  • 12. IMNCI Components and Intervention areasImprove health Improve health Improve family &worker skills systems community practicesMaintenance of Referral Communitycompetence pathways & services planningamong trained services & monitoringhealth Health Information System
  • 13. Components of IMNCITrainingEffective implementation • Improvements to the health system • Improvement of Family and Community PracticesCollaboration/coordination with other Departments
  • 14. Components of IMNCI TrainingIMNCI is a skill based training in both facility and community settingsBroadly, two categories of training are includedfor medical officersfor front-line functionaries including ANM’s and AWW’s
  • 15. Components of IMNCIEffective implementation Improvements to the health system • Ensuring availability of the essential drugs • Improve referral • Referral mechanism • Functioning referral centers • Ensuring availability of health workers / providers at all levels • Ensuring supervision and monitoring through follow up visits
  • 16. Components of IMNCIEffective implementation Improvement of Family and Community Practices Counseling of families and creating awareness which includes: • Promoting healthy behaviors • IEC campaigns • Counseling of care givers and families • During home visits identify sickness and focused BCC
  • 17. Components of IMNCICollaboration/coordination with other Departments• Involvement of ANM and AWWs• Involvement of grass-root functionaries of other sectors• Active involvement of PRI, SHGs and women’s groups
  • 18. F-IMNCIFrom November 2009 IMNCI has been re -baptized as F-IMNCI, (F -Facility) with added component of: • Asphyxia Management and • Care of Sick new born at facility level, besides all other components included under IMNCI
  • 19. Institutional Arrangements• State Level• District Level
  • 20. State level Institutional Arrangements• Appoint Nodal Officer• Set up a co-ordination Group• Arrange logistics• Create pool of State level trainers• Selection of priority districts• Review progress• Identify the State Nodal institute for training• Improvement in family and community practices
  • 21. District level Institutional Arrangements• Appoint District Coordinator• Set up an IMNCI Coordination Group• Train District Trainers.• Develop a detailed plan for implementation• Ensure timely supplies & logistics, supervision and follow-up• IEC activities
  • 22. ng Training in IMNCI • Medic• Clinical • Medical Officer • 8 • Physicia skills and Pediatrician day n al training s Package colleg e /Distri ct Hospit al • Health workers • 8 • Health • Distric ANMs, LHVs, day Worker t Mukhya sevika s s Hospit CDPO’s and Package al AWWs
  • 23. Type of Personnel to Durat Package Place ofTraining be trained ion to be Training usedSupervis Medical 2days Superviso Medicalory Skills Officers, ry Skills collegeTraining Pediatricians, package /District CDPO’s LHVs Hospital and Mukhiya Sevikas)
  • 24. Training Institutions• State Level• District Level
  • 25. State Level Training Institutions• Identify a Regional Training Centre• The Departments of Pediatrics and Preventive & Social Medicine in each college
  • 26. District Level Training Institutions• District hospital for training of medical officers• CHCs/operational FRUs etc for training of health workers
  • 27. Follow-up Training (FUT)• The Follow-up Training is designed to improve supportive supervision for 2 days which may either be clubbed with Clinical skills training or conducted within 6-8 weeks of the initial Clinical skills training.
  • 28. Pre-Service Training• Training of undergraduate students and interns• ANM, AWW, and Staff Nurses’ training schools need to include IMNCI in their training schedules
  • 29. Thanks….

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