2. THE INEQUITIES OF CHILD HEALTH
• Over the last 3 decades the annual number of
deaths among children less than 5 years of age
has decreased by almost a third. However, this
reduction has not been evenly.
• Distributed throughout the world. Every year
more than 10 million children die in Developing
countries before they reach their fifth birthday.
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3. THE INEQUITIES OF CHILD HEALTH
Seven in 10 of these deaths are due to acute
respiratory infections (mostly
pneumonia), diarrhoea, measles, malaria, or
Malnutrition and often to a combination of
these illnesses.
In India, common illnesses in children under 3
years of age include fever (27%)
Acute Respiratory infections (17%)
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4. THE INEQUITIES OF CHILD HEALTH
• Diarrhoea (13%) And malnutrition (43%) – and
often in Combination (National Family Health
Survey. Infant Mortality Rate continues to be
high per year.
• Neonatal mortality contributes to over 64% of
infant deaths and most of these deaths occur
during the first week of life.
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5. GOALS OF IMNCI
• Standardized case management of sick
newborns and children.
• Focus on the most common causes of mortality.
• Nutrition assessment and counselling for all sick
infants and children.
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6. GOALS OF IMNCI
Home care for newborns to :
• Promote exclusive breastfeeding.
• Prevent hypothermia.
• Improve illness recognition & timely care
seeking
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7. PRINCIPLES OF IMNCI
• All sick children under five years of age must be
examined for condition which indicate
immediate referral or hospitalization
• Children must be routinely assessed for major
symptoms, nutritional and immunization
status, Feeding problems and other potential
problems
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8. PRINCIPLES OF IMNCI
• Only limited number of carefully selected clinical
signs are used based on evidence of their
sensitivity and specificity to detect disease
• Based on the presence of selected clinical signs
the child is placed in “classification”.
• classifications are not specific diagnosis but
categories that are used to determine the
treatment
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9. PRINCIPLES OF IMNCI
• Classifications are color coded and suggest
referral (pink), treatment in healthy facility
(yellow) or management at home (green).
• IMNCI guidelines address most common , but
not all pediatric problems
• A limited number of essential drugs are use
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10. RATIONALE FOR AN INTEGRATED EVIDENCE-
BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
• Many well-known prevention and
treatment strategies have already proven
effective for saving young lives.
• Childhood vaccinations have successfully
reduced deaths due to measles
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11. RATIONALE FOR AN INTEGRATED
EVIDENCE-BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
• Prompt treatment of malaria has allowed
more children to recover and lead healthy
lives.
• Even modest improvements in
breastfeeding practices have reduced
childhood deaths.
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12. RATIONALE FOR AN INTEGRATED
EVIDENCE-BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
• While each of these interventions has been
successful, accumulating evidence suggests
that an integrated approach is needed to
manage sick children to achieve better
outcomes.
• Child health programme need to move
beyond single diseases to addressing the
overall health and well-being of the child.
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13. RATIONALE FOR AN INTEGRATED
EVIDENCE-BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
• An integrated approach is needed to
manage sick children to achieve better
outcomes.
• Child health programme need to move
beyond tackling single diseases in order to
address the overall health and well-being of
the child.
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14. RATIONALE FOR AN INTEGRATED
EVIDENCE-BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
• The guidelines represent an evidence-
based, syndromic approach to case
management that includes effective and
affordable use of drugs and diagnostic
tools.
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15. RATIONALE FOR AN INTEGRATED
EVIDENCE-BASED
SYNDROMIC APPROACH TO CASE
MANAGEMENT
An evidence-based syndromic approach
can be used to determine the:
health problem the child may have;
• severity of the child’s condition; and
actions that can be taken to care for the
child (e.g. refer the child
immediately, manage with available
resources, or manage at home).
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16. COMPONENTS OF THE INTEGRATED
APPROACH
• The IMNCI strategy includes both preventive
and curative interventions that aim to improve
practices in health facilities, the health system
and at home.
At the core of the strategy is integrated case
management of the most common neonatal and
childhood
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17. COMPONENTS OF THE INTEGRATED
APPROACH
• The strategy includes three main components:
Improvements in the case-management skills of
health staff through the provision of locally-
adapted guidelines on Integrated Management
of Neonatal and Childhood Illness and activities
to promote their use;
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18. COMPONENTS OF THE INTEGRATED
APPROACH
• Improvements in the overall health system
required for effective management of neonatal
and childhood illness;
• Improvements in family and community health
care practices.
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19. IMNCI CASE MANAGEMENT PROCESS
STEPS OF CASE MANAGEMENT
PROCESS:-
• Assess the young infant or child.
• Classify the illness.
• Identify the treatment
• Counsel the mother
• Provide follow up care.
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20. Bibliography
• K.K.Gulani community health nursing principal
& practice, kumar publishers, page no. 379-380.
• B.T. vasvanthappa community health
nursing, j.p.publishers page no. 265-267
• Preventive & social medicine k. park 18th
edition, page no. 345-346.
• Joan m. cookfair nursing care in the
community, published by mosby, second edition.
Page no. 520-524.
• www google. Com. Pub.
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