FBIMNCI.pptx session 1

Introduction of FBIMNCI for Paramedics

1. Facility Based Integrated Management of Neonatal and Childhood Illness (FB-IMNCI) Training CHILD HEALTH AND IMMUNIZATION SERVICE SECTION FAMILY WELFARE DIVISION DoHS / MoHP 1

2. Situation of newborn, infant and child mortality and morbidity 2

3. Trend in child mortality 3 Decreased by 59% from 1990 to 2018

4. Globally, U5MR has decreased by 59%, from an estimated rate of 93 deaths per 1000 live births in 1990 to 39 deaths per 1000 live births in 2018. i.e 1 in 11 children dying before reaching age 5 in 1990, compared to 1 in 26 in 2018. 5.3 million children under age five died in 2018 (WHO 2019) 4

5. 5

6. Global situation Source: WHO/ UNICEF 2017 6

7. National situation Annually 13,000 newborn babies die within the first 28 days of life One-third deaths occur in the first day of life 78% of these neonatal deaths is avertable and can be prevented through cost-effective interventions 7 NDHS 2016

8. Trends of Under-5 Mortality in Nepal 8

9. Causes of Deaths Among Children U-5 Years 9 NDHS, 2016

10. Cause of Neonatal Deaths Respiratory & cardiovascular disorder of perinatal period 31% Complications of pregnancy, labor & delivery 31% NDHS, 2016 10

11. Neonatal Deaths Percent distribution of neonatal deaths within 0-27 days of birth 11 NDHS, 2016

12. What is being done?? 12

13. Child Survival Program: Major Milestones 13

14. Child Survival Program: Major Milestones 14

15. FB-IMNCI package integration of the existing IMNCI package and the facility based care package into one package. provides a continuum of quality care for severely ill newborns and children referred from the community 15

16. FB-IMNCI Package contd.. Focuses on providing appropriate inpatient management of major causes of neonatal and childhood mortality asphyxia, sepsis, and low birth weight among neonates; pneumonia, diarrhoea, malaria, meningitis, malnutrition among children

17. Need for Referral Package for IMNCI CB-IMNCI package do not cover the management of severe referred cases . Patient expectation for specialized care is increasing while availability of pediatricians in all district hospitals may not be possible at least for some years. Enhancement of skill of MOs, Nurses & Paramedical staffs working at referral hospital is a must for management of severe illness among newborn and children.

18. CB-IMNCI FB-IMNCI Linkages Between CB and FB-IMNCI “Red” PRE-REFERRAL TREATMENT AND REFERRAL

19. Objectives of the Training To enhance knowledge and skill of health workers regarding emergency triage assessment and treatment (ETAT) To learn the integrated approach of management of sick child To enhance the skills of service providers working at referral hospitals for management of sick newborn and U5 children To increase the access and quality of FB-IMNCI services through proper referral system

20. Referral Proposed Newborn and Child Health Services Structure 20