REDUCING MORTALITY FROM MAJOR KILLERS OF CHILDREN THROUGH IMCI

SALAH UDDIN AHMEDSALAH UDDIN AHMEDSOCIAL MARKETING SOCIAL MARKETING

COMPANY (SMC) COMPANY (SMC) BANGLADESHBANGLADESH

IMCIIMCI

Integrated Management of Childhood Illness (IMCI) is a strategy formulated by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), presented in 1996 as the principal strategy to improve child health.

IMCI was introduced in Bangladesh in 2002 with assistance from UNICEF, WHO and other development partners.

Distribution of various diseases among 1-5 years children (n=1,301,503)

IMCI diseases in IMCI diseases in Bangladesh Bangladesh

Source: IMCI Performance Report- 2010 - Management Information System (MIS), Directorate General of Health Services (DGHS), www.dghs.gov.bd

According to the figure : Majority of the children were found to suffer from Acute Respiratory Infection (ARI) i.e. cough and cold, pneumonia & very severe disease

ARIARIAcute respiratory infection (ARI), mostly in the form of pneumonia, is the leading cause of death in children under five, killing over two million children annually.

IMCI reduces the death toll IMCI reduces the death toll from ARIfrom ARI

IMCI reduces the death toll from ARI in developing countries by promoting:

•Prompt identification of pneumonia;

•Rapid treatment with antibiotics;

•Quick referral of the most serious cases;

•Improved home care management;

•Prevention through immunization, reduced indoor

air pollution, and improved nutrition, including

breastfeeding;

ChallengesChallengesImproved medical treatment combined with wider access to health care could help to reduce child mortality but huge numbers of children continue to die needlessly. Many of these children were never seen at a health facility due to :

•Lack of service delivery centers•Lack accessibility to the existing services•Families and other caregivers do not recognize the warning signs of life-threatening illness. 

Source: IMCI Performance Report- 2010 - Management Information System (MIS), Directorate General of Health Services (DGHS), www.dghs.gov.bd

SMC Initiatives to address the SMC Initiatives to address the challenges challenges • SMC has a huge franchising

network (>4000) of private health providers throughout the country which is known as Blue-Star • Blue Star is a network of private sector providers managed by Social Marketing Company (SMC)Bangladesh:95% are Non-Graduate medical Practitioners (NGMPs) and 5% are Graduate doctors)

• Blue Star was set up to actively engage the private sector in the delivery of Family Planning and other health services since a vast majority of the population depend on them for their health needs

Advantages of adding IMCI services in SMC’s Blue Star Network

• 9 out of 10 people in Bangladesh seek health care from the private medical practitioners

• 60% health service users preferred NGMPs• 27% use qualified/graduate providers• 13% turned to government health services

• The Blue Star NGMPs are widely accessible across the country (over 4000)

• Very well-known to the community as quality service provider & most of them are the owner of the pharmacy/chemist shops where they practice for a long period of time

• Available from morning till night

• Products like OR Saline-N, Zinc, Moni-Mix (micronutrient powder) also available

SMC Initiatives to address the SMC Initiatives to address the challenges challenges

Capacity building of the BSPs:

BSPs are the social change agents in their respective territories and themselves are very much enthusiastic to contribute in ARI control program. Build the capacity of BSPs through providing them training to make them competent to •Deliver correct information to the community•Quick case detection & treatment• Effective referral whenever necessary to the nearby service delivery center.

SMC Initiatives to address the SMC Initiatives to address the challenges challenges

Improving family practices:

• SMC has already 10 Mobile audio Visual unit covering 2 m people annually• Health Providers training program through which 17,000 drug seller/chemist/other non-graduate practitioners are trained annually• Introducing local level campaign like courtyard meeting, IPC, Market place meeting etc.

SMC’s SMC’s SuccessSuccess

• People expressed lot of interest towards SMC’s outreach activities and had high participation from the locality.

• The local leaders and influential people made their commitment to extend their utmost support to implement the SMC’s programs

• Blue-Star centers became the primary referral point in any health related issues from the community

• BSPs become competent and confident in delivering health services upon which they got training from SMC e.g. FP, MNH, TB

ConclusionConclusionAbout 90 per cent of the children die each year, die at home. How children are cared for at home and in their community has a decisive impact on their chances of survival. We need to provide parents and caregivers with essential knowledge and commodities that can save the lives of their children. SMC has enormous capability to overcome the challenges to avoid such unwanted deaths of the children of Bangladesh.

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