Integrated management of neonatal and childhood illness

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1. INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS

2. Factors contributing to illness Poor living conditions- lack of safe water supply poor hygiene overcrowding Inability of parents to recognize danger signs

3. delay in seeking appropriate treatment poor quality of care provided at health facilities. More than one morbid condition

4. " The Integrated Management of Childhood Illness (IMCI)" 1992 UNICEF and WHO

5. Objectives

6. Guidelines Evidence-based syndromic approach Determining the health problems of the child Severity of child's condition Evaluation of the actions taken Rational , effective, and affordable use of drugs and diagnostic tools.

7. IMCI Strategy

8. IMNCI Central pillar of child health interventions under RCH II

9. IMNCI Inclusioin of 0-7 years of age. Incorporating national programmes . Training begins with sick infants <2 mths . Training time devoted to sick infant & sick child are almost equal. Skill based

10. Implications Standardized case management procedures based on two age categories: upto 2 months 2 months to 7 years . Only a limited number of carefully-selected clinical signs are considered, based on their sensitivity and specificity , to detect the disease.

11. Classification - urgent hospital referral or admission - specific medical Rx or advice - home management P Y G

12. Management Assessment Classification of illness Identification of specific Rx Clear instructions to mother Counsel to solve feeding problems Follow-up care.

13. Advantages Evidence-based management decisions. Eg:oral rehydration therapy for diarrhea . Focus on communication and counselling skills. Locally adapted recommendation for infant and young child feeding.

14. Increased effectiveness of care and reduction in cost. Potential of lowering the burden on hospitals. Model for improving one aspect of service delivery that could be applied to other aspects of health care.

15. What it does not address... Not all major illnesses are included Management of trauma / other emergencies not included .

16. Challenges Feasibility Sustaining what is initiated through indicator-based monitoring Making home-based care of young infants operational by ANMs and AWWs

17. Future aims To provide a comprehensive newborn and child care package at all levels of care: At the village/household level - AWWs. Sub- center level - through ANMs PHCs - doctors, nurses, and Lady Health Visitors; At First Referral Units – MOs and nurses

18. Summarizing... Major diseases Origin Objectives IMCI strategy IMNCI Classification Management Advantages Challenges Future aims

19. ...Very much Thank you...