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IMNCI

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Can be viewed at www.sihfwrajasthan.com

Can be viewed at www.sihfwrajasthan.com

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IMNCI IMNCI Presentation Transcript

  • Integrated Management of Neonatal & Childhood Illnesses (IMNCI) State Institute of Health and Family Welfare, Jaipur
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • Institutional Arrangements • State Level • District Level SIHFW: an ISO:9001 certified institution 18
  • 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
  • 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
  • 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
  • Training in IMNCI Training at two levels • In-service training for the existing staff • Pre-Service Training SIHFW: an ISO:9001 certified institution 22
  • 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
  • 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
  • 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
  • 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
  • Training Institutions • State Level • District Level SIHFW: an ISO:9001 certified institution 27
  • 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
  • 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
  • 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
  • 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
  • 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
  • Funding arrangements • Translation, printing and supply of training material • Field-level Monitoring Support, Follow up and Coordination SIHFW: an ISO:9001 certified institution 33
  • 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
  • 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
  • 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
  • Thank You For more details log on to www. sihfwrajasthan.com or contact : Director-SIHFW on sihfwraj@yahoo.co.in