Imci components by dr najeeb memon

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IMCI Components by dr najeeb memon

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Imci components by dr najeeb memon

  1. 1. IMCI
  2. 2. Integrated Management of Childhood illness (IMCI) 3
  3. 3. Why is IMCI better than single-condition approaches? • Children are often suffering from more than one condition • This overlap means that a single diagnosis may not be possible or appropriate and treatment may be complicated by the need to combine therapy for several conditions • An integrated approach to managing sick children is, therefore, indicated as is the need for child health programs to go beyond single diseases “Looking to The Child as a Whole (Health of a child) ”.
  4. 4. Health Delivery System Health Care Providers Specialists, Doctors, Nurses, Paramedical Staff Population Served Tertiary Hospitals Referral Centers THQ / DHQ: They typically have 40-60 beds and appropriate support services including x-ray, laboratory and surgery facilities. The staff includes at least three specialists: an obstetrician & gynecologist, a pediatrician and a general surgeon. RHC: Pop: 50,000 to 100,000 , 10-20 beds, with about 30 staff including 2 M.Os, 1 WMO, 1 dental surgeon & a no: of paramedics. , x-ray, laboratory and minor surgery facilities. These do not include delivery and emergency obstetric services. BHUs staff of 10 ( a male doctor, a LHV or a FHT, a Male Medical Technician or/and a dispenser, a trained or unqualified midwife (dai), a sanitary inspector, a vaccinator, and 2-3 support staff (guard, sweeper, gardener, etc.). They are required to offer first level curative, MCH, family planning and preventive services . District Headquarters Hospital Rural Health Centers DHQ: 1Million to 1.5m THQ: 100,000 – 300,000 50,000 –100,000 Basic Health Units Primary care facilities: (MCH, BHU, RHC) Referral level care facilities: MCH ,Family planning , THQH, DHQH & Curative, prev: services 5,000 – 10,000 Tertiary care facilities: Teaching Institutions
  5. 5. IMCI Case Management Focused Assessment Classification Need to Refer Danger signs Main Symptoms Nutritional status Immunization status Other problems Specific treatment Counsel & Follow-up Treatment Counsel caretakers Follow-up Identify treatment Treat Home management
  6. 6. The strategy includes 1) 1. Improving case management skills of health-care staff. (Improvement of health worker skills)  2. Improving overall health system  3. Improving family and community health practices (in relation to child health)
  7. 7. IMCI Component 1: Improves Health Worker Skills  Case management guidelines  Training of health providers (Doctors , Medical Assistants & Nurses) who look after sick infants and children up to 5 years (pre-service and in-service)  Follow-up after training 11
  8. 8. IMNCI HEALTH SYSTEM COMPONENT: BACKGROUND:  Strengthening health systems is one of the three key elements of the IMCI strategy to ensure universal access to services of high quality.  IMCI packages essential interventions and strengthens service delivery in primary care settings with a focus on conditions of significant public health importance.
  9. 9. IMCI Component 2: Improves Health Systems Objectives of field visits to BHU & RHC: To identify the health services available at the health facility. A. Health work force. B. Technologies available at the health facilities. C. Availability of drugs and supplies. D. Monitoring & Supervision E. Health information system. F. Referral pathways and system. 1. 2. To identify barriers against coverage for child health care. • • • Gaps in capacity of health care delivery. Inadequate/ ineffective human resources. Inadequate financial resources to support cost-effective health programs like IMNCI. Poor referral system and quality of care. Inadequate knowledge and practices of caretakers. System improvements • • • 13
  10. 10. What progress may be made in improving health systems for child health? • Leadership and governance in key policy areas in health. • Health financing system. • Improving the capacity of the health work force. • Filling the gap in health care delivery to the needy consumers.
  11. 11. IMCI Component 3: Improves Family and Community Practices (Household & Community base Component) To improve the knowledge, attitude and practices of families --greatest impact on child survival , growth & Development Objectives For Household Surveys: 1. 2. 3. 4. 5. To prevent common childhood illness including malnutrition, injuries and neglect at the household and community level. To improve the household and community response to childhood illness and the quality of care provided at home. To improve appropriate and timely care seeking behaviour when children need additional assistance outside the home. To increase compliance to recommended treatment and advice from trained care providers. To promote a supportive and enabling environment at the household and community level for children’s survival, growth, and development. 15
  12. 12. Improves Family and Community Practices  Exclusive Breastfeeding  Complementary feeding  Cont. feeding during illness.  Routine vaccination  Regular growth monitoring.  Early care seeking.  Compliance to provider advice  Home care of sick children  Recognition of severe illness
  13. 13. IMCI Component 3: Improves Family and Community Practices Proper waste disposal. Use of Nets Antenatal care TT for pregnant ladies. Proper nutrition for pregnant ladies. 17
  14. 14. Volunteers were trained on Key Family practices and communication skills . Community-based activities: • LHWs, Female Health Technicians (FHTs) and TBAs. Provides MCH, family planning services . • Each LHW has established a “Health House” in her home and also reaches the doorsteps of the people to serves as the first level of health services for the rural and peri -urban women and children. LHWs maintain records for all the households in their catchment areas and actively follow up each family every month, especially the defaulters for immunization or dropouts for family planning and to persuade families to adopt healthier life style.
  15. 15. END

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