Presentation on theme: "Institute of Child Health"— Presentation transcript:
1 Institute of Child Health Integrated Management of Childhood illness (IMCI) Approach to School careAdebola E. OrimadegunInstitute of Child HealthCollege of MedicineUniversity of Ibadan
2 Introduction What is IMCI? A joint WHO/UNICEF initiative since 1992 Is the integrated strategy that combines and links together existing child health programs.Is an evidenced based, syndrome approach to case management that supports the rational, effective and affordable use of drugs and diagnostic tools.A joint WHO/UNICEF initiative since 1992
3 Objectives of IMCI:To reduce significantly mortality and morbidity associated with the major cause of diseases in childrenTo promote improved growth and development of children.
4 Major causes of death in under five, 2002 ARI18%Other25%Diarrhea 15%Deaths assoc. withmalnutrition54%Perinatal23%Malaria 10%Measles 5%HIV/AIDS4%
5 Essential IMCI Drugs at Health Facilities OresolOral antibiotics(1st line – CotrimoxazoleOral anti malarial1st line-Chloro quine and Primaquine2nd line – Aretemether LumefrantineNalidixic Acid TabletsTetracycline tabletsIronVitamin AParacetamolVaccineMebendazole /AlbendazoleTetracycline eye ointmentGentian violetChloramphenicol IM(optional)Gentamicin IM (optional)Benzyl Penicillin IM(Optional)
6 Other Essential Equipments and Supplies: 1-weighing scale2-timing devices3-refrigerator with voltage regulator4-sterilizers5-BP apparatus6-pediatric cuff7-oral thermometerSupplies:1-cold chain supplies and immunization supplies2-ORT supplies3-water jars4-IV fluid (plain LR and insertion sets 05-sterile water for dilutions6-plaster, cotton swab, tongue depressors7-70% ethyl alcohol
7 IMCIThe IMCI training was designed to teach integrated management of sick infants and children to first level health workers in primary care settings that have NO laboratory support and only a limited number of essential drugs.
9 Action-oriented CLASSIFICATIONS , rather than EXACT DIAGNOSES are used. A careful balance has been struck between SENSITIVITY and SPECIFICITY.Using FEW CLINICAL SIGNS as possible which health workers of diverse background can be trained to recognize.
10 The IMCI guidelines rely on detection of cases based on SIMPLE CLINICAL SIGNS without laboratory tests and offer EMPIRIC TREATMENT.
11 IMCI CASE MANAGEMENT PROCESS Health worker assesses the sick child. - IDENTIFY any danger sign present (unable to feed and drink, vomits everything, convulsion, difficult to awaken or abnormally sleepy)- ASK about the four(4) main symptomscough, diarrhea, fever, and ear problem- REVIEW nutrition, Vitamin A and immunization
12 IMCI2. Health worker CLASSIFIES child’s illness using a color-coded triage:PINK = urgent referralYELLOW = specific medical treatment and adviceGREEN = simple advice on home care
13 IMCI 3. Heath worker then identifies SPECIFIC TREATMENT. - an INTEGRATED TREATMENT PLAN isdeveloped
14 IMCI4. TREATMENT INSTRUCTIONS are carried out: oral drugs, ORS, treat local infections, signs to come back immediately, when to return for routine follow-up.5. COUNSELING mothers.6. Follow-UP instructions when the child returns to clinic.
15 IMCI Management of sick children Nutrition Immunization Other disease PreventionPromotion ofgrowth anddevelopmentIntegrated Managementof Childhood Illness (IMCI)
16 IMCI CHILD HEALTH INTERVENTIONS IN IMCI Case Management Interventions: Pneumonia MalariaDiarrhea Malnutrition- dehydration Anemia- persistent diarrhea Measles- dysentery Ear infectionMeningitisSepsis