Imci components by dr najeeb memon
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IMCI Components by dr najeeb memon
Transcript of Imci components by dr najeeb memon
BY DR: MUHAMMED NAJEEBAssist: Professor
Faculty of Community Medicine & P.H.S, LUMHSJamshoro, Sind, Pakistan
E mail [email protected]
IMCI
3
Integrated Management of Childhood illness
(IMCI)
Integrated Management of Childhood Illness(IMCI)
Why is IMCI better than single-condition approaches?• Children are often suffering from more than one condition• This overlap means that a single diagnosis may not be
possible or appropriate and treatment may be complicated by the need to combine therapy for several conditions
• An integrated approach to managing sick children is, therefore, indicated as is the need for child health programs to go beyond single diseases
“Looking to The Child as a Whole (Health of a child) ”.
Health Delivery System
Basic Health Units
Rural Health Centers
District Headquarters
Hospital
Tertiary Hospitals
Population Served
Referral Centers
DHQ: 1Million to 1.5mTHQ: 100,000 – 300,000
5,000 – 10,000
Health Care Providers
Specialists, Doctors, Nurses, Paramedical Staff
RHC: Pop: 50,000 to 100,000 , 10-20 beds, with about 30 staff including 2 M.Os, 1 WMO, 1 dental surgeon & a no: of paramedics. , x-ray, laboratory and minor surgery facilities. These do not include delivery and emergency obstetric services.
THQ / DHQ: They typically have 40-60 beds and appropriate support services including x-ray, laboratory and surgery facilities. The staff includes at least three specialists: an obstetrician & gynecologist, a pediatrician and a general surgeon.
BHUs staff of 10 ( a male doctor, a LHV or a FHT, a Male Medical Technician or/and a dispenser, a trained or unqualified midwife (dai), a sanitary inspector, a vaccinator, and 2-3 support staff (guard, sweeper, gardener, etc.). They are required to offer first level curative, MCH, family planning and preventive services .
50,000 –100,000
Primary care facilities:(MCH, BHU, RHC)MCH ,Family planning , & Curative, prev: services
Referral level care facilities:THQH, DHQH
Tertiary care facilities:Teaching Institutions
IMCI Case Management
Danger signsMain Symptoms
Nutritional statusImmunization status
Other problems
Need to Refer
Specific treatment
Homemanagement
ClassificationFocused
Assessment
Identify treatmentTreat
Counsel caretakersFollow-up
Treatment
Counsel & Follow-up
The strategy includes
1) 1. Improving case management skills of health-care staff. (Improvement of health worker skills)
2. Improving overall health system
3. Improving family and community health practices
(in relation to child health)
IMCI Component 1: Improves Health Worker Skills
Case management guidelines
Training of health providers (Doctors , Medical
Assistants & Nurses) who look after sick infants and children up to 5 years (pre-service and in-service)
Follow-up after training
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IMNCI HEALTH SYSTEM COMPONENT:
BACKGROUND:
Strengthening health systems is one of the three key elements of the IMCI strategy to ensure universal access to services of high quality. IMCI packages essential interventions and strengthens service delivery in primary care settings with a focus on conditions of significant public health importance.
IMCI Component 2: Improves Health Systems
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Objectives of field visits to BHU & RHC:
1. To identify the health services available at the health facility.A. Health work force.B. Technologies available at the health facilities.C. Availability of drugs and supplies.D. Monitoring & SupervisionE. Health information system.F. Referral pathways and system.
2. To identify barriers against coverage for child
health care.
• Gaps in capacity of health care delivery.• Inadequate/ ineffective human resources.• Inadequate financial resources to support cost-effective health
programs like IMNCI.• Poor referral system and quality of care.• Inadequate knowledge and practices of caretakers.• System improvements
What progress may be made in improving health systems for child health?
• Leadership and governance in key policy areas in health.
• Health financing system. • Improving the capacity of the health work force.• Filling the gap in health care delivery to the needy
consumers.
IMCI Component 3: Improves Family and Community Practices (Household & Community base Component)
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To improve the knowledge, attitude and practices of families --greatest impact on child survival , growth & Development
Objectives For Household Surveys:
1. To prevent common childhood illness including malnutrition, injuries and neglect at the household and community level.
2. To improve the household and community response to childhood illness and the quality of care provided at home.
3. To improve appropriate and timely care seeking behaviour when children need additional assistance outside the home.
4. To increase compliance to recommended treatment and advice from trained care providers.
5. To promote a supportive and enabling environment at the household and community level for children’s survival, growth, and development.
Improves Family and Community Practices
Exclusive BreastfeedingComplementary feedingCont. feeding during illness.Routine vaccination Regular growth monitoring.Early care seeking. Compliance to provider adviceHome care of sick childrenRecognition of severe illness
IMCI Component 3: Improves Family and Community Practices
Proper waste disposal.
Use of Nets
Antenatal care
TT for pregnant ladies.
Proper nutrition for pregnant ladies.
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Volunteers were trained on Key Family practices and communication skills.Community-based activities: • LHWs, Female Health
Technicians (FHTs) and TBAs. Provides MCH, family planning services .
• Each LHW has established a “Health House” in her home and also reaches the doorsteps of the people to serves as the first level of health services for the rural and peri -urban women and children.
LHWs maintain records for all the households in their catchment areas and actively follow up each family every month, especially the defaulters for immunization or dropouts for family planning and to persuade families to adopt healthier life style.
END
