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Integrated Management of

Childhood Illness
(IMCI)

Integrated
Management
Childhood
Illness

5 major killers of children:

Diarrhea
Acute
Respiratory
Infections
(Pneumonia)

Measles
Malaria
Malnutrition

The world health organization is concerned of


the unecessary deaths of children below 5 years
old in the developing countries. integrated
management for childhood illness is trying to
fight these unecessary deaths. accourding to
WHO, the mose common cause of death among
these under 5 children is:
A. diarrhea
B. pneumonia
C. malaria
D. malnutrition

Assess the child or young


infant

Check for General Danger Signs

Convulsion
Abnormally sleepy/unconsciousness
Not able to drink or breastfeed
Severe vomiting/vomits everything

Which of the following is not a


danger sign?
A. convulsion
B. inability to drink or breastfeed
C. lethargy/ unconsciousness
D. difficulty of breathing

4 MAIN SYMTPOMS
Cough or difficult breathing
Diarrhea
Ear pain
Fever

CLASSIFY THE ILLNESS

I M C I Color Coding
Needs urgent attention and referral or
admission for in-patient care.
This is a severe classification
Child needs an appropriate antibiotic,
an oral anti-malarial or other
treatment which can be given in
health center
Does not need specific medication /
treatment such as antibiotic. Can be
manage at home by mother

If the child has only one of the danger


sign implicitly stated in the IMCI
guideline, this child will be classified
under what color?
A. pink
B. blue
C. yellow
D. green

CURATIVE

TREAT

&
HOLISTIC
CARE

COUNSEL

HEALTH
EDUCATION

IMCI Case Management


Focused
Assessment
Danger signs
Main Symptoms
Nutritional status
Immunization status
Other problems

Classificatio
n
Need to Refer
Specific treatment
Home
management

Counsel & Followup

Treatmen
t

Counsel caretakers
Follow-up

Identify treatment
Treat

Causes of Death in children

Undernutrition

53%

Source: CHERG estimates of under-five deaths, 2000-03

IMCI IMPLEMENTATION IN THE


Philippines
Initiation

Phase IMCI adaptation,


meetings with key stakeholders
Early implementation phase
trainings implementation in pilot
areas
Expansion phase
cascade to other areas
curriculum integration nursing,
midwifery, medical schools

Common Problems That Affect


the Quality of Care Provided to
Sick Children at Health
Facilities
1. Health workers skills
Incomplete examinations and counseling
Poor communication between health
workers and parents
Irrational use of drugs

Common Problems That Affect


the Quality of Care Provided to
Sick Children at Health
Facilities
2. Health system issues
Location of health services and responsibility
(centralization)
Availability of appropriate drugs and vaccines
Supervision/division of labor/organization of
work

Common Problems That Affect


the Quality of Care Provided to
Sick Children at Health
Facilities
3. Community and family practices
Poor knowledge of when to return to
a healthassistance
facility
Seeking
from unqualified
providers
Poor adherence to health worker advice
and treatment
Delayed care seeking

Essential package of child


survival interventions
1. Skilled attendance during pregnancy,
childbirth and the immediate postpartum
2. Care of the newborn
3. Breastfeeding and complementary feeding
4. Micronutrient supplementation
5. Immunization of children and mothers
6. Integrated management of sick
children
7. Use of insecticide treated bed nets (in malarious areas)

Objectives of IMCI

Reduce deaths and the frequency and


severity of illness and disability among
children

Contribute to improved growth and


development

Important Elements
for Improving Child Health

Improve case management of sick children

Improve nutrition

Ensure immunization

Prevent injuries

Prevent other diseases

Improve psychosocial support and


stimulation

Case Management Process


1. Assess the child or young infant
2. Classify the illness
3. Identify treatment
4. Treat the child or refer
5. Counsel the mother
6. Give follow-up Care

Which vital sign is important in


classifying a child with pneumonia
from those who do not have?
A. temperature
B. respiratory rate
C. chest indrawing
D. stridor

In home management of a child


with pneumonia, caretaker is
counseled on how not to:
A. give oral drugs
B. treat local infection at home
C. when to return
D. discontinue feeding

If pneumonia is present with


major signs and symptoms,
treatment will include:
A. Cotrimoxazole P.O. BID
B. Amoxicyllin P.O. BID
C. ORS 240cc/ loose stool
D. Procaine Penicillin IM OD