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    IMCI NewsletterIMCI NewsletterM I NewsletterM I Newsletter

    Performance Report for January to December 2011erformance Report for January to December 2 11

    Issue 4 |March 2013

    Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212

    Web:www.dghs.gov.bd; Email: info@dghs.gov.bd

    Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212

    Web:www.dghs.gov.bd; Email: info@dghs.gov.bd

    Managem ent Information System MIS)

    Directorate General of Health Services DGHS)

    Mohakhali, Dhaka-1212

    Web:www.dghs.gov.bd; Email: info@dghs.gov.bd

    Contents

    Messages and Editorial P.02

    Introduction P.03

    Data and Method P.04

    Limitation of the data P.05

    Results P.05

    Conclusion P.16Annexure P.16

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    Director GeneralDirectorate General of Health Services

    Mohakhali, Dhaka

    Our country made a significant progress in child

    mortality reduction and received the UN MDG Award

    for its success in MDG4. IMCI program is playing thevital role to sustain and improve universal child

    immunization.

    It is indeed a great pleasure for me to know that MIS

    of DGHS is going to publish the 4th issue of IMCI

    Newsletter. This newsletter is a very useful

    publication as it enables us to get facility based

    graphical data on childhood illness of the whole

    country in a concised and understandable way.

    I hope that this newsletter will give some

    programmatic direction to policy-makers and program

    managers and to understand the current situation toundertake interventions for the future about the IMCI

    services in Bangladesh. Finally, I would like to thank

    everyone who worked hard directly and behind the

    screen for publishing this newsletter successfully.

    Professor Dr. Khondhaker Md. Shefyetullah

    Additional Director General(Planning and Development)

    & Line Director,Management Information System (MIS)Directorate General of Health Services

    Mohakhali, DhakaOur country has made a remarkable progress in

    improving the health of children. In fact, as per

    recent estimate, we already achieved MDG4. The

    recognition to Bangladesh's success in improving

    child health came much earlier through the UN

    MDG4 Award in 2010.

    It is my great pleasure that the 4th issue of the

    IMCI newsletter is going to be published from the

    Department of MIS-Health of DGHS. The contents

    of this newsletter will not only include the result of

    the performance assessment of IMCI services infacilities but will also encompass other areas of

    child and neonatal health, including community

    IMCI. The team associated with this newsletter

    made very sincere efforts to improve the quality of

    the contents than those of the previous issues. An

    attempt was made to analyze the data received

    during the reporting period to understand the care-

    seeking and morbidity pattern of the sick under-

    five children attending the IMCI-designated

    facilities. I like to thank the entire team of IMCI

    section for their sincere support and cooperation in

    publishing this newsletter. I also wish to

    congratulate the entire team of MIS-Health whose

    relentless work and efforts have made this

    possible. I also convey my thanks to all the

    managers, doctors, paramedics, and other service

    providers and staffs who helped in various ways

    and thus enabled us to publish this newsletter.

    I express my gratefulness to the Director General of

    Health Services and Director, PHC, for their continuous

    support and advice in accomplishing our tasks. I

    extend my special thanks to UNICEF for their

    cooperation as well as technical and financial support

    in publishing this newsletter. I congratulate the editorialboard for their success in reviewing the contents of this

    newsletter despite various constraints. The attempt will

    be successful if we can use the information for the

    betterment of our children who deserve quality and

    equitable health services.

    Professor Dr. Abul Kalam Azad

    Director, Primary Health Care

    & Line Director, Maternal, Neonatal, Childand Adolescent Health (MNC&AH)

    Directorate General of Health Services

    Mohakhali, Dhaka

    I am happy to know that the Management Information

    System (MIS) of the Directorate General of Health

    Services (DGHS) is going to publish the 4th issue of IMCI

    Newsletter. This publication has now become a necessary

    source of information containing statistics on child health

    aspects of the health sector.

    I congratulate the MIS-Health and IMCI program as well

    as the health managers and service providers at different

    levels for their reporting from the IMCI facilities for

    publication of the newsletter. I would like to give thanks to

    our development partners, specially UNICEF, UNFPA and

    WHO for their financial and technical support for this

    important task in the child health sector.

    I expect that the IMCI Newsletter will be helpful for all

    concerned and the Newsletter will be published regularly.

    Dr. Syed Abu Jafar Md. Musa

    Message

    Editorial NoteMessage

    02

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    Introduction

    Mortality in children younger than 5 years

    (under-5 mortality) remains high in Bangladesh

    at 57 in 1000 live-births, despite declines over

    the past decade. Pneumonia, diarrhoea,

    malnutrition, and measles account for more

    than half (52%) of these deaths. Integrated

    Management of Childhood Illness (IMCI) is a

    strategy developed and promoted by WHO

    and UNICEF for reducing childhood morbidity

    and mortality and promoting healthy growth

    and development. In 1998, the Government of

    Bangladesh adopted Integrated Management

    of Childhood Illness (IMCI) strategy to reduce

    these deaths and improve child health and

    development. The IMCI strategy throughHPNSDP was designed to include coordinated

    activities within two objectives: (1) to reduce

    morbidity and mortality associated with the

    major causes of diseases in under five children

    through quality case management, and (2) too

    promote healthy growth and development by

    preventing diseases and promoting healthy

    practices through counseling the mother and

    caretakers.

    Newborn Health

    Reducing Neonatal mortality and ensure

    health of the newborn is one the main target of

    IMCI section. National Neonatal Strategy &

    Guidelines has developed and Standard

    Operation Protocol (SOP) has formulated.

    Implementation of Neonatal Action Plan has

    started. Twelve Special Care Newborn Unit

    (SCANU) in the District Hospitals and Medical

    Colleges are functioning. A total of 41 SCANU

    will be established by 2015.

    IMCI has 3 (three) components

    1. Improving case management skills of

    health workers

    2. Improving the health system

    3. Improving family and community practices

    A large number of childhood morbidity and

    mortality (every year around 10 million children

    die before they reach their fifth birthdays) in

    the developing countries is caused by five

    conditions: acute respiratory infections (mostly

    pneumonia), diarrhoea, measles, malaria, or

    malnutrition. The Integrated Management of

    Childhood Illness (IMCI) strategy encompasses

    a range of interventions to prevent and

    manage this major childhood illness, both in

    health facilities and in the home. . In spite of

    various disease-specific control programs in

    operation, there has not been significant

    reduction in childhood morbidity and

    mortality. In response to this challenge,

    WHO/UNICEF proposed a comprehensivesingle efficient and effective approach to

    manage childhood illnesses, i.e. Integrated

    Management of Childhood Illness (IMCI).

    After adaptation of WHO generic modules

    Bangladesh had piloted the IMCI strategy in 3

    Upazilas (Matlab, Chandpur, Dhamrai, Dhaka

    and Kahaloo, Bogra) in the year 2002. After

    completion of pilot activities in December

    2002 a joint National-International Experts

    Review of early implementation phase was

    held in February 2003. Based on the

    recommendations of the review, Bangladesh

    has started expansion of IMCI. Facility IMCI has

    expanded in 410 Upazilas up to December

    2012. Ten training centers for IMCI have been

    established where the Clinical Management

    Training (11-days CMT) is ongoing for all types

    of service providers (doctors, nurses,paramedics) from selected upazilas. We have

    also started the process of developing and

    introducing community-IMCI. A national

    strategy paper on community IMCI has been

    prepared to provide directions and guidelines

    on the introduction, adaptation and

    implementation of C-IMCI. C-IMCI has

    expanded in 150 upazilas.

    03

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    IMCI protocol has incorporated in under

    graduate medical curriculum. All the

    Government Medical Colleges and most of

    the Private medical colleges are following the

    protocol. Initiative has taken to incorporate

    this protocol in Nursing Institute and Medical

    Assistant Training Schools (MATS) curriculum.

    During the HPNSDP (2011-2016)