Integrated Management of Childhood Illness (IMCI) is a strategy that improves the health of children under five. It is better than single-condition approaches because children often have multiple conditions. IMCI takes a holistic approach to the child's health. The strategy includes improving health worker skills through training, strengthening health systems, and improving family and community health practices related to child health. This approach helps provide high quality and accessible services to improve child survival, growth, and development.

2. IMCI

3. Integrated Management
of Childhood illness
(IMCI)
3

6. 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) ”.

7. 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

8. 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

10. 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)

11. 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
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12. 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.

13. 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
•
•
•
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14. 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.

15. 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.
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16. 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

17. 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.
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18. 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.

19. END