2. IMNCI:
WHO/UNICEF have developed a new approach to
tackling the major diseases of early childhood
called the Integrated Management of Childhood
Illnesses (IMCI)
3. Why IMNCI
Reduce infant and child mortality rates
Improving child health & survival
IMR reduced from 114 to 53
Malnutrition and low birth weight (LBW)
are contributors to the about 50%
deaths
4. Attention to counselling skills to promote exclusive
breastfeeding, complementary feeding & micronutrient
supplementation is a key strength of IMNCI
Malaria*
5% Measles*
Other 7%
32%
Diarrhoea*
19%
Malnutrition*
54%
Acute Respiratory
Perinatal Infections*
18% 19%
* Based on data taken from The Global Burden of Disease 1996, edited by Murray CJL and Lopez AD, and
Epidemiologic evidence for a potentiating effect of malnutrition on child mortality, Pelletier DL, Frongillo
EA and Habicht JP, AmJ Public Health 1993;83:1130-1133
5. THE INTEGRATED CASE
MANAGEMENT
Out Patient Health Facility (up to 5 yrs)
Check for Danger Signs
Ask about main symptoms
Assess Nutrition & Immunization Status
Check for other Problems
Classify Conditions & Identify Management Strategy
6. Case management strategy
PINK CLASSIFICATION:
Child needs referral ( Inpatient care)
YELLOW CLASSIFICATION:
Child needs specific treatment, provide it at home (e.g.
Antibiotics, ORS)
GREEN CLASSIFICATION:
Child needs no medicine, give home care
7. IMNCI Beneficiaries
• Care of Newborns and Young Infants (infants
under 2 months)
• Care of Infants (2 months to 5 years)
8. Care of Newborns and Young
Infants (infants under 2
months)
• Keeping the child warm
• Initiation of breastfeeding
• Counseling for exclusive breastfeeding
• Cord, skin and eye care
• Recognition of illness in newborn and
management and/or referral
• Immunization
• Home visits in the postnatal period
9. Care of Infants (2 months to 5
years)
• Management of diarrhoea, ARI
malaria, measles, acute ear
infection, malnutrition and anemia
• Recognition of illness and risk
• Prevention and management of Iron and
Vitamin A deficiency
• Counseling on feeding for all children below 2
years
• Counseling on feeding for malnourished
• Immunization
10. IMNCI Components and
Intervention areas
• Improve health • Improve • Improve
worker skills health family &
systems community
practices
• Case • District & • Appropriate
management Block Care seeking
standards & planning
guidelines and
managemen
t
• Training of • Availability • Nutrition
facility-based of IMNCI
public health drugs
care providers
11. IMNCI Components and
Intervention areas
Improve health Improve health Improve family
worker skills systems & community
practices
IMNCI roles for Quality Home case
private providers improvement management &
and supervision adherence to
at health recommended
facilities – treatment
public & private
12. IMNCI Components and
Intervention areas
Improve health Improve health Improve family &
worker skills systems community
practices
Maintenance of Referral Community
competence pathways & services planning
among trained services & monitoring
health
Health
Information
System
13. Components of IMNCI
Training
Effective implementation
• Improvements to the health system
• Improvement of Family and Community
Practices
Collaboration/coordination with other
Departments
14. Components of IMNCI
Training
IMNCI is a skill based training in both facility
and community settings
Broadly, two categories of training are
included
for medical officers
for front-line functionaries including ANM’s
and AWW’s
15. Components of IMNCI
Effective implementation
Improvements to the health system
• Ensuring availability of the essential drugs
• Improve referral
• Referral mechanism
• Functioning referral centers
• Ensuring availability of health workers /
providers at all levels
• Ensuring supervision and monitoring through
follow up visits
16. Components of IMNCI
Effective implementation
Improvement of Family and Community Practices
Counseling of families and creating awareness
which includes:
• Promoting healthy behaviors
• IEC campaigns
• Counseling of care givers and families
• During home visits identify sickness and
focused BCC
17. Components of IMNCI
Collaboration/coordination with other Departments
• Involvement of ANM and AWWs
• Involvement of grass-root functionaries of other
sectors
• Active involvement of PRI, SHGs and women’s
groups
18. F-IMNCI
From November 2009 IMNCI has been re -baptized
as F-IMNCI, (F -Facility) with added component
of:
• Asphyxia Management and
• Care of Sick new born at facility level, besides
all other components included under IMNCI
20. State level Institutional
Arrangements
• Appoint Nodal Officer
• Set up a co-ordination Group
• Arrange logistics
• Create pool of State level trainers
• Selection of priority districts
• Review progress
• Identify the State Nodal institute for training
• Improvement in family and community
practices
21. District level Institutional
Arrangements
• Appoint District Coordinator
• Set up an IMNCI Coordination Group
• Train District Trainers.
• Develop a detailed plan for implementation
• Ensure timely supplies & logistics, supervision
and follow-up
• IEC activities
22. ng
Training in IMNCI • Medic
• Clinical • Medical Officer • 8 • Physicia
skills and Pediatrician day n al
training s Package colleg
e
/Distri
ct
Hospit
al
• Health workers • 8 • Health • Distric
ANMs, LHVs, day Worker t
Mukhya sevika s s Hospit
CDPO’s and Package al
AWWs
23. Type of Personnel to Durat Package Place of
Training be trained ion to be Training
used
Supervis Medical 2days Superviso Medical
ory Skills Officers, ry Skills college
Training Pediatricians, package /District
CDPO’s LHVs Hospital
and
Mukhiya
Sevikas)
25. State Level Training
Institutions
• Identify a Regional Training Centre
• The Departments of Pediatrics and
Preventive & Social Medicine in each
college
26. District Level Training
Institutions
• District hospital for training of medical officers
• CHCs/operational FRUs etc for training of
health workers
27. Follow-up Training (FUT)
• The Follow-up Training is designed to improve
supportive supervision for 2 days which may
either be clubbed with Clinical skills training or
conducted within 6-8 weeks of the initial
Clinical skills training.
28. Pre-Service Training
• Training of undergraduate students and
interns
• ANM, AWW, and Staff Nurses’ training schools
need to include IMNCI in their training
schedules
