INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS (IMNCI)*IMNCI IMNCI is an integrated strategy which deals with a number of priority health problems resulting in major cause of mortality and morbidity in under five children. e IMNCI was developed by United Nations Children’s Fund and the World Health Organization in 1992 ¢ IMNCI is one of the main interventionsEFINITION: ® IMNCT is an integrated approach to child health that focuses on the well being of the whole child. It focussed primarily on the most common causes of child mortality-diarrhea, pneumonia, measles, malaria, and malnutrition, illness affecting children aged 1 week — 2 months, 2 months -5 year including both preventive and curative elements to be implemented by families.Why IMNCI? _*To Reduce infant and child moa rates |* Improving child health & survival India is still among high infant mortality Rate countries but there has been significant decline in the IMR from 204 during 1911-1915 to 129 per 1000 live births in 1970 and remained static at around 127 for many years. ¥As of 2011 data India’s Infant Mortality Rate is 44 aon ia pee 5Causes of neonatal mortality Neonatal mortality(0-4 Post neonatal weeks) mortality(1-12 months) + Low birth weight & + Diarrhoeal diseases prematurity + Acute respiratory + Birth injury and difficult infections labour + Communicable disease + Sepsis + Malnutrition + Congenital anomalies + Congenital anomalies + Hemolytic disorders + Accidents + Conditions of placenta and cord + Diarrhoeal diseases + Acute respiratory infections + Tetanus 6Beneficiaries of IMNCIComponents of IMNCI ; rf : Collaboration es Effective : Training i i with other implementation | departments 6 Improvement of family and community health practicesTraining in IMNCI 1. Average size district -1800 health staff need to be trained 2. Number of the staff of other departments should be included in consultation with the concerned district officers. 3. Staff belonging to PHC areas may be taken up fully before moving to another PHC areaTraining at two levels In-Service training for the existing staff Pre-Service TrainingTrainees of IMNCI Paediatricians Selected Medical Officers from Community Health Centres and block PHCs elected staff nurses ,Lady Health Visitors and Child Development Project OfficersTraining in IMNCI Type of Personnel |Duration |Package | Place of training to be to be used | training trained Clinical Medical 8 days Physician | Medical skills Officers, package College/ training Paediatrician District s Hospital 8days Health Health workers District workers,ANM package Hospital s, CDPOs and ponecontd Type of Personnelto | Duration Package to | Place of | training be trained be used training Supervisory | Medical 2days Supervisory | Medical Skill Training | Officers, Skills College/ Paediatricians, Package District CDPOs and Hospital LHVs 14Principles of IMNCI 1. All sick children must be examined for “general danger signs” which indicate the need for immediate referral or admission to a hospital. 2. All sick children must be routinely assessed for major symptoms (for children age 2 months up to 5 years: cough or difficult breathing, diarrhoea, fever, ear problems for young infants up to 2 months: very severe disease, diarrhoea, jaundice and....Contd 3.They must also be routinely assessed for nutritional and immunization status, feeding problems and other problems e 4.Assess Vitamin A supplementation and de- worming status for children age 2 months up to 5 years.Care of newborns and young infants(<2months) * Keep the child warm « Initiation of breast feeding ¢ Counselling of mother for exclusive breast feeding ¢ Cord,skin and eye care © - Recognition of iliness in newbom and its management mmunizationCare of infants (2 months-5 years of age) Management of diarrhoea, ARI,malaria,measles,malnutrition and anaemia ¢ Recognition of illness ¢ Prevention and management of Iron Deficiency and Vit B12 deficiency « Counselling for feeding for malnourished children ©| CHECK for danger signs » Convulsions | > Inability to drink/breastfeed vomiting ASSESS main symptoms ¥ Coughidifficulty in breathing ¥ Diamhoea wv Fever ¥ Ear problems Assess Nutrition and Immunization status and potential feeding problems ‘Check for any other problemUrgent referral | Pre-referral treatments -advise patients -refer child Referral facility Emergency triage and {treatment (ETA -Diagnosis Treatment -Monitoring -Follow up: CLASSIFY conditions and identify treatment actions According to color coded s Treatment at outpatient health facility +Treat local infection *Give oral drugs Advise and teach the care taker +Follow up stem (Green) Home management Care taker is counselled on how to +Give oral drugs ‘Treat local infections *Continue feeding -Follow upThank YoU