Dr. Animesh Gupta discusses the Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy aimed at improving child health in India by focusing on prevention, promotion, and treatment aspects. The approach targets children under five years of age, addressing major illnesses and incorporating home-based care and training for health workers. Key goals include reducing infant mortality and improving growth and development through targeted interventions and community support.

1. Dr. Animesh Gupta
MBBS, MD, FAGE
Assistant Professor
Dept. of Community Medicine, SIMS & RC

2.  WHO and UNICEF recognized the need to strengthen child-health
activities in the country and decided to launch IMCI.
 IMNCI strategy is one of the main interventions under RCH-
II/NRHM, that focuses on Preventive, Promotive and Curative
aspects of program.
 IMNCI is an integrated approach to child health that focuses on the
well-being of the whole child.
 IMNCI aims to reduce death, illness and disability, and to promote
improved growth and development among children under five years
of age.
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3.  Inclusion of 0-7 days age group (as against 1 week to 5 years in
IMCI) to address the neonatal mortality challenge.
 The total duration of training was reduced from 11 days to 8 days
out of which, half of the training time was earmarked for the
management of the young infants, 0 to 2 months.
 Incorporating National guideline on Malaria, Anemia, Vitamin A
supplementation and Immunization schedule.
 Home-based care of newborns and young infants was included.
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4.  Integrated approach is child centred
 Five conditions : Pneumonia (ARI), Diarrhoea, Measles, Malaria and
Malnutrition are major cause of Death.
 Children likely to be suffering from more than one condition.
 Making a single diagnosis may be difficult.
 Such children often need combined therapy for successful treatment.
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5. Reducing infant mortality
Reducing the incidence and seriousness of illnesses and
health problems
Improving growth and development during the first five
years of a child's life
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7.  Assess
 Danger signs, nutrition and
immunization status
 Other problems
 Classify - as per Color
Coding
 Identify - Specific Treatment
 Provide Treatment
 Pre referral
 Medical treatment
 Home Management
 Counsel
 Feeding problems
 Mother’s health
 Follow-up care
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8.  Only a limited number of carefully-selected clinical signs are
considered, based on their sensitivity and specificity, to detect the
disease.
 A combination of these signs helps in arriving at the child's
classification, rather than a diagnosis.
 Classification(s) also indicates the severity of the condition.
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9. PINK : suggests hospital referral or admission
(Child needs urgent referral)
YELLOW : indicates initiation of treatment
(Child needs specific medical treatment and
advise)
GREEN : calls for home treatment
(Child needs no medicine, advise home care)
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14.  Care of Newborns and Young Infants (infants under 2 months):
 Keeping the child warm.
 Cord, skin and eye care.
 Recognition of illness in newborn , management and/or referral.
 Immunization.
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15.  Home visits in the postnatal period:
 Home visits by health workers (ANMs, AWWs, ASHAs ).
 Three home visits are to be provided to every newborn:
 1st on the day of birth (day 1) & next 2 visit on day 3 & 7.
 For low birth weight babies, 3 more visits: on Day 14, 21 and 28.
 Care of mothers during the post-partum period.
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16.  Management of diarrhoea, acute respiratory infections
(pneumonia), malaria, measles, acute ear infection, malnutrition
and anaemia.
 Recognition of illness / at risk conditions and management/referral
 Prevention and management of Iron and Vitamin A deficiency.
 Feeding Counselling for all children below 2 years
 Feeding Counselling for malnourished children between 2 to 5
years.
 Immunization.
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18. 1. Operational Guidelines for Implementation of Integrated Management of
Neonatal and Childhood Illness
2. Integrated management of childhood illness. Available from: URL:
http://www.unicef.org/health/23958_imci.html
3. Kishore J. National Health Programs of India, 11th edition. New Delhi: Century;
2014
4. Student’s Handbook for IMNCI. Integrated Management of Neonatal and
Childhood Illness. Ministry of Health and Family Welfare , Government of India;
2003
5. K Park, Textbook of Preventive and Social Medicine, 23rd edition. Bhanot
Publisher, 2015
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