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IMNCI - Intregrated Management of Neonatal and childhood illness
1.
2. DEFINITION:
IMNCI is an integrated approach to child health that
focuses on the well being of the whole child. It
focussed primarily on the most common causes of
child mortality-diarrhea, pneumonia, measles,
malaria, and malnutrition, illness affecting children
aged 1 week – 2 months, 2 months -5 year including
both preventive and curative elements to be
implemented by families.
4. GOAL
To assess current statues of child survival
indicators and process indicators for
existing programme activities in
intervention and compassion districts.
5. OBJECTIVES
*To determine baseline mortality among
children under 5yrs of age(NMR,IMR,USMR)
*To determine prevalence of fever,loose stools,cough
and any other illness(morbidity density)in two
weeks prior to day of field survey among children
under 5yrs of age.
*To assess effective programme coverage for specified
disease condition(cough with fast
breathing)occuring in two weeks prior to day of
field survey
6. *Causes of under 5 mortality and path way analysis of
events prior to death and recovery of sick under 5
children
*Sickness management practices at house
hold,community level and health facility level.
*Sickness and care providing competencis of health care
providers(doctors,health workers and other
community level non convectional service providers)
*Health system support for man power,legistics,referal
mechanism,intersectoral coordination,social
moliblisation and monitoring and supervision.
7. COMPONENTS
*HEALTH WORKER COMPONENT
Case management skills
*HEALTH SERVICE COMPONENT
Improvement in overall health
*COMMUNITY COMPONENT
Improvements in family and community health care
practices
8. IMPLEMENTATION OF IMNCI
*adopting an integrated approach to child health and
development in the national health policy.
*adapting the IMNCI clinical guidelines to countries
needs, available drugs, policies and to the local foods
and language used by the population.
*up grading care in local clinics by training health workers
in new method examine and treat children and to
effectively council parents.
*making up grade care possible by insuring that enough
of the right low-cost medicines and simple equipment
are available.
9. *strengthening care in hospitals for those children too
sick to be treated in an out patient clinic
*developing support mechanism within communities
for preventing disease,for helping families to care for
sick children and for getting children to clinics or
hospitals when needed.
10. PRINCIPLES
*All sick young infants upto two months must be assessed
for baerial infection/jaundice and major symptoms of
diarrhea
*all sick children 2months to 5yrs must examine for general
danger signs which indicate the need for referral or
admission to a hospital
*all young infants and child 2months-5yrs of age must be
routinely assessed for nutritional and immunisation
status,feeding problems and other potential problems
11. *Only a limited number of care fully selected clinical
signs are used based on evidence of drugs sensitivity
and specificity to detect disease.
*A combination of individual signs leads to an infants
or childs classification rather than diagnosis.
12. CLASSIFICATION ACCORDING TO COLOR
CODE
COLOR
*pink
*yellow
*green
CLASSIFICATION
Hospital referral or admission
Initiation of special treatment
Home management
13. TRAINING IN IMNCI
Training is at 2 levels
*Inservice training for the existing staff
*Pre service training
14. CARE OF CHILDREN ACCORDING
TO IMNCI
0-2 MONTHS
*keeping the child warm
*intiation of breast feeding.
*counselling for exclusive breast feeding.
*cord,skin and eye care.
*recognition of illness in newborn and management
and/referral.
*immunisation
*home visit in the post natal period.
15. 2MONTHS-5YRS
*management of diarrhea,ARI,malaria,measels,acute
ear infecton,mal nutrition and anemia.
*recognition of illness and risk.
*prevention and management of iron and vitaminA
deficiency
*counselling on feeding for all chilkdren below 2yrs.
*counselling on feeding for malnutrished.
*immunization
16. Assessment of sick young infant
upto 2 months
Possible bacterial infection / jaundice
Does the infant have diarrhea
Feeding problems
Immunization status
26. TEACHING & COUNSELING
Teach mother to keep infant warm.
Teach correct position for breast feeding
Advice on home care of young infant
Advice mother to return immediately if danger signs
present
27. Assessment of young child
2 months – 5 years
General danger signs
Ask about main symptoms [coughing/ breathing
difficulty]
diarrhea
Malnutrion
Anamia
Immunization - prophylactic vit A, iron & folic
acid supplement
37. 6 – 12 months
Breast feed as often
Give smashed roti, rice, bread, biscuit, undil: milk
or vegetables
Keep child on your lap
Wash childs hand before feeding
38. 12 – 2 yrs
Breast feed as often
Offer family food
Sit by the side of child
Wash hands with soap
39. > 2 years
Give family food
Ensure that child finishes the serving
Teach child to wash hands
40. CONCLUSION
IMNCI strategy has emerged as a promising approach
to deal with issues related to child survival.
Major strength is it use evidence based management
decisions
This approach could help country to achieve
millenium goal.