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Imnci

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IMNCI

Introduction

Integrated Management of Childhood Illness (IMCI) strategy, developed by World Health


Organization in collaboration with UNICEF and many other agencies in mid 1990s, combines
improved management of common childhood illnesses with prevention of diseases and
promotion of health by including counseling on feeding and immunization. This strategy has
been adapted and expanded in India to include neonatal care at home as well as in the health
facilities and renamed as Integrated Management of Neonatal and Childhood Illness (IMNCI).

Objective

To reduce under five morbidity and mortality in the developing countries in the developing
countries by improved performance of health workers.

Principles

The IMNCI guidelines are based on the following principles:


 All children under 5 yr of age must be examined for conditions which indicate immediate
referral
 Children must be routinely assessed for major symptoms, nutritional and immunization
status, feeding problems and other problems
 Only a limited number of carefully selected clinical signs are used for assessment
 A combination of individual signs is used to classify the severity of illness which calls for
specific action rather than a 'diagnosis'. Classifications are color coded and suggest
referral (pink), initiation of treatment in health facility (yellow) or management at home
(green)
 IMNCI guidelines address most common, but not all pediatric problems
 IMNCI management protocols use a limited number of essential drugs
 Caretakers are actively involved in the treatment of children
 IMNCI includes counseling of caretakers about home care including feeding, fluids and
when to return to health facility.

Components

The IMNCI strategy includes both preventive and curative interventions that aim to improve
practices in health facilities, the health system and at home.

The strategy includes three main components:

i. Improvements in the case management skills of health staff through use of locally adapted
guidelines

ii. Provision of essential drug supplies


iii. Optimization of family and community practices in relation to child health.

Sets of charts

Depending on a child's age, various clinical signs and symptoms differ in their degrees of
reliability and diagnostic value and importance. IMNCI clinical guidelines focus on children up
to 5 year of age. The treatment guidelines have been broadly described under two age categories:

l. Young infants age up to 2 months

2. Children age 2 months up to 5 year

Process

Steps of case management process are:


Step 1: Assess the young infant/child
Step 2: Classify the illness
Step 3: Identify treatment
Step 4: Treat the young infant/ child
Step 5: Counsel the mother
Step 6: Follow up care
Advantages of integrated approach

• Speeds up the urgent treatment and treatment seeking practices.

• Prompt recognition of serious condition, hence prompt referral.

• Involves parents in effective care of baby at home.

• Partial Success of Individual disease control programme.

• Involves prevention of diseases by active immunization, Improved nutrition and Exclusive


Breastfeeding practices.

• Highly cost effective.

• It avoids wastages of resources by using most appropriate medicines and treatment.

• It reduces duplication of effort.

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