Integrated Management of Neonatal and Childhood Illness (IMNCI)
IMCI is an integrated approach to child health that focuses on the well-being
of the whole child. IMCI aims to reduce death, illness and disability, and to
promote improved growth and development among children under five years
of age. IMCI includes both preventive and curative elements that are
implemented by families and communities as well as by health facilities.
The strategy includes three main components:
Improving case management skills of health-care staff
Improving overall health systems
Improving family and community health practices
In health facilities, the IMCI strategy promotes the accurate identification of
childhood illnesses in outpatient settings, ensures appropriate combined
treatment of all major illnesses, strengthens the counselling of caretakers,
and speeds up the referral of severely ill children. In the home setting, it
promotes appropriate care seeking behaviours, improved nutrition and
preventative care, and the correct implementation of prescribed care.
Objectives of IMCNI strategy:
● To reduced significantly: mortality and morbidity, associated with the major
causes of disease in children.
● To contribute to healthy growth and development of children.
Strategy:
● It's not another vertical program.
● Incorporates elements of diarrhoeal diseases and ARI control programme and
child orientated aspects of malaria control, nutrition, EPI and other relevant
programs.
● Depends on effective functioning of essential drugs and EPI program.
● Improves the quality of care of sick children in the primary healthcare context.
Components:
Improving case Management skills of health workers:
● Standard guidelines
● Training preservice and inservice
● Follow up after training
Improving the health system to deliver IMNCI:
● Essential drug supply and management
● Organisation of work in health facilities
● Management and supervision
Improving family and community practices
IMNCI Case Management Processes:
● Classification based on a colour-coded triad system:
○ Red: urgent pre referral treatments and referral
○ Yellow: specific medical treatment and advice
○ Green: simple advice on home management
● Assess a child
● Classify a child's illness
● Identify treatment for the child
● Treatment instructions:
○ Counsel the mother to solve any feeding problems and her own health.
○ Whenachild is brought back to the clinic give follow-up care and if necessary
re-assess the child for new problems.
Key family practices:
● Exclusive breastfeeding
● Complementary feeding and weaning
● Micronutrient supplementation for vitamin A iron and zinc
● Hygiene: dispose of faeces and wash hands
● Immunisation as per EPI
● Preventing malaria
● Promote mental and social development by responding to a child's needs for
care
● Home care during illness
● Give sick children appropriate home treatment for infections
● Care seeking
● Compliance with advice
● Antenatal care