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8/8/2019 IMCI Introduction
1/23
Integrated Management
of Childhood Illness
(IMCI)
A STRATEGY,AN APPROACH
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IMCI as a Strategy
Management of common childhood illnessis done in an integrated manner
Includes preventive interventions Adjusts curative interventions to the
capacity and functions of the health system(evidence based-syndromic approach)
Involves the family members and thecommunity in the health care process
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IMCI Objectives:
1. To reduce global mortality and
morbidity associated with the
major causes of diseases in
children such as pneumonia,diarrhea,
dengue fever, malaria, measles and
malnutrition.
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IMCI- Objectives:
2.To contribute to healthy
growth and development of
children.
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Why IMCI?
Overlap of conditions
Diagnostic tools are minimal or non-
existent
Drugs and equpment are scarce
Health workers have few opportunities to
practice complicated clinical procedures
Relies on history and signs and symptoms
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Components of IMCI
Improvements in the case-management skills ofhealth workers
-*Standard guidelines
- *Training (pre-service, in-service training)
- *Follow- up after training
Improvements in the overall health system
Improvements in family and community healthcare practices
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Target Age for IMCI Strategy
Young infants
1 week up to 2 months
Older children
2 months up to 5 years old
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IMCI in the Philippines
Pre-Implementation Phase (1995-1997)
Adaptation of the IMCI generic protocol
Conduct of model courses (basic 11-day &facilitators course)
Early Implementation Phase (1997-1999)Pilot implementation in Saranggani and
Zamboanga del Norte
Review & re-planning
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IMCI in the Philippines
Expansion Phase (1999 to present)
IMCI Training of health workers (basic 11-day,
facilitators and follow-up training)Accreditation of hospitals for in-patient
practicum (initially1 hospital per region)
Training on family and community IMCI
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Expnasion phase contd
Integration of IMCI in the pre-servicecurriculum
Revision of IMCI materialsTo include care for development in the counsel
the mother module
New treatment protocol for malaria management
Inclusion of Zinc in diarrhea management
Use of reformulated ORS
Redefinition of signs for dengue hemorrhagicfever
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IMCI IN THE Pre-service
Curriculum WHY?
IMCI clinical guidelines define the most
essential knowledge and skills needed toeffectively manage sick children
Children account for 30-70% of all patients in
the outpatient clinics
Students have rare opportunities to develop
essential outpatient skills
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Principles of Integrated Care
All sick children must beexamined for general danger
signs. -NOT ABLE TO DRINK OR BREASTFEED
-VOMITS EVERYTHING
-CONVULSIONS
-ABNORMALLY SLEEPY OR DIFFICULT TOAWAKEN
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All sick children must be
routinely assessed for:
Major Symptoms
Cough/difficulty breathing
Diarrhea
Fever
Ear Problem
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Allsick childrenshouldbe
routinely assessed for: Nutrition, Vit A Supplementation and
Immunization status and
Potential feeding problems andcheck other problems
Only limited number of carefully-selected
clinical signs
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Principles...
Classification(s) rather than a diagnosis
Address most, but not all, of the major reasons a
sick child is brought to a clinic Use limited number of essential drugs and
encourage active participation of caretakers in
the treatment of children
Counseling of caretakers about home
management
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Methods in Managing Childhood
Illnesses Assess the patient
Classify the disease
Treat the patient
Counsel the patient
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Assess the patient
Take patients history to get information
about disease condition
Done by asking and observing the patients
condition exploring possible causes
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Classify the Disease
A thorough assessment
Supported with laboratory results for
classification of illnesses and confirmationof the disease, which are:
1) Mild
2) Moderate3) Severe
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Treat the patient
A curative method of treating the disease
Varies on the condition of the patient
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Counsel the patient
Provide health education to clients
promoting health & avoiding risk of
infection important for parents/caregivers especially
who lack knowledge on health practices &
risks factors that contribute to diseaseailments
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Color-coded system used in
IMCI Green mild classification home care
management
Yellow moderate classification manage
at the RHU
Pink severe classification urgent referral
in hospital
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IMCI Case Management Process
Outpatient health facility
Assessment
Classification and identification of treatment
Referral, home treatment (feeding & fluids) or counseling of thechilds caretaker
When to return immediately; Follow-up care
Referral health facility Emergency triage assessment and treatment (ETAT)
Diagnosis, treatment and monitoring & follow-up of patient
Appropriate home management Teaching the mother or caretakers how to give oral drugs and treat
local infections at home
Counseling mother or caretaker about food
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Practice questions
1. Target ages for IMCI strategy
2. Classification of the disease, color coding used,and its equivalent management approaches used
3. Major symptoms assessed in all sick children
4. Methods of managing childhood illness
5. How do you assess the patient?
6. How do you classify the disease?7. How is the patient treated?
8. How do you counsel the patient?