INTEGRATED

MANAGEMENT
OF CHILDHOOD
ILLNESS (IMCI)
GROUP 2- BSN 2C
Amarille, Alliah Ferrer, Honey

Ayon, Gwyneth Genelza, Ralph

Cabiling, Adam Licayan, Judy

Cutab, Althea Melliza, Jelly

Engbino, Paul Sumalinog, Cedric

Introduction
The World Health Organization (WHO) and UNICEF developed the Integrated
Management of Childhood Illness (IMCI) plan, which was introduced as the main
approach to enhancing child health in 1996. It focuses on the treatment of young
children under the age of five, paying attention to both their general health state and
any disorders that may sporadically impact them. As a result, it lessens the likelihood
that diseases will go unnoticed by parents and healthcare professionals, leading to a
lower risk of the sickness getting worse and developing consequences. In addition,
IMCI emphasizes prevention and health promotion as essential elements of treatment.

The goal of IMCI is to lower preventable mortality rates, lessen disease and disability,
and encourage young children's healthy growth and development. Both preventive and
curative components of IMCI are available for implementation by communities,
families, and healthcare facilities.
Introduction

The IMCI strategy in healthcare facilities encourages the timely referral of critically
ill infants and children, ensures appropriate combined treatment of all major
conditions that affect a young child, strengthens caretaker counseling, and ensures
accurate identification of childhood illnesses in outpatient settings. It encourages
appropriate care-seeking behaviors, better nutrition and support for early
childhood development, sickness prevention, and proper implementation and
adherence to treatment in the home environment.
Objectives
> Reducing infant mortality.

> Reducing the incidence and seriousness of illnesses and health

problems that affect boys and girls.

> Improving growth and development during the first five years of a
child's life.

Components

> Improving case management skills of healthcare

providers;
> Improving health systems to provide quality care;
> Improving family and community health practices for
health, growth and development.
 Rationale for an integrated approach

in the management of sick children

3 out

5 CONDITIONS that causes childhood illness

PNEUMONIA MALARIA
of 4
EPISODES OF

CHILDHOOD ILLNESS

ARE CAUSED BY THESE

FIVE CONDITIONS
MALNUTRITION

DIARRHEA
X
MEASLES
 Children covered by the IMCI protocol

1 2

Sick young infant Sick child

Sick children
Sick children

birth up to 2
2 months up

months to 5 years

old
 Strategies/Principles
of IMCI
All sick children aged 2 months up
to 5 years are examined for
GENERAL DANGER signs and all
Sick Young Infants Birth up to 2
months are examined for VERY
SEVERE DISEASE AND LOCAL
BACTERIAL INFECTION.
These signs indicate immediate
referral or admission to hospital
The children and infants are then
assessed for main symptoms. For
sick children, the main symptoms
include: cough or difficulty
breathing, diarrhea, fever and ear
infection. For sick young infants,
local bacterial infection, diarrhea
and jaundice. All sick children are
routinely assessed for nutritional,
immunization and deworming
status and for other problems
 Strategies/Principles
of IMCI
Only a limited number of A combination of individual
clinical signs are used signs leads to a child’s
classification within one or
more symptom groups
rather than a diagnosis.
 Strategies/Principles
of IMCI
IMCI management
procedures use limited
number of essential drugs
and encourage active
participation of caretakers
in the treatment of children
Counseling of caretakers
on home care, correct
feeding and giving of fluids,
and when to return to clinic
is an essential component
of IMCI
 BASIS FOR
CLASSIFYING THE
CHILD’S ILLNESS

Pink Yellow GREEN

Urgent Initiation of
specific supportive
hospital home care
referral or Outpatient
admission Treatment
 CHECK FOR FEEDING PROBLEM OR LOW
WEIGHT FOR AGE

ASK: LOOK, LISTEN, FEEL:

Is there difficulty feeding? Determine weight for age.
Is the infant breastfed or Look for ulcers or white
not? patches in the mouth
(thrush).
 If the infant is breastfed:

1. How many times in 24 hours?

2. Does the infant usually receive any other foods or
drinks? If yes, how often?

ASSESS BREASTFEEDING:
-By observing the mother during breasfeeding

Has the infant breastfed in the previous hour?

If not, ask the mother to

put her infant to the breast. Observe the
breastfeed for 4 minutes.
If yes, ask the mother if she can wait and tell you when the infant is
willing to feed again.
TO CHECK ATTACHMENT, LOOK FOR:
1. Chin touching breast
2. Mouth wide open
3. Lower lip turned outwards
4. More areola visible above than below the mouth

Classification:
No attachment at all, not well attached, or good attachment

TO CHECK SUCKLING, OBSERVE FOR:

Slow deep sucks, sometimes pausing of baby

Classification:
No suckling at all, not well suckling, or good suckling

Classification Table for Feeding Problem or Low Weight

for Breastfed Infant

If the infant is not breastfed:

1. what do you use to feed the infant?

2. What milk are you giving?
3. How many times during the day and night?
4. How much is given at each feed?
5. How are you preparing the milk? Let mother demonstrate or explain how a
feed is prepared, and how it is given to the infant.
6. Are you giving any breast milk at all?
7. What foods and fluids in addition to replacement feeds is given?
8. How is the milk being given? Cup or bottle?
9. How are you cleaning the feeding utensils?
Classification Table for Feeding Problem or Low Weight
for Non-breastfed Infant

VACCINATION STATUS
 Classification for 2 months to
4 years

Newborn usually refers to a baby from birth to

about 2 months of age.

Infants can be considered children anywhere
from birth to 1 year old.
Baby can be used to refer to any child from birth
to age 4 years old, thus encompassing newborns,
infants, and toddlers.
Examples of non-specific
symptoms are:

General feeling of illness

Fatigue
Pain
Weight loss
Fever
 Coughs or Difficulty of Breathing
Coughing. A thick, wet cough
can mean you have a cold or the

COUGH flu. But if you also feel short of

breath, it can be a sign of
another condition, such as
chronic obstructive pulmonary
disease (COPD.) People with
COPD have airways that are
inflamed, that are clogged with
mucus, or that don't work as
well as they used to.
 Medication for
cough

This combination medication is used to relieve

Robitussin 1. coughs caused by the common cold, bronchitis, and
other breathing illnesses.

Common term for Vitex negundo. Which is

Lagundi 2. traditionally used to treat insect and snake bites,

ulcers, rheumatism, sore throat, cough, fever, and
clogged sinuses. This plant is common and widely
distributed in the country.


DIFFICULTY
OF

BREATHING

Common causes of feeling short of breath are:

lung problems, such as asthma and chronic

obstructive pulmonary disease (COPD) heart

problems, such as a cardiovascular disease and

heart failure. infections in the airways, such as

croup, bronchitis, pneumonia, COVID-19, the flu
and even a cold.

HOW TO RELIEVE SHORTNESS OF BREATHING

1. Pursed-lip breathing
This is a simple way to control shortness of breath due to panic, COPD, or
hyperventilation. It helps quickly slow your pace of breathing, which makes each breath
deeper and more effective. If you’re very short of breath after exercising, you should
seek medical help.

Sitting forward
2. Resting while sitting can help relax your body and make breathing
easier.
Standing with supported back
3. Standing can also help relax your body and airways.
DIARRHEA
loose, watery and possibly more-frequent bowel
movements — is a common problem. It may be present
alone or be associated with other symptoms, such as
nausea, vomiting, abdominal pain or weight loss. Luckily,
diarrhea is usually short-lived, lasting no more than a few
days.
 Symptoms
Signs and symptoms associated with diarrhea (loose,
watery stools) may include:
Abdominal cramps or pain
Bloating
Nausea
Vomiting
Fever
Blood in the stool
Mucus in the stool
Urgent need to have a bowel movement
 What causes diarrhea?
Diarrhea may be caused by many things, including:
A bacterial infection
A virus
Trouble digesting certain things (food intolerance)
Food allergy (such as celiac disease, gluten allergy)
Parasites that enter the body through food or water
A reaction to medicines
An intestinal disease, such as inflammatory bowel
disease
Indications of dehydration in infants and young children
These include:

Not having a wet diaper in three or more hours

Dry mouth and tongue
Fever above 102 F (39 C)
Crying without tears
Drowsiness, unresponsiveness or irritability
Sunken appearance to the abdomen, eyes or cheeks
 How is diarrhea treated?
Your healthcare provider will make a care plan for you based on:
Your age, overall health, and past health
How serious your case is
How well you handle certain medicines, treatments, or therapies
If your condition is expected to get worse
What you would like to do
In most cases you will need to replace the fluids you have lost.
You may also need a medicine that fights infection (antibiotic) if a bacterial
infection is causing your diarrhea.
 CHECK FOR FEVER
IF YES, decide the malaria risk high or low
Then Ask: LOOK FOR SIGNS OF DENGUE

For how long? Bleeding tendencies

If more than 7 days, has fever
Flushing
been present every day? Positive tourniquet test
Has the child had measles within
Rashes
the last 3 months? LOOK FOR SIGNS OF MEASLES

Generalized rash
One of these: cough, runny

nose, or red eyes

CLASSIFICATION TABLE FOR NO MALARIA RISK AND NO TRAVEL TO A MALARIA

RISK AREA
CLASSIFICATION TABLE FOR MEASLES ( IF MEASLES NOW OR WITHIN THE LAST 3

MONTHS)
 CHECK FOR MALNUTRITION AND ANAEMIA

LOOK AND FEEL:

Look for visible severe wasting

Look for palmar pallor. Is it:
sever palmar pallor?
Some palmar pallor
Look for edema of both feet
Determine weight for age

CLASSIFICATION TABLE FOR MALNUTRITION AND ANAEMIA

Vaccination Status
2 MONTHS - 4 YEARS


Antigen Age Dose Route Site

DPT-HepB-HIB

6 weeks, 10 Right deltoid

(Pentavalent 0.5 ml Intramuscular
weeks, 14 weeks Region (arm)
vaccine)

Oral Polio 6 weeks, 10 Anterolateral

2 drops Oral
Vaccine weeks, 14 weeks thigh muscle

Anti-measles

Anterolateral
Vaccine 9-11 months 0.5 ml Subcutaneous
thigh muscle
(AMV1)

Measle-mumps-rubella

vaccine 12-15 months 0.5 ml Subcutaneous Mouth

(AMV2)

Rotavirus 6 weeks, 10 Outer part of

1.5 ml Oral
vaccine weeks the upper arm

Outer part of
BCG vaccine At birth 0.05 ml Intradermal
the upper arm

Hepatitis B
At birth 0.5 ml Intramuscular Mouth
vaccine
NONSPECIFIC
SIGNS OF
SERIOUS
ILLNESS

Does the young infant have diarrhea?

Does the young infant have diarrhea?