SHIMLA NURSING COLLEGE
SHURALA SHIMLA
MODULE
ON
INTEGRATED MANAGEMENT OF
NEONATAL AND CHILDHOOD ILLNESS
SUBMITTED TO - SUBMITTED BY –
Mrs Nisha Bhimta Miss Anchal
Assistant professor [Link] [N] 5th sem
Shimla Nursing ROLL NO-
College Shimla Nursing
SUBMITTED ON -
INTEGRATED MANAGEMENT
OF NEONATAL AND
CHILDHOOD ILLNESS
INDEX
SR CONTENT PAGE NO REMAR
NO KS
1. IMNCI-
Introduction•
Background and
Objectives
• Components and
principles
• Rationale for an
integrated evidence
based syndrome
approach to case
management
2. Steps of case
management
process
• Assess the young
infant/child
• Classify the illness
• Identify treatment
• Treat the young infant/
child
• Counsel the mother
• Provide follow up care
3. Assessment of sick young
infants•
History taking
• Checking for possible bacterial
infection/jaundice
• Diarrhea
• Feeding problem/ malnutrition
• Immunization status
• Other problems
4. Assessment of sick
children
• History taking
• Checking for general danger
signs
Checking main symptoms•
Checking for malnutrition•
Checking for anemia•
Assessment of feeding•
Checking immunization•
Assessing other problems
5. Treatment procedures•
Identify treatment
• Inpatient and outpatient
treatment
• Home management
• Referral
6. Parental counseling•
Advice regarding feeding
and fluid intake, and
solving of feeding problems
• Administration of oral
drugs•
Advise when to return
INTRODUCTION
• IMCI is an integrated approach that
focuses on the health and well-being
of the child. IMCI aims to reduce
preventable mortality, minimize
illness and disability, and promote
healthy growth and development of
children under five years of age. IMCI
includes both preventive and curative
elements that can be implemented by
families, in communities and in health
facilities.
DEFINITION
• According to "Neelam Kumari“
• IMCI is an integrated approach to child health
that focuses on the well-being of the whole
child. IMCI aims to reduce death, illness and
disability, and to promote improved growth
and development among children under five
years of age. IMCI includes both preventive
and curative elements that are implemented
by families and communities as well as by
health facilities.
• According to "Veerbhadra“
• IMNCI is also called Integrated management of
neonatal and childhood illness. It is a process to
prevention of infection or disease and any
abnormality of neonatal or child is called
BACKGROUND-
• In India, common illnesses in children years of age
include fever (27 respiratory infections (17%),
diarrhoea and malnutrition (43%) and
combination."• Projections based on the 1996
analysis indicate that common childhood illnesses
will continue to be major contributors to child
deaths through the year 2020 unless greater
efforts are made to control them.**• Many sick
children are not properly assessed
• OBJECTIVES
Reducing infant mortality. )
Reducing the incidence and seriousness of
illnesses and health problems.
Improving growth and development during
the first five years of a child's life
• ,
COMPONENTS
Improving case management skills of health
workers:• Standard guidelines• Training (pre-
service and in-services)• Follow-up after training
• Improving the health system to deliver IMNCI:•
Essential drug supply and management
• Organization of work in health facilities•
management and supervision Improving Family
and Community practices
PRINCIPLES
Examine all sick children aged upto 5 years.
• Assess for main symptoms
.• Routinely check for nutrition, immunization, HIV
status in high HIV settings & other potential
problems
.• Classify the problem
.• Use of limited drugs & active participation of
caregiver.
• Counselling of caregiver.
Rational For an Evidence
Base Syndromic Approach
To Case Management
Prevention and treatment strategies
proven effective for saving young lives
such as
• Childhood vaccinations reduced
deaths due tome
• ORS reduction in diarrhea deaths.
Effective antibiotics have saved
millions of children with pneumonia
. • Prompt treatment of malaria and
breastfeeding practices have reduced
childhood
STEPS OF CASE
MANAGEMENT PROCESS
• ASSESS THE YOUNG INFANT
/CHILD –
CLASSIFY THE ILLNESS
CLASSIFICATION OF BACTERIAL
INFECTION/JAUNDICE -
• CLASSIFICATION OF MALNUTRITION
IDENTIFY THE TREATMENT -
TREAT THE YOUNG
INFANT CHILD
• FOLLOW UP VISIT
ASSESSMENT OF SICK
YOUNG INFANTS
HISTORY TAKING
CHECK FOR IMMUNIZATION
ASSESSMENT OF SICK
CHILDREN
TREATMENT
PROCEDURES -
PARENTRAL
COUNSELLING
• 1. A child who is seen at the clinic needs to
continue treatment, feeding and fluids at home.
The child's mother or caretaker also needs to
recognize when the child is not improving, or is
becoming sicker. The success of home treatment
depends on how well the mother or caretaker
knows how to give treatment, understands its
importance and knows when to return to a health
care provider. The steps to good communication
were listed earlier. Some advice is simple; other
advice requires teaching the mother or caretaker
how to do a task. When you teach a mother how
to treat a child, use three basic teaching steps: give
information; show an example; let her practice .
When teaching the mother or caretaker: (1) use
words that s/he understands; (2) use teaching aids
that are familiar; (3) give feedback when s/he
practices, praise what was done well and make
corrections; (4) allow more practice, if needed;
and (5) encourage the mother or caretaker to ask
questions and then answer all questions. on the
child's condition and classifications.
Teach how to give oral drugs or to
treat local infection at home:
Simple steps should be followed when teaching a
mother or caretaker how to give oral drugs or treat
local infections. These steps include:
(1) determine the appropriate drugs and dosage
for the child's age or weight;
(2) tell the mother or caretaker what the
treatment is and why it should be given;
(3) demonstrate how to measure a dose;
(4)describe the treatment steps;
(5) watch the mother or caretaker practice
measuring a dose;
(6) ask the mother or caretaker to give the dose to
the child;(7) explain carefully how, and how often,
to do the treatment at home; (8) explain that All
oral drug tablets or syrups must be used to finish
the course of treatment, even if th echild gets
better;
Advise to continue feeding
and increase fluids
• Advise to continue feeding and increase
fluids: The IMNCI guidelines give feeding
recommendations for different age groups.
These feeding recommendations are
appropriate both when the child is sick and
when the child is healthy. During illness,
children's appetites and thirst may be
decreased. However, mothers and
caretakers should be counsel to increase
fluids and to offer the types of food
recommended for the child's age, as often
as recommended, even though a child may
take small amounts at each feeding. After
illness, good feeding helps make up for
weight loss and helps prevent malnutrition.
When the child is well, good feeding helps
prevent future illness.
ADVICE WHEN TO RETURN
CONCLUSION
IMNCI is a combined management of
illness of under five children and
taking care of their nutrition,
immunization and health promotion
activities
IMNCI Strategy focus on the diseases
of the childhood that causes the
greatest global burden.
The key elements are assess, classify,
identify and treat the sick child age up
to 5 years
A systemic approach to plan and
implement
BIBLIOGRAPHY
• BOOK REFRENCE –
Integrated management of neonatal and
childhood illness. Modules 1 to 9. Ministry of
health & Family welfare, Government of India,
New Delhi. 2009.
Student's handbook for IMNCI. Ministry of health
& Family welfare, Government of India, New Delhi.
2007.
• NET REFRENCE-
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