Presentation on theme: "Integrated Management of Childhood Illness"— Presentation transcript:
1Integrated Management of Childhood Illness IMCIIntegrated Management of Childhood Illness
2Summary of slides Introduction to IMCI –Slide 3 Rationale for IMCI- Slides 4-10Advantages – Slide 11Objectives- Slide 12Components- Slide13Intervention areas- Slide 14IMCI in NigeriaImplementation steps (in another file)
3An Approach for who? Clinical Officers Nurses Medical Assistants Health assistantsCommunity Health Officers (CHOs)Other health workersNot for in-patient carean approach for health workers who care for sick children in first level health facilities:
4UNDER FIVE MORTALITY RATES FOR DIFFERENT COUNTRIES – Countries of AfricaCountries of South AmericaCountries of EuropeEthiopia 174Argentina 26FranceGabonBoliviaSwedenNigeriaGuatemala 69Tajikistan 56KenyaBrazilSpain
5Leading causes of under five mortality in developing countries Acute respiratory infections (ARI) - especially pneumoniaDiarrhoeaMalariaMeaslesMalnutrition
6Frequency of presenting complaints of 450 children (as volunteered by their mothers), Gondar, Ethiopia, 1994Fever 58%}Cough 56%Diarrhoea 47%Ear problems 10%Skin lesions 03%Abd. painsEye dischargeDental problemsNeck swellinge.t.c.The first four complaints constitute about 87% of the complaints and these are covered by the chart, the remaining 13 % are not covered by the charts
7Consequences of Vertical Approach In practice, the sick child is not managed in a holistic manner at the health centre. More often, only the predominant symptom is considered for diagnosis and treatment.Many training courses are organised by individual programmes. This disturbs the continuity of services at the health centre.At health level, programmes often have the same target population and are delivered by the same health workers.Verticalization usually results in inappropriate use of resources.
8A single diagnosis may not be apparent or appropriate ______________________________________Presenting complaint Possible cause or associated_____________________________ condition________________Cough and/or fast breathing PneumoniaSevere anaemiaP.falciparum malariaLethargy or unconsciousness Cerebral malariaMeningitisSevere dehydrationVery severe pneumoniaMeasles rash PneumoniaDiarrhoeaEar Infection“Very sick young infant PneumoniaSepsis
9Integrated Management of Childhood illness (IMCI) as a key strategy for improving child health The IMCI strategy combines improved case management with aspects of nutrition, immunisation, and several other important influences on child health
10Integrated Management of childhood illness The IMCI strategy is an approach, not entirely different from what we have known, as several national programmes have collaborated to develop these guidelines.
11ADVANTAGES OF IMCIAccurate identification of illnessMore appropriate & combined treatmentRational use of drugsPrompt referral of severe casesStrengthening of preventive servicesAttention to the health needs of the mother.
12ObjectivesTo reduce significantly mortality and morbidity associated with the major causes of disease in childrenTo contribute to healthy growth and development of childrenIn short, the strategy is to improve the health of children up to age of five and reduce their chances of death. The WHO and UNICEF are committed to this strategy. Nigeria has also made a firm commitment to the strategy and has in-fact adopted it as the main thrust of its child survival effort.
13Components Improving case management skills of health workers Improving the health system to deliver IMCIImproving family and community practicesThe Health system will be improved through provision of drugs and ensuring that supervisory systems are in place to support the strategy.The third component of IMCI includes promotyon, education and programs all in an effort to support and improve family and community practices e.g breastfeeding, routine immunisations, use of ITN e.t.c.
14IMCI components and intervention areas Improving health Improving health Improving family &workers skills systems community practices-Case management - District planning - Appropriatestandards & and management care-seeking &prevention ofguidelines diseases- Training of - Availability of Nutritionfacility-based public IMCI drugshealth care providers-Training for private - Improvement and -Home case managementhealth care providers supervision of referral -Adherence to recommendedpathways treatment-Maintenance of - Improved Health Community involvementcompetence among information system in health planning andtrained health workers monitoring