1. IMCI University of Liverpool LSTM MSc Infectious Disease and Tropical Medicine Dr. Wail Bajhmoum

2. INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS

3. Outline Background and Brief History. Definition. Objectives and Goals.

4. Outline Strategy. THE CASE MANAGEMENT PROCESS. Examples.

5. Background * Each year more than 10 million children in low- and middle-income countries die before they reach their fifth birthday. * Seven in ten of these deaths are due to just five conditions: * pneumonia (19%) * diarrhea (19%) * malaria (5%) * measles (7%) * malnutrition (54%)

6. Background IMCI was first developed in 1992 by UNICEF and the World Health Organization (WHO)

7. Definition * IMCI is an integrated approach to child health that focuses on the well-being of the whole child. * IMCI includes both preventive and curative elements.

8. * IMCI is designed for use in outpatient clinical settings with limited diagnostic tools and medications. ie. rural areas- specifically in developing countries

9. Objectives and Goals 1. Reducing mortality. 2. Reducing the incidence and seriousness of illnesses and health problems . 3. Improving growth and development during the first five years of a childs life.

10. Strategy. *Improving case management skills of health-care staff. *Improving overall health systems. *Improving family and community health practices.

11. THE CASE MANAGEMENT PROCESS 1 assessment 2 - classification and identification of treatment. 3 - referral, treatment or counseling of the childs caretaker. 4 - follow-up care.

12. Fever With Rashes

13. For A L L sick children ask the mother about the childs problem, check for general danger signs, ask about cough or difficult breathing, diarrhoea and then A S K : D O E S T H E C H IL D H A V E F E V E R ? If If NO YE S D o e s t h e c h ild h a v e f e v e r ? ( by history or feels hot or temperature 37.5 C** or above) IF YES: Decide the Malaria Risk: high or low THEN ASK: LOOK AND FEEL: For how long? Look or feel for stiff neck. If more than 7 days, has Look for runny nose. fever been present every day? Look for signs of MEASLES Has the child had measles within the last 3 months? Generalized rash and One of these: cough, runny nose, or red eyes. If the child has me as le s now or Look for mouth ulcers. w ithin the las t 3 months : Are they deep and extensive? Look for pus draining from the eye. Look for clouding of the cornea. C L A S S IF Y the childs illness using the colour-coded classification tables for fever. Then A S K about the next main symptom: ear problem, and CHECK for malnutrition and anaemia, immunization status and for other problems.

14. Is it effective ?!

15. The Multi-Countries Evaluation of (IMCI) includes studies of the effectiveness, cost, and impact of the IMCI strategy in Bangladesh, Brazil, Peru, Tanzania, and Uganda.

16. *MCE conclude : more detailed descriptions of methodological and analytic approaches developed to address specific issues need to be provided. *The MCE will continue these and other methodological challenges in future articles

17. Thank you