IMNCI.pptx

Its only for study purpose for Nursing Students. Kindly refer and share to others. Now a days child mortality rate is very high due to diarrhoea and malnutrition. If we identify the child in first stage we can save them.

1. IMNCI (Integrated Management for Neonatal and Childhood I llness)

2. INTRODUCTION The integrated management for neonatal and childhood illness (IMNCI) concept was developed by WHO and UNICEF as a new strategy. For the common illnesses management among paediatric population, the IMNCI is working towards controlling of morbidity and mortality rates among children.

3. Conti.. It is working to reduce the under five morbidity and mortality in the developing countries. Through integrated management the health workers are getting the good professional training and improving the performance towards child care.

4. Conti.. Integrated management of childhood illness (IMCI) strategy was developed in mid 1990. It is a curative, preventive and promotive strategy aimed at reducing the death and frequency and severity of illness and disability, and contributes to improve growth and nutrition of under-five children.

5. Conti.. This strategy has been expanded in India to include neonatal care at home as well as in the health facilities and it renamed as Integrated Management of Neonatal and Childhood Illness (IMNCI).

6. Objectives of IMNCI

7. MAJOR COMPONENTS OF THE INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS Components are following :- Improvement of family and community practices towards child health care . Provision of essential drugs and their supplies . Betterment of technical skill of health care providers in case of management .

8. Conti.. 4. Community involvement in health care programmes of children. 5. Equitable distribution of health care facilities and maximum reach out to all paediatric population.

9. SERVICE PROVIDED UNDER INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS These are following :- Vaccination services Vitamin 'A' and micro-nutrient supplementation . Breast feeding . Management of ARI ,

10. Conti.. Prevention of diarrhoea . Prevention of malnutrition. Malaria control programmes . Counselling on various health problems.

11. Conti.. Integrated management of childhood illness is working on preventive and curative aspect of health among paediatric population.

12. PRINCIPLES OF INTEGRATED CARE Principles of integrated care depending on a child's age, various clinical signs and symptoms differ in their degree of reliability and diagnostic value and importance. IMNCI clinical guidelines focus on neonates , infants as well as children upto 5 years of age.

13. The treatment guidelines have been broadly described under two age categories -.

14. Integrated management of neonatal and childhood illness guidelines are based on following principles - Children below 5 years of age, all should be examined for condition which indicates immediate referral or hospitalization . Children must be routinely assessed for major symptoms, nutritional and immunization status, feeding problems and other potentials problems .

15. Conti.. Only a limited number of carefully selected clinical signs are used based on evidence of their sensitivity and specificity to detect disease. Based on the presence of selected clinical signs, the child is placed in 'classification '

16. Conti.. Classifications are not specific diagnoses but categories that are used to determine the treatment .   Classifications are colour coded and suggest referral (pink), treatment in health facility (yellow) or management at home (green).

17. Conti.. IMNCI guidelines address most common, but not all paediatric problems . A limited numbers of essential drugs are used . Care takers are actively involved in the treatment of children . Counselling of caretakers about home care including feeding, fluid and when to return to health facility .

18. IMNCI Case Management Process Steps of case management process are following : Assess the young infant/child . Classify the illness. Identify the treatment Treat the young infant/child Counsel the mother Provide follow up care.

19. Assess  a child by checking first for general danger signs (or possible bacterial infection in a young infant), asking questions about common conditions, examining the child, and checking nutrition and immunization status. Assessment includes checking the child for other health problems. Assessment

20. Classify  a child’s illnesses using a colour -coded classification system. Because many children have more than one condition, each illness is classified according to whether it requires: Urgent pre-referral treatment and referral (pink), or Specific medical treatment and advice (yellow), or Simple advice on home management (green). Classification

21. Identify treatment After classifying all conditions,  identify  specific treatments for the child. If a child requires urgent referral, give essential treatment before the patient is transferred. If a child needs treatment at home, develop an integrated treatment plan for the child and give the first dose of drugs in the clinic. If a child should be immunized, give immunizations. Identify

22. Provide practical  treatment  instructions, including teaching the caregiver how to give oral drugs, how to feed and give fluids during illness, and how to treat local infections at home. Ask the caregiver to return for follow-up on a specific date, and teach her how to recognise signs that indicate the child should return immediately to the health post. Treat

23. Assess feeding, including assessment of breastfeeding practices, and counsel to solve any feeding problems found. Then counsel the mother about her own health. Counsel

24. When a child is brought back to the health post as requested, give follow-up care and, if necessary, reassess the child for new problems. Follow-up care

25. IMNCI Case Management Process For all sick children up to 5 years who are brought to a first level Health facility Select age appropriate treatment chart Sick child age 2 months up to 5 years Sick young infant age up to 2 months Possible bacterial infection Jaundice Danger Signs Convulsions, lethargy, unconsciousness, inability to drink/ breastfeed, vomiting Check everyone Cough or difficult breathing, diarrhoea , fever, ear problem Malnutrition, anaemia , immunization, vitamin A, folic acid supplementation Diarrhoea Check everyone Ask for major symptoms & assess if present Feeding problem & malnutrition, immunization

26. IMNCI Case Management Process continue Assess other problems Classify illness & identify treatment use color coded treatment charts PINK (urgent referral) OUTPATIENT HEALTH FACILITY - P rereferral treatment - Advice parents - Refer young infant/child PINK (urgent referral) REFERRAL FACILITY - Emergency treatment - Diagnosis - Treatment - Monitoring & follow up YELLOW OUTPATIENT HEALTH FACILITY - Treat local infections - Give oral drug Advice & teach Caretaker Follow-up GREEN (Home Management) Care taker is counseled how to - Give oral drug, treat local infections, breastfeeding Keep the young infant warm When to return Immediately Follow up Give follow up care when young infant or child return to clinic and if necessary. Reassesses for any new problem.

27. IMNCI has the following advantages: Promotes the accurate identification of childhood illnesses in out-patient settings Ensures appropriate combined treatment of all major childhood illnesses Strengthens the counselling of mothers or caregivers

28. Conti.. Strengthens the provision of preventive services Speeds up the referral of severely ill children Aims to improve the quality of care of sick children at the referral level.