Integrated Management of
Childhood Illness
(IMCI)
Integrated
Management
Childhood
Illness
5 major killers of children:
•Diarrhea
•
•Acute Respiratory Infections (Pneu
•
•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
Classification
Focused Assessment
Need to Refer
Danger signs
Main Symptoms
Nutritional status Specific treatment
Immunization status
Other problems Home
management
Counsel & Follow-up Treatment
Counsel caretakers Identify treatment
Follow-up Treat
Causes of Death in children
Under -
nutrition
53 %
Source: CHERG estimates of under-five deaths, 2000-03
IMCI IMPLEMENTATION IN THE Philippines
nInitiationPhase – IMCI adaptation,
meetings with key stakeholders
nEarly implementation phase –
trainings implementation in pilot
areas
nExpansion 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 worker’s 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
•Seeking facility 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
nReduce deaths and the frequency and
severity of illness and disability among
children
nContribute
to improved growth and
development
Important Elements
for Improving Child Health
nImprove case management of sick children
nImprove nutrition
nEnsure immunization
nPrevent injuries
nPrevent other diseases
nImprove 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
1.
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
