University of Liverpool
MSc Infectious Disease and Tropical
Dr. Wail Bajhmoum
INTEGRATED MANAGEMENT OF
Background and Brief History.
Objectives and Goals.
THE CASE MANAGEMENT PROCESS.
* Each year more than 10 million children in low-
and middle-income countries die before they
reach their fifth birthday.
* Seven in ten of these deaths are due to just
* pneumonia (19%)
* diarrhea (19%)
* malaria (5%)
* measles (7%)
* malnutrition (54%)
IMCI was first developed in 1992 by UNICEF
and the World Health Organization (WHO)
* IMCI is an integrated approach to child
health that focuses on the well-being of
the whole child.
* IMCI includes both preventive and
* IMCI is designed for use in outpatient
clinical settings with limited diagnostic
tools and medications.
ie. rural areas- specifically in developing
Objectives and Goals
1. Reducing mortality.
2. Reducing the incidence and seriousness
of illnesses and health problems .
3. Improving growth and development
during the first five years of a child’s life.
*Improving case management skills of
*Improving overall health systems.
*Improving family and community health
THE CASE MANAGEMENT
1 – assessment
2 - classification and identification of treatment.
3 - referral, treatment or counseling of the
4 - follow-up care.
Fever With Rashes
For A L L sick children ask the mother about the child’s problem, check for general danger signs,
about cough or difficult breathing, diarrhoea and then
A S K : D O E S T H E C H IL D H A V E F E V E R ?
NO YE S
D o e s t h e c h ild h a v e f e v e r ?
( by history or feels hot or temperature 37.5 °C** or above)
Decide the Malaria Risk: high or low
THEN ASK: LOOK AND FEEL:
For how long? Look or feel for stiff neck.
If more than 7 days, has Look for runny nose.
fever been present every day?
Look for signs of MEASLES
Has the child had measles within
the last 3 months? Generalized rash and
One of these: cough, runny nose,
or red eyes.
If the child has me as le s now or Look for mouth ulcers.
w ithin the las t 3 months : Are they deep and extensive?
Look for pus draining from the eye.
Look for clouding of the cornea.
C L A S S IF Y the child’s illness using the colour-coded classification tables for
Then A S K about the next main symptom: ear problem, and CHECK for malnutrition and
immunization status and for other problems.
Is it effective ?!
The Multi-Countries Evaluation of (IMCI)
includes studies of the effectiveness, cost,
and impact of the IMCI strategy in
Bangladesh, Brazil, Peru, Tanzania, and
*MCE conclude : more detailed descriptions
of methodological and analytic approaches
developed to address specific issues need
to be provided.
*The MCE will continue these and other
methodological challenges in future