3 IMNCI Presentation Pediatrics Medical.pptx

IMNCI

1. IMNCI: Integrated management of neonatal and childhood illness is a broad strategy to reduce childhood mortality and morbidity in developing countries. IMNCI strategy is collaborated by WHO and UNICEF and this program was launched in 1997. It was recognised that five conditions namely ACUTE RESPIRATORY INFECTION, DIARRHOEA, MEASLES, MALARIA, and MALNUTRITION causes most deaths in children of developing countries. In this strategy simple life saving measures are used to reduce childhood mortality and morbidity. IMNCI also has health promoting and preventive strategies such as Reducing missed opportunities for immunization Breastfeeding Nutritional counselling Vitamin A and iron suppementation Treatment of worm infestation

2. Qualities of program: It deals with all problems of the child simultaneously because a child usually has more than one problem at a time No costly equipment is required for its implementation such as stethoscope, microscope, X ray etc. No technical expertise is required The focus of the IMNCI strategy is at 1 st level health facilities.

3. OBJECTIVES: Objectives of IMNCI are To prevent illness. To reduce deaths from most common child health problems. To promote child health and development.

4. Components and IMNCI package Health worker components Improvement in overall health system Improvement in family and community health care practices IMNCI based on 2 age categories 1) up to 2 month 2) 2 month to 5 years

5. Principles Examine all children aged up to 5 years Assess for main symptoms Routinely check for immunization , nutritional status HIV status in high HIV settings and other potential problems Classify the problem Active participation of caregivers and use of limited drug Counseling of caregiver

6. Advantages Speed up the urgent treatment and treatment seeking practices Prompt recognition of serious condition involve parents in effective care of baby Partial success of individual disease control programme Involve prevention of disease by active immunization, improved nutrition, exclusive breastfeeding Highly cost effective Avoid wastage of resources

7. ASSESS AND CLASSIFY THE SICK CHILD AGE 2 MONTHS UP TO 5 YEARS: Assess and CLASSIFY the sick child. Ask the Mother what the child problems are.

8. PNEUMONIA AND VERY SEVERE DISEASE

9. Diarrhoea, Dehydration, dysentery

10. Counsel the mother on the 4 rules of home treatment 1) give extra fluid 2) give zinc supplements 3) continue feeding 4) when to return Give recommended amount of ORS over 4 hours Show the mother how to give ORS solution After 4 hours reassess the child Begin feeding in clinic If mother leaves before completing the treatment show her how to make ORS and how to give also explain plan A PLAN B: Treat some dehydration with ORS Plan A: Treat diarrhoea at home

11. PLAN C: Treat severe dehydration quickly Start IV fluid immediately Start rehydration by tube or mouth Reassess the child after every 1-2 hours If there is vomiting and abdominal distension give the fluid slowly

12. Fever,Malaria,Measles

13. Ear problem,anemia

14. MALNUTRITION

15. HIV INFECTION

16. Check for immunization EPI CARD deworming status : give every child mebendazole every 6 month from the age of 1 year vit A supplementation : give every child vit A supplements every 6 month from the age of 6 month

17. Feeding recommendation

18. New born up to 1 week 1 week to 6 month 6 month to 9 month 9 month to 12 month 12month to 2 year 2 year and older Immediately after birth Give colostrum Breast feed at least 8 time in 24 hours for low birth weigh baby feed after every 2-3 hours Do not give other food or fluid Breastfeed as often as child want Check for hunger signs lik3 sucking finger 8 times in 24 hours Do not give other fluid Breastfeed As often as child want Give thick porridge or smashed food vit A supplements Start giving 2-3 tablespoon gradually increasing to half cup Give meal 2-3 times a day Offer 1 or 2 snack each day Variety of food Half cup per meal 3-4 meals per day Continue breast feeding For snack give small chewable items ¾ cup per meal Snack between 2 meals Continue breastfeeding Do not force child to eat Variety of food includes vegetable meat and fruits 3-4 meals each day If child refuse new food offer taste several times and be patient

19. Feeding recommendations for a child with persistent diarrhoea: If still breastfeeding give more frequent,longer breastfeeds, day abd night If taking other milk: Replace with increased breastfeeding Replace with fermented milk products such as yogurt Replace half the milk with nutrient rich semi For other food follow feeding recommendations for childs age

20. TREAT THE CHILD Teach mother to give oral drugs at home Follow instructions below for every drug to be given at home Follow the instructions listed with each drug dosage table See page 58 to 64 of pervaiz Akbar