Imci components by dr najeeb memon

IMCI Components by dr najeeb memon

1. BY DR: MUHAMMED NAJEEB Assist: Professor Faculty of Community Medicine & P.H.S, LUMHS Jamshoro, Sind, Pakistan E mail [email protected] IMCI

2. 3 Integrated Management of Childhood illness (IMCI)

3. Integrated Management of Childhood Illness (IMCI )

4. Why is IMCI better than single-condition approaches? Children are often suffering from more than one condition This overlap means that a single diagnosis may not be possible or appropriate and treatment may be complicated by the need to combine therapy for several conditions An integrated approach to managing sick children is, therefore, indicated as is the need for child health programs to go beyond single diseases “ Looking to The Child as a Whole (Health of a child) ”.

5. Health Delivery System Basic Health Units Rural Health Centers District Headquarters Hospital Tertiary Hospitals Population Served Referral Centers DHQ: 1Million to 1.5m THQ : 100,000 – 300,000 5,000 – 10,000 Health Care Providers Specialists, Doctors, Nurses, Paramedical Staff RHC: Pop: 50,000 to 100,000 , 10-20 beds, with about 30 staff including 2 M.Os, 1 WMO, 1 dental surgeon & a no: of paramedics. , x-ray, laboratory and minor surgery facilities. These do not include delivery and emergency obstetric services. THQ / DHQ : They typically have 40-60 beds and appropriate support services including x-ray, laboratory and surgery facilities. The staff includes at least three specialists: an obstetrician & gynecologist, a pediatrician and a general surgeon. BHUs staff of 10 ( a male doctor, a LHV or a FHT, a Male Medical Technician or/and a dispenser, a trained or unqualified midwife (dai), a sanitary inspector, a vaccinator, and 2-3 support staff (guard, sweeper, gardener, etc.). They are required to offer first level curative, MCH, family planning and preventive services . 50,000 –100,000 Primary care facilities : (MCH, BHU, RHC) MCH ,Family planning , & Curative, prev: services Referral level care facilities : THQH, DHQH Tertiary care facilities : Teaching Institutions

6. IMCI Case Management Danger signs Main Symptoms Nutritional status Immunization status Other problems Need to Refer Specific treatment Home managemen t Classification Focused Assessment Identify treatment Treat Counsel caretakers Follow-up Treatment Counsel & Follow-up

7. The strategy includes 1. Improving case management skills of health-care staff. (Improvement of health worker skills) 2. Improving overall health system 3. Improving family and community health practices (in relation to child health)

8. IMCI Component 1: Improves Health Worker Skills Case management guidelines Training of health providers (Doctors , Medical Assistants & Nurses) who look after sick infants and children up to 5 years (pre-service and in-service) Follow-up after training 11

9. IMNCI HEALTH SYSTEM COMPONENT: BACKGROUND : Strengthening health systems is one of the three key elements of the IMCI strategy to ensure universal access to services of high quality. IMCI packages essential interventions and strengthens service delivery in primary care settings with a focus on conditions of significant public health importance.

10. IMCI Component 2: Improves Health Systems 13 Objectives of field visits to BHU & RHC : To identify the health services available at the health facility. Health work force. Technologies available at the health facilities. Availability of drugs and supplies . Monitoring & Supervision Health information system. Referral pathways and system.   To identify barriers against coverage for child health care . Gaps in capacity of health care delivery. Inadequate/ ineffective human resources. Inadequate financial resources to support cost-effective health programs like IMNCI. Poor referral system and quality of care . Inadequate knowledge and practices of caretakers. System improvements

11. What progress may be made in improving health systems for child health? Leadership and governance in key policy areas in health. Health financing system. Improving the capacity of the health work force. Filling the gap in health care delivery to the needy consumers .

12. IMCI Component 3: Improves Family and Community Practices (Household & Community base Component) 15 To improve the knowledge, attitude and practices of families -- greatest impact on child survival , growth & Development Objectives For Household Surveys:   To prevent common childhood illness including malnutrition, injuries and neglect at the household and community level. To improve the household and community response to childhood illness and the quality of care provided at home. To improve appropriate and timely care seeking behaviour when children need additional assistance outside the home. To increase compliance to recommended treatment and advice from trained care providers. To promote a supportive and enabling environment at the household and community level for children’s survival , growth, and development .

13. Improves Family and Community Practices Exclusive Breastfeeding Complementary feeding Cont. feeding during illness. Routine vaccination Regular growth monitoring. Early care seeking. Compliance to provider advice Home care of sick children Recognition of severe illness

14. IMCI Component 3: Improves Family and Community Practices Proper waste disposal. Use of Nets Antenatal care TT for pregnant ladies. Proper nutrition for pregnant ladies. 17

15. Volunteers were trained on Key Family practices and communication skills . Community-based activities: LHWs, Female Health Technicians (FHTs) and TBAs . Provide s MCH, family planning services . Each LHW has established a “Health House” in her home and also reaches the doorsteps of the people to serves as the first level of health services for the rural and peri - urban women and children. LHWs maintain records for all the households in their catchment areas and actively follow up each family every month, especially the defaulters for immunization or dropouts for family planning and to persuade families to adopt healthier life style.

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