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Dr. Abdul Rehman Dr. Abdul Rehman PirzadoPirzadoProvincial MnCAH Officer , WHO Sindh, Provincial MnCAH Officer , WHO Sindh, PakistanPakistan
To reduce significantly mortality and
morbidity associated with the major
causes of disease in children.
To contribute to healthy growth and
development of children.
Abdul Rehman Pirzado 2014
Is not another vertical program
Incorporates: Elements of diarrheal diseases and ARI control program and child oriented aspects of malaria control, nutrition , EPI and other relevant programs
Depends on: Effective functioning of essential drugs and EPI program
Demands and Facilitates: Active collaboration of all these existing programs
Improves: The quality of care of sick children in the primary health care context
Abdul Rehman Pirzado 2014
Improving Case Management Skills of Health Workers:Improving Case Management Skills of Health Workers:
Standard guidelinesStandard guidelines
Clinical Case Management (pre and in-service)Clinical Case Management (pre and in-service)
Follow-up after IMNCI training Follow-up after IMNCI training
Improving the Health System to deliver:Improving the Health System to deliver:
Essential drugs: supply and management Essential drugs: supply and management
Organization of work in Health FacilitiesOrganization of work in Health Facilities
Management and SupervisionManagement and Supervision
Improving Family and Community practices Improving Family and Community practices
Abdul Rehman Pirzado 2014
Assess a child
Classify a child’s illnesses using signal lights approach
Identify treatments for the child.
Treatment instructions
counsel the mother to solve any feeding problems and her
own health.
When a child is brought back to the clinic give follow-up
care and if necessary reassess for new problems
Red - urgent pre-referral treatments and referral
Yellow - specific medical treatment and advice
Green - simple advice on home management
Abdul Rehman Pirzado 2014
1.1. Exclusive BreastfeedingExclusive Breastfeeding
2.2. Complementary feeding / WeaningComplementary feeding / Weaning
3.3. Micronutrients supplementation for vitamin A, Micronutrients supplementation for vitamin A,
Iron and Zinc Iron and Zinc
4.4. Hygiene: Disposal of faeces and Wash hands Hygiene: Disposal of faeces and Wash hands
5.5. Immunization as per EPIImmunization as per EPI
6.6. Preventing MalariaPreventing Malaria
Abdul Rehman Pirzado 2014
7. Promote mental and social development by
responding to a child’s needs for care
8. Home care during Illness
9. Give sick children appropriate home treatment
for infections
10. Care Seeking behaviour
11. Compliance with advice
12. Antenatal Care
Abdul Rehman Pirzado 2014
Launched globally in 1991
Pakistan adapted 1998-2000
First national clinical course 2000
First clinical course in Sindh 2004
Pre-service adaptation in Pakistan 2004
Pre-service adaptation in Sindh 2009
First Pre-service evaluation in Pakistan – LUMHS 2011.
First logbook on Pakistan- LUMHS 2010
Abdul Rehman Pirzado 2014
Total Health Facilities
Health Facilities with IMNCI trained HCP
CoverageHealth care Providers Trained
1,727 77545 %
(12 – 100)2, 257
Good News:
• Government of Sindh has declared IMNCI as SoP for Children U5
• Follow up has been integral part of HRD in 10 districts.
• Follow up has revealed 60 % scores in trained HR
Concerns:
• No policy to procure IMNCI medicine and supplies
• Poor management support
Abdul Rehman Pirzado 2014
Section on Nutrition to be aligned with
CMAM
WHO Growth Charts have been proposed
Distance Learning IMNCI clinical course
Abdul Rehman Pirzado 2014
Abdul Rehman Pirzado 2014