IMCI

1. IMCI Integrated Management of Childhood Illness

2. Summary of slides • Introduction to IMCI –Slide 3 • Rationale for IMCI- Slides 4-10 • Advantages – Slide 11 • Objectives- Slide 12 • Components- Slide13 • Intervention areas- Slide 14 • IMCI in Nigeria • Implementation steps (in another file)

3. An Approach for who? • Clinical Officers • Nurses • Medical Assistants • Health assistants • Community Health Officers (CHOs) • Other health workers Not for in-patient care

4. UNDER FIVE MORTALITY RATES FOR DIFFERENT COUNTRIES –

5. Leading causes of under five mortality in developing countries • Acute respiratory infections (ARI) - especially pneumonia • Diarrhoea • Malaria • Measles • Malnutrition

6. Frequency of presenting complaints of 450 children (as volunteered by their mothers),Gondar, Ethiopia, 1994 Fever 58%} Cough 56% Diarrhoea 47% Ear problems 10% Skin lesions 03% Abd. pains Eye discharge Dental problems Neck swelling e.t.c.

7. Consequences of Vertical Approach • In practice, the sick child is not managed in a holistic manner at the health centre. More often, only the predominant symptom is considered for diagnosis and treatment. • Many training courses are organised by individual programmes. This disturbs the continuity of services at the health centre. • At health level, programmes often have the same target population and are delivered by the same health workers. Verticalization usually results in inappropriate use of resources.

8. A single diagnosis may not be apparent or appropriate ______________________________________ Presenting complaint Possible cause or associated _____________________________ condition________________ Cough and/or fast breathing Pneumonia Severe anaemia P.falciparum malaria Lethargy or unconsciousness Cerebral malaria Meningitis Severe dehydration Very severe pneumonia Measles rash Pneumonia Diarrhoea Ear Infection “Very sick young infant Pneumonia Meningitis Sepsis

9. Integrated Management of Childhood illness (IMCI) as a key strategy for improving child health The IMCI strategy combines improved case management with aspects of nutrition, immunisation, and several other important influences on child health

10. Integrated Management of childhood illness The IMCI strategy is an approach, not entirely different from what we have known, as several national programmes have collaborated to develop these guidelines.

11. ADVANTAGES OF IMCI • Accurate identification of illness • More appropriate & combined treatment • Rational use of drugs • Prompt referral of severe cases • Strengthening of preventive services • Attention to the health needs of the mother.

12. Objectives • To reduce significantly mortality and morbidity associated with the major causes of disease in children • To contribute to healthy growth and development of children

13. Components • Improving case management skills of health workers • Improving the health system to deliver IMCI • Improving family and community practices

14. IMCI components and intervention areas • Improving health Improving health Improving family & • workers skills systems community practices • -Case management - District planning - Appropriate • standards & and management care-seeking &prevention of • guidelines diseases • - Training of - Availability of - Nutrition • facility-based public IMCI drugs • health care providers • -Training for private - Improvement and -Home case management • health care providers supervision of referral -Adherence to recommended • pathways treatment • -Maintenance of - Improved Health - Community involvement • competence among information system in health planning and • trained health workers monitoring