Integrated management of neonatal and childhood illness(imnci)

Integrated management of neonatal and childhood illness(IMNCI)

1. INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS (IMNCI)

2. Contents Introduction Principles of IMNCI Components of IMNCI Training in IMNCI Care of newborn and young infants IMNCI case management process 1

3. Developments Related To Child Health 1974: Expanded Programme on Immunization(EPI) 1984: Universal Immunization Programme (UIP) 1985: Oral Rehydration Therapy(ORT) 1992: Child Survival and Safe Motherhood(CSSM) 1997: Reproductive and Child Health (RCH-1) 2005: NRHM and RCH II 2

4. IMNCI IMNCI is an integrated strategy which deals with a number of priority health problems resulting in major cause of mortality and morbidity in under five children. IMNCI was developed by United Nations Children’s Fund and the World Health Organization in 1992 IMNCI is one of the main interventions under RCH-II/NRHM 3

5. F-IMNCI From November 2009 IMNCI has been re -baptized as F-IMNCI, (F -Facility) with added component of: • Asphyxia Management and • Care of Sick new born at facility level 4

6. Why IMNCI? India is still among high infant mortality Rate countries but there has been significant decline in the IMR from 204 during 1911-1915 to 129 per 1000 live births in 1970 and remained static at around 127 for many years. As of 2011 data India’s Infant Mortality Rate is 44 per 1000 live births. 5

7. Causes of neonatal mortality 6

8. Status of IMNCI in India As of December 2011, about 433 districts are implementing this programme , of which 156 districts are in high focus states of Bihar,Chattisgarh,Himachal Pradesh,Jammu and Kashmir,Jharkhand,Madhya Pradesh,Orissa,Rajasthan,Uttar Pradesh and Uttarakhand ,29 districts of North East States,106 non high focus large states and 6 other non high focus North East States 4,92,611 personell have been trained for IMNCI programme 7

9. Beneficiaries of IMNCI 8

10. Components of IMNCI 9

11. Training in IMNCI Average size district -1800 health staff need to be trained Number of the staff of other departments should be included in consultation with the concerned district officers. Staff belonging to PHC areas may be taken up fully before moving to another PHC area 10

12. Training at two levels 11

13. Trainees of IMNCI 12

14. Type of training Personnel to be trained Duration Package to be used Place of training Clinical skills training Medical Officers, Paediatricians Health workers,ANMs , CDPOs and LHVs 8 days 8days Physician package Health workers package Medical College/ District Hospital District Hospital Training in IMNCI 13

15. Type of training Personnel to be trained Duration Package to be used Place of training Supervisory Skill Training Medical Officers, Paediatricians , CDPOs and LHVs 2 days Supervisory Skills Package Medical College/ District Hospital … contd 14

16. Principles of IMNCI All sick children must be examined for “ general danger signs” which indicate the need for immediate referral or admission to a hospital. All sick children must be routinely assessed for major symptoms (for children age 2 months up to 5 years: cough or difficult breathing, diarrhoea , fever, ear problems for young infants up to 2 months : very severe disease, diarrhoea , jaundice and feeding. 15

17. …. Contd 3 .They must also be routinely assessed for nutritional and immunization status, feeding problems and other problems 4 .Assess Vitamin A supplementation and de-worming status for children age 2 months up to 5 years. 16

18. Care of newborns and young infants(<2months) Keep the child warm Initiation of breast feeding Counselling of mother for exclusive breast feeding Cord,skin and eye care Recognition of illness in newborn and its management Immunization 17

19. Care of infants (2 months-5 years of age) Management of diarrhoea,ARI,malaria,measles,malnutrition and anaemia Recognition of illness Prevention and management of Iron Deficiency and Vit B12 deficiency Counselling for feeding for malnourished children Immunization 18

20. IMNCI case management process OUTPATIENT HEALTH FACILITY CHECK for danger signs Convulsions lethargy/unconsciousness Inability to drink/breastfeed vomiting ASSESS main symptoms Cough/difficulty in breathing Diarrhoea Fever Ear problems Assess Nutrition and Immunization status and potential feeding problems Check for any other problem 19

21. … contd CLASSIFY conditions and identify treatment actions According to color coded system Treat local infection Give oral drugs Advise and teach the care taker Follow up Care taker is counselled on how to : Give oral drugs Treat local infections Continue feeding Follow up (pink) (Green) yellow Home management 20

22. Thank YoU