IMNCI

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IMNCI

  1. 1. Integrated Management of Neonatal & Childhood Illnesses (IMNCI) State Institute of Health and Family Welfare, Jaipur
  2. 2. IMNCI? WHO/UNICEF have developed a new approach to tackling the major diseases of early childhood called the Integrated Management of Childhood Illnesses (IMCI) SIHFW: an ISO:9001 certified institution 2
  3. 3. Developments related to child health 1978: EPI 1984: UIP 1985: Oral Rehydration Therapy1 1990: UIP and ORT universalized, ARI as a pilot in26 districts 1992: CSSM 1997: RCH-1 2005: NRHM and RCH II SIHFW: an ISO:9001 certified institution 3
  4. 4. Why IMNCI • Reduce infant and child mortality rates • Improving child health & survival • IMR reduced from 114 (1980) to 53 (2008 SRS bulletin) • Decline not uniform across states • 8 states including Rajasthan are below national average • Malnutrition and low birth weight (LBW) are contributors to the about 50% deaths SIHFW: an ISO:9001 certified institution 4
  5. 5. IMNCI: Status India Rajasthan Number of districts where IMNCI is 156 33 implemented Total Numbers of People trained on 124636 16672 IMNCI(30th Nov. ‘09) SIHFW: an ISO:9001 certified institution 5
  6. 6. IMNCI Beneficiaries • Care of Newborns and Young Infants (infants under 2 months) • Care of Infants (2 months to 5 years) SIHFW: an ISO:9001 certified institution 6
  7. 7. 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 SIHFW: an ISO:9001 certified institution 7
  8. 8. 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 SIHFW: an ISO:9001 certified institution 8
  9. 9. IMNCI Components and Intervention areas Improve health Improve Improve family worker skills health & community systems practices Case management District & Block Appropriate Care standards & planning and seeking guidelines management Training of facility- Availability of Nutrition based public health IMNCI drugs care providers SIHFW: an ISO:9001 certified institution 9
  10. 10. IMNCI Components and Intervention areas Improve health Improve health Improve family worker skills systems & community practices IMNCI roles for Quality Home case private providers improvement management & and supervision adherence to at health recommended facilities – public treatment & private SIHFW: an ISO:9001 certified institution 10
  11. 11. IMNCI Components and Intervention areas Improve health Improve health Improve family worker skills systems & community practices Maintenance of Referral Community competence pathways & services planning among trained services & monitoring health Health Information System SIHFW: an ISO:9001 certified institution 11
  12. 12. Components of IMNCI Ø Training Ø Effective implementation • Improvements to the health system • Improvement of Family and Community Practices Ø Collaboration/coordination with other Departments SIHFW: an ISO:9001 certified institution 12
  13. 13. Components of IMNCI Training Ø IMNCI is a skill based training in both facility and community settings Ø Broadly, two categories of training are included • for medical officers • for front-line functionaries including ANM’s and AWW’s SIHFW: an ISO:9001 certified institution 13
  14. 14. Components of IMNCI Effective implementation Ø 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 SIHFW: an ISO:9001 certified institution 14
  15. 15. Components of IMNCI Effective implementation Ø 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 SIHFW: an ISO:9001 certified institution 15
  16. 16. Components of IMNCI Collaboration/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 SIHFW: an ISO:9001 certified institution 16
  17. 17. F-IMNCI From 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 SIHFW: an ISO:9001 certified institution 17
  18. 18. Institutional Arrangements • State Level • District Level SIHFW: an ISO:9001 certified institution 18
  19. 19. 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 SIHFW: an ISO:9001 certified institution 19
  20. 20. 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 SIHFW: an ISO:9001 certified institution 20
  21. 21. Training in IMNCI Focus on Skill Development Ø Hands-on training • Visits to hospitals • Field visits and visits to the homes of sick children SIHFW: an ISO:9001 certified institution 21
  22. 22. Training in IMNCI Training at two levels • In-service training for the existing staff • Pre-Service Training SIHFW: an ISO:9001 certified institution 22
  23. 23. Type of Personnel to be Durat Package Place of Training trained ion to be Training used Clinical Medical Officer 8 Physician Medical skills and Pediatrician days Package college training /District Hospital Health workers 8 Health District ANMs, LHVs, days Workers Hospital Mukhya sevika Package CDPO’s and AWWs SIHFW: an ISO:9001 certified institution 23
  24. 24. Type of Personnel to Durati Package Place of Training be trained on to be Training used Supervis Medical 2days Superviso Medical ory Skills Officers, ry Skills college Training Pediatricians, package /District CDPO’s LHVs Hospital and Mukhiya Sevikas) SIHFW: an ISO:9001 certified institution 24
  25. 25. Training of Trainers • All pediatricians in the district • Selected medical officers from CHCs and block PHCs • Selected staff nurses and LHVs and CDPO’s and Mukhiya Sevikas from ICDS SIHFW: an ISO:9001 certified institution 25
  26. 26. Number to be trained • Average size District -1800 health staff will need to be trained • Number of the staff of other departments should be included in consultation with concerned district officers • Staff belonging to PHC areas may be taken up fully before moving to another PHC area SIHFW: an ISO:9001 certified institution 26
  27. 27. Training Institutions • State Level • District Level SIHFW: an ISO:9001 certified institution 27
  28. 28. State Level Training Institutions • Identify a Regional Training Centre • The Departments of Pediatrics and Preventive & Social Medicine in each college SIHFW: an ISO:9001 certified institution 28
  29. 29. District Level Training Institutions • District hospital for training of medical officers • CHCs/operational FRUs etc for training of health workers SIHFW: an ISO:9001 certified institution 29
  30. 30. 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. SIHFW: an ISO:9001 certified institution 30
  31. 31. Pre-Service Training • Training of undergraduate students and interns • ANM, AWW, and Staff Nurses’ training schools need to include IMNCI in their training schedules SIHFW: an ISO:9001 certified institution 31
  32. 32. Funding arrangements Ø National Level training: by the GoI Ø State Level training: State project funding - NRHM/RCH-II-PIPs Ø District Level training: State project funding -NRHM/RCH-II-PIPs a. At District Training Cell (in the District Hospital) b. At other Training Centres within the District (Maximum two in identified CHCs/PHCs) SIHFW: an ISO:9001 certified institution 32
  33. 33. Funding arrangements • Translation, printing and supply of training material • Field-level Monitoring Support, Follow up and Coordination SIHFW: an ISO:9001 certified institution 33
  34. 34. Navjat Shishu Suraksha Karykram(NSSK) Launched on September 15, 2009 Focuses on: • Prevention of Hypothermia • Prevention of Infection • Early initiation of Breast feeding • Basic Newborn Resuscitation SIHFW: an ISO:9001 certified institution 34
  35. 35. Navjat Shishu Suraksha Karykram (NSSK) Objectives: • One trained person at institutional facility, where deliveries take place • NSSK will train healthcare providers at the district hospitals, CHCs & PHCs SIHFW: an ISO:9001 certified institution 35
  36. 36. Limitations of IMNCI • Outpatient Facility Based • Community activities not given adequate focus • Training centre of attention • Vertical initiatives in Non IMNCI districts sorely lacking SIHFW: an ISO:9001 certified institution 36
  37. 37. Thank You For more details log on to www. sihfwrajasthan.com or contact : Director-SIHFW on sihfwraj@yahoo.co.in

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