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1. INTEGRATED MANAGEMENT OF
NEONATAL AND CHILDHOOD
ILLNESS

2. ADD
Mal-
nutrition ARI
7/10
<5mort.
Measles Malaria

3. Factors contributing
to illness
Poor living conditions-
lack of safe water supply
poor hygiene
overcrowding
Inability of parents to recognize danger signs

4. delay in seeking appropriate
treatment
poor quality of care provided at
health facilities.
More than one morbid condition

5. "The Integrated Management of Childhood
Illness (IMCI)"
1992
UNICEF and WHO

6. Objectives
Reduce mortality
Reduce frequency and severity of illness
and disability
Improve growth and development during
the first 5 years of a child's life

7. Guidelines
Evidence-based
syndromic approach
Determining the health problems of the child
Severity of child's condition
Evaluation of the actions taken
Rational, effective, and affordable use of drugs
and diagnostic tools.

8. IMCI Strategy
Health-worker component:
Improvements in the case-
management skills of health staff
through locally adapted guidelines.
Health-service component:
Improvements in the overall health
system required for effective
management.
Community component:
Improvements in family and
community health care practices.

9. IMNCI
Central pillar of child health interventions
under
RCH II

10. IMNCI
• Inclusioin of 0-7 years of age.
• Incorporating national programmes.
• Training begins with sick infants <2 mths.
• Training time devoted to sick infant & sick
child are almost equal.
• Skill based

11. Implications
Standardized case management procedures
based on two age categories:
1. upto 2 months
2. 2 months to 7 years.
Only a limited number of carefully-selected
clinical signs are considered, based on their
sensitivity and specificity, to detect the
disease.

12. Classification PYG
- urgent hospital referral or admission
- specific medical Rx or advice
- home management

13. Management
Assessment
Classification of illness
Identification of specific Rx
Clear instructions to mother
Counsel to solve feeding problems
Follow-up care.

14. Advantages
Evidence-based management decisions.
Eg:oral rehydration therapy for diarrhea.
Focus on communication and counselling
skills.
Locally adapted recommendation for infant
and young child feeding.

15. Increased effectiveness of care and reduction
in cost.
Potential of lowering the burden on hospitals.
Model for improving one aspect of service
delivery that could be applied to other aspects
of health care.

16. What it does not address...
• Not all major illnesses are included
• Management of trauma / other emergencies
not included.

17. Challenges
Feasibility
Sustaining what is initiated through
indicator-based monitoring
Making home-based care of young
infants operational by ANMs and
AWWs

18. Future aims
To provide a comprehensive newborn and child
care package at all levels of care:
At the village/household level - AWWs.
Sub-center level - through ANMs
PHCs - doctors, nurses, and Lady Health Visitors;
At First Referral Units – MOs and nurses

19. Summarizing...
Major diseases
Origin
Objectives
IMCI strategy
IMNCI
Classification
Management
Advantages
Challenges
Future aims

20. Thank ...Very
you... much