Its only for study purpose for Nursing Students. Kindly refer and share to others. Now a days child mortality rate is very high due to diarrhoea and malnutrition. If we identify the child in first stage we can save them.

1. IMNCI
(Integrated Management for Neonatal
and Childhood Illness)

2. INTRODUCTION
• The integrated management for neonatal and
childhood illness (IMNCI) concept was developed by
WHO and UNICEF as a new strategy.
• For the common illnesses management among
paediatric population, the IMNCI is working towards
controlling of morbidity and mortality rates among
children.

3. Conti..
• It is working to reduce the under five morbidity and
mortality in the developing countries.
• Through integrated management the health workers
are getting the good professional training and
improving the performance towards child care.

4. Conti..
• Integrated management of childhood illness (IMCI)
strategy was developed in mid 1990.
• It is a curative, preventive and promotive strategy
aimed at reducing the death and frequency and
severity of illness and disability, and contributes to
improve growth and nutrition of under-five children.

5. Conti..
• This strategy has been expanded in India to include
neonatal care at home as well as in the health
facilities and it renamed as Integrated Management
of Neonatal and Childhood Illness (IMNCI).

6. Objectives of IMNCI
• to reduce mortality and
morbidity associated with the
major causes of disease in
children less than five years of
age.
Objective
• to contribute to the healthy
growth and development of
children.
Objective

7. MAJOR COMPONENTS OF THE INTEGRATED
MANAGEMENT OF NEONATAL AND
CHILDHOOD ILLNESS
Components are following :-
1. Improvement of family and community
practices towards child health care.
2. Provision of essential drugs and their
supplies.
3. Betterment of technical skill of health care
providers in case of management.

8. Conti..
4. Community involvement in health care programmes
of children.
5. Equitable distribution of health care facilities and
maximum reach out to all paediatric population.

9. SERVICE PROVIDED UNDER INTEGRATED
MANAGEMENT OF NEONATAL AND
CHILDHOOD ILLNESS
These are following :-
• Vaccination services
• Vitamin 'A' and micro-nutrient supplementation.
• Breast feeding.
• Management of ARI,

10. Conti..
• Prevention of diarrhoea.
• Prevention of malnutrition.
• Malaria control programmes.
• Counselling on various health problems.

11. Conti..
• Integrated management of childhood illness is
working on preventive and curative aspect of
health among paediatric population.

12. PRINCIPLES OF INTEGRATED CARE
• Principles of integrated care depending on a child's
age, various clinical signs and symptoms differ in
their degree of reliability and diagnostic value and
importance.
• IMNCI clinical guidelines focus on neonates, infants
as well as children upto 5 years of age.

13. The treatment guidelines have
been broadly described under
two age categories -.
Young
infants age
upto 2
months.
Children
age 2
months
upto 5
years.

14. Integrated management of neonatal and childhood
illness guidelines are based on following principles -
• Children below 5 years of age, all should be
examined for condition which indicates immediate
referral or hospitalization.
• Children must be routinely assessed for major
symptoms, nutritional and immunization status,
feeding problems and other potentials problems.

15. Conti..
• Only a limited number of carefully selected clinical
signs are used based on evidence of their sensitivity
and specificity to detect disease.
• Based on the presence of selected clinical signs, the
child is placed in 'classification'

16. Conti..
• Classifications are not specific diagnoses but
categories that are used to determine the
treatment.
• Classifications are colour coded and suggest referral
(pink), treatment in health facility (yellow) or
management at home (green).

17. Conti..
• IMNCI guidelines address most common, but not all
paediatric problems.
• A limited numbers of essential drugs are used.
• Care takers are actively involved in the treatment of
children.
• Counselling of caretakers about home care including
feeding, fluid and when to return to health facility.

18. IMNCI Case Management Process
Steps of case management process are following :
1. Assess the young infant/child.
2. Classify the illness.
3. Identify the treatment
4. Treat the young infant/child
5. Counsel the mother
6. Provide follow up care.

19. • Assess a child by checking first for general danger
signs (or possible bacterial infection in a young
infant), asking questions about common conditions,
examining the child, and checking nutrition and
immunization status.
• Assessment includes checking the child for other
health problems.
Assessme
nt

20. • Classify a child’s illnesses using a colour-coded
classification system. Because many children have more
than one condition, each illness is classified according to
whether it requires:
– Urgent pre-referral treatment and referral (pink), or
– Specific medical treatment and advice (yellow), or
– Simple advice on home management (green).
Classificat
ion

21. • Identify treatment
• After classifying all conditions, identify specific
treatments for the child.
• If a child requires urgent referral, give essential
treatment before the patient is transferred.
• If a child needs treatment at home, develop an
integrated treatment plan for the child and give the
first dose of drugs in the clinic.
• If a child should be immunized, give immunizations.
Identify

22. • Provide practical treatment instructions, including
teaching the caregiver how to give oral drugs, how to
feed and give fluids during illness, and how to treat
local infections at home.
• Ask the caregiver to return for follow-up on a specific
date, and teach her how to recognise signs that
indicate the child should return immediately to the
health post.
Treat

23. • Assess feeding, including assessment of
breastfeeding practices, and counsel to solve any
feeding problems found.
• Then counsel the mother about her own health.
Counsel

24. • When a child is brought back to the health post as
requested, give follow-up care and, if necessary,
reassess the child for new problems.
Follow-up
care

25. IMNCI Case Management Process
For all sick children up to 5 years who are brought to a first level Health facility
Select age appropriate treatment chart
Sick child age 2 months up to 5 years
Sick young infant age up to 2 months
•Possible bacterial
infection
•Jaundice
Danger Signs
•Convulsions, lethargy,
unconsciousness, inability
to drink/ breastfeed,
vomiting
Check everyone
•Cough or difficult
breathing, diarrhoea,
fever, ear problem
•Malnutrition, anaemia,
immunization, vitamin A,
folic acid supplementation
Diarrhoea
Check everyone
Ask for major symptoms
& assess if present
Feeding problem &
malnutrition,
immunization

26. IMNCI Case Management Process
continue
Assess other
problems
Classify illness & identify treatment use color coded
treatment charts
PINK (urgent referral)
OUTPATIENT HEALTH
FACILITY
- Prereferral treatment
- Advice parents
- Refer young infant/child
PINK (urgent referral)
REFERRAL FACILITY
- Emergency treatment
- Diagnosis - Treatment
- Monitoring & follow up
YELLOW
OUTPATIENT HEALTH
FACILITY
- Treat local infections
- Give oral drug
-Advice & teach Caretaker
- Follow-up
GREEN (Home
Management)
Care taker is counseled
how to
- Give oral drug, treat local
infections, breastfeeding
-Keep the young infant
warm
- When to return
Immediately
- Follow up
Give follow up care when
young infant or child return
to clinic and if necessary.
Reassesses for any new
problem.

27. IMNCI has the following advantages:
• Promotes the accurate identification of childhood
illnesses in out-patient settings
• Ensures appropriate combined treatment of all major
childhood illnesses
• Strengthens the counselling of mothers or caregivers

28. Conti..
• Strengthens the provision of preventive services
• Speeds up the referral of severely ill children
• Aims to improve the quality of care of sick children at
the referral level.