IMNCI is an integrated approach to child health that focuses on the major causes of child mortality for children aged 1 week to 5 years. It includes both preventive and curative elements to be implemented by families and health workers. The goal of IMNCI is to assess child survival indicators and existing program activities in intervention districts. Key objectives include determining baseline mortality rates and morbidity among children under 5, as well as assessing program coverage. IMNCI implements an integrated approach through adapting clinical guidelines, training health workers, and developing community support mechanisms.

1.  IMNCI is an integrated approach to child health thatfocuses on the well being of the whole
child. Itfocussed primarily on the most common causes ofchild mortality-diarrhea, pneumonia,
measles,malaria, and malnutrition, illness affecting childrenaged 1 week – 2 months, 2 months
-5 year includingboth preventive and curative elements to beimplemented by
families.FINITION:
 2. Beneficiaries of IMNCI*care of young infants for new borns(under 2months)*young
children(2months-5yrs)
 3. GOALTo assess current statues of child survivalindicators and process indicators
forexisting programme activities inintervention and compassion districts.
 4. OBJECTIVES*To determine baseline mortality amongchildren under 5yrs of
age(NMR,IMR,USMR)*To determine prevalence of fever,loose stools,coughand any other
illness(morbidity density)in twoweeks prior to day of field survey among childrenunder 5yrs
of age.*To assess effective programme coverage for specifieddisease condition(cough with
fastbreathing)occuring in two weeks prior to day offield survey
 5. *Causes of under 5 mortality and path way analysis ofevents prior to death and recovery of
sick under 5children*Sickness management practices at household,community level and health
facility level.*Sickness and care providing competencis of health careproviders(doctors,health
workers and othercommunity level non convectional service providers)*Health system support
for man power,legistics,referalmechanism,intersectoral coordination,socialmoliblisation and
monitoring and supervision.
 6. COMPONENTS*HEALTH WORKER COMPONENTCase management skills*HEALTH
SERVICE COMPONENTImprovement in overall health*COMMUNITY
COMPONENTImprovements in family and community health carepractices
 7. IMPLEMENTATION OF IMNCI*adopting an integrated approach to child health
anddevelopment in the national health policy.*adapting the IMNCI clinical guidelines to
countriesneeds, available drugs, policies and to the local foodsand language used by the
population.*up grading care in local clinics by training health workersin new method examine
and treat children and toeffectively council parents.*making up grade care possible by insuring
that enoughof the right low-cost medicines and simple equipmentare available.
 8. *strengthening care in hospitals for those children toosick to be treated in an out patient
clinic*developing support mechanism within communitiesfor preventing disease,for helping
families to care forsick children and for getting children to clinics orhospitals when needed.
 9. PRINCIPLES*All sick young infants upto two months must be assessedfor baerial
infection/jaundice and major symptoms ofdiarrhea*all sick children 2months to 5yrs must
examine for generaldanger signs which indicate the need for referral oradmission to a
hospital*all young infants and child 2months-5yrs of age must beroutinely assessed for
nutritional and immunisationstatus,feeding problems and other potential problems
 10. *Only a limited number of care fully selected clinicalsigns are used based on evidence of
drugs sensitivityand specificity to detect disease.*A combination of individual signs leads to
an infantsor childs classification rather than diagnosis.
 11. CLASSIFICATION ACCORDING TO
COLORCODECOLOR*pink*yellow*greenCLASSIFICATIONHospital referral or
admissionInitiation of special treatmentHome management

2.  12. TRAINING IN IMNCITraining is at 2 levels*Inservice training for the existing staff*Pre
service training
 13. CARE OF CHILDREN ACCORDINGTO IMNCI0-2 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 managementand/referral.*immunisation*home
visit in the post natal period.
 14. 2MONTHS-5YRS*management of diarrhea,ARI,malaria,measels,acuteear infecton,mal
nutrition and anemia.*recognition of illness and risk.*prevention and management of iron and
vitaminAdeficiency*counselling on feeding for all chilkdren below 2yrs.*counselling on
feeding for malnutrished.*immunization
 15. Immunization statusFeeding problemsDoes the infant have diarrheaPossible bacterial
infection / jaundiceAssessment of sick young infantupto 2 months
 16. Checking for bacterialinfection/jaundice
 17. IN CASE OF DIARRHEA
 18. Checking skin turgor
 19. FEEDING PROBLEM
 20. TEACHING & Advice mother to return immediately if danger signspresentAdvice on
home care of young infantTeach correct position for breast feeding Teach mother to keep
infant warm.COUNSELING
 21. Immunization - prophylactic vit A, ironAnamiaMalnutrion diarrheaAsk about main
symptoms [coughing/ breathingdifficulty]General danger signsAssessment of young child2
months – 5 years & folicacid supplement
 22. In case of diarrhea
 23. In case of fever
 24. MALNUTRITION
 25. ANEMIA
 26. IMMUNIZATIONAGE VACCINEBirth BCG , OPV ,Hepatitis6 WEEKS BCG(if not
given). OPV-1,HIB 1, DPT 110 WEEKS- POV -2 , DPT 2, HEP B 214 WEEKS OPV 3, DPT
3, HEP B 39MONTHS MEASLES , VIT A16- 18 MONTHS DPT, OPV,VIT A
 27. 16 – 36 months - 2 lakh unit 9 months - 1 lakh unitVit A Prophylaxis
 28. TREAT DEHYDRATION - ORS
 29. IRON & FOLIC ACIDAGE / WEIGHT PAEDIATRIC TABLET4-24 MONTHS (6-12
KG) 1 TABLET2 YRS - 5 YRS ( 12 – 19 KG) 2 TABLETVITAMIN A6 – 12 MONTHS 1
ML12 – 5 YRS 2 ML

3.  30. Continue breast feeding if child is sickDo not give any other foodBreast feed as often as
child wantFEEDING RECOMMENDATION0-6 MONTHS
 31. Wash childs hand before feedingKeep child on your lapGive smashed roti, rice, bread,
biscuit, undil: milkor vegetablesBreast feed as often6 – 12 months
 32. Wash hands with soapSit by the side of childOffer family foodBreast feed as often12
– 2 yrs
 33. > Teach child to wash handsEnsure that child finishes the servingGive family food2
years
 34. This approach could help country to achievemillenium goal.Major strength is it use
evidence based managementdecisionsIMNCI strategy has emerged as a promising
approachto deal with issues related to child survival.CONCLUSION