Integrated Management of Childhood Illness

(IMCI)

Integrated

Management

Childhood

Illness

•Diarrhea

•Acute Respiratory Infections (Pneumonia)

•Measles

•Malaria

•Malnutrition

5 major killers of children:

The world health organization is concerned of the unecessary deaths of children below 5 years old in the developing countries. integrated management for childhood illness is trying to fight these unecessary deaths. accourding to WHO, the mose common cause of death among these under 5 children is:

A. diarrhea  

B. pneumonia  

C. malaria  

D. malnutrition

Assess the child or young infant

Check for General Danger Signs

• Convulsion

• Abnormally sleepy/unconsciousness

• Not able to drink or breastfeed

• Severe vomiting/vomits everything

Which of the following is not a danger sign?  

A. convulsion

B. inability to drink or breastfeed  

C. lethargy/ unconsciousness  

D. difficulty of breathing          

4 MAIN SYMTPOMS

• Cough or difficult breathing

• Diarrhea

• Ear pain

• Fever

CLASSIFY THE ILLNESS

I M C I Color Coding

Needs urgent attention and referral or admission for in-patient care. This is a severe classification

Child needs an appropriate antibiotic, an oral anti-malarial or other treatment which can be given in health center

Does not need specific medication / treatment such as antibiotic. Can be manage at home by mother

If the child has only one of the danger sign implicitly stated in the IMCI guideline, this child will be classified under what color?

A. pink  

B. blue  

C. yellow  

D. green

TREAT

CURATIVE

&

HOLISTIC CARE

COUNSEL

HEALTH EDUCATION

IMCI Case Management

Danger signsMain Symptoms

Nutritional statusImmunization status

Other problems

Need to Refer

Specific treatment

Homemanagement

ClassificationFocused

Assessment

Identify treatmentTreat

Counsel caretakersFollow-up

Treatment

Counsel & Follow-up

Causes of Death in children

Source: CHERG estimates of under-five deaths, 2000-03

Under-nutritio

n53%

IMCI IMPLEMENTATION IN THE Philippines

Initiation Phase – IMCI adaptation, meetings with key stakeholders

Early implementation phase –

trainings implementation in pilot areas

Expansion phase

cascade to other areas

curriculum integration – nursing, midwifery, medical schools

Common Problems That Affect the Quality of Care Provided to

Sick Children at Health Facilities

1. Health worker’s skills

• Incomplete examinations and counseling

• Irrational use of drugs

• Poor communication between health workers and parents

2. Health system issues

• Availability of appropriate drugs and vaccines

• Supervision/division of labor/organization of

work

• Location of health services and responsibility (centralization)

Common Problems That Affect the Quality of Care Provided to

Sick Children at Health Facilities

3. Community and family practices

• Poor knowledge of when to return to

a health facility• Seeking assistance from unqualified providers• Poor adherence to health worker advice and treatment• Delayed care seeking

Common Problems That Affect the Quality of Care Provided to

Sick Children at Health Facilities

1. Skilled attendance during pregnancy, childbirth and the immediate postpartum

2. Care of the newborn3. Breastfeeding and complementary feeding4. Micronutrient supplementation

5. Immunization of children and mothers

6. Integrated management of sick children

7. Use of insecticide treated bed nets (in malarious areas)

Essential package of child survival interventions

Objectives of IMCI

Reduce deaths and the frequency and severity of illness and disability among children

Contribute to improved growth and development

Important Elements for Improving Child Health

Improve case management of sick children Improve nutrition Ensure immunization Prevent injuries Prevent other diseases Improve psychosocial support and

stimulation

Case Management Process

1. Assess the child or young infant2. Classify the illness3. Identify treatment4. Treat the child or refer5. Counsel the mother6. Give follow-up Care

Which vital sign is important in classifying a child with pneumonia from those who do not have?

A. temperature  

B. respiratory rate

C. chest indrawing  

D. stridor

In home management of a child with pneumonia, caretaker is counseled on how not to:  

A. give oral drugs

B. treat local infection at home  

C. when to return  

D. discontinue feeding

If pneumonia is present with major signs and symptoms, treatment will include:  

A. Cotrimoxazole P.O. BID  

B. Amoxicyllin P.O. BID  

C. ORS 240cc/ loose stool  

D. Procaine Penicillin IM OD