IMNCI described method for assessing immunization, folic acid and vitamin A supplementation status of children from 0 to 2 months and 2 months to 5 years of age group.

1. CHECKING FOR IMMUNIZATION,
FOLIC ACID AND VITAMIN A
STATUS
Curative component
Health promotive and preventive component

2. CHECKING FOR IMMUNIZATION STATUS
Immunization Schedule
Check the Immunization Schedule
Decide if the immunization is required today
or mother needs to bring child later for
immunization
Check for Contraindications

3. CHECKING FOR IMMUNIZATION STATUS
Immunization schedule
Age Vaccine
Birth BCG OPV-'0' Hep B-'0'
6 weeks DPT-'1' OPV-'1' Hep B-'1'
10 weeks DPT-'2' OPV-'2' Hep B-'2'
14 weeks DPT-'3' OPV-'3' Hep B-'3'
9 months Measles Vitamin A
16-24 months DPT-booster OPV-booster MMR (18)
5-6 years DPT-booster

4. CHECKING FOR IMMUNIZATION STATUS
Immunization Schedule
Check the Immunization Schedule
Decide if the immunization is required today
or mother needs to bring child later for
immunization
Check for Contraindications

5. CHECKING FOR IMMUNIZATION STATUS
Determine age of child
Ask the mother for immunization card
YES. Check which vaccines
are to be given at current
visit
Circle the vaccines that
are to be given in next
visit with date
In not reliable, then give OPV,
Pentavalent and measles
NO. Ask the mother for
immunization status
Give her immunization card
and ask to bring for next visit

6. CHECKING FOR IMMUNIZATION STATUS
• Only 4 CONTRAINDICATIONS for immunization of sick children:
1. Being referred urgently to hospital
2. Live vaccines ⇏ children with immunodeficiency diseases
3. DPT-'2'/DPT-'3' ⇏ if convulsions or shock within 3 days of a
previous dose of DPT.
4. DPT ⇏ children with recurrent convulsions or active neurological
disease

7. CHECKING FOR FOLIC ACID STATUS
• 20 mg elemental iron and 100 mcg folic acid
≣ one tablet of pediatric IFA
≣ 5 ml of IFA syrup
≣ 1 ml of IFA drops
• For a total of 100 days in a year, after child has recovered from acute
illness

8. CHECKING FOR FOLIC ACID STATUS
• CONTRAINDICATIONS
1. Child below 6 months of age
2. Received pediatric IFA tablets/syrup/drops for 100 days in last one
year

9. CHECKING FOR VITAMIN A STATUS
• Prophylactic:
• For children > 12 months and < 8 kg ⟹ 100,000 IU orally ➠ Oil-based
formulation
• IM treatment ⟹ in children with severe anorexia, oedematous
malnutrition or septic shock ⟿ Water based formulation, ½ oral dose
(50,000 IU)

10. CHECKING FOR VITAMIN A STATUS
• Treatment
• Single dose to all Severe Acute Malnutrition (SAM) children unless
there is evidence that child received vitamin A dose in last 1 month
• Recommended oral dose of Vitamin A according to child's age:
Age Vitamin A dose
< 6 months 50,000 IU
6-12 months or if weight < 8 kg 100,000 IU
> 12 months 200,000 IU

11. CHECKING FOR VITAMIN A STATUS
Age Dose
9 months 100,000 IU
16-18 months 200,000 IU
24 months 200,000 IU
30 months 200,000 IU
36 months 200,000 IU
42 months 200,000 IU
48 months 200,000 IU
54 months 200,000 IU
60 months 200,000 IU

12. CHECKING FOR VITAMIN A STATUS
• Clinical evidence of Vitamin A deficiency
• On examination:
1. Dry conjunctiva or cornea
2. Bitot's spots
3. Corneal ulceration
4. Keratomalacia
Treatment: Same dose on Day 1, 2 and 14