CONTENTS

 INQUITIES OF CHILD HEALTH

 IMCI: THE SOLUTION
 WHAT IS IMNCI ?
 COMPONENTS OF IMNCI
 PRINCIPLES OF IMNCI
 CASE MANAGEMENT PROCESS
 REFRENCES
INQUITIES OF CHILD HEALTH

Distribution of 10.5 Million Deaths Among Children Less Than

5 Years Old in All Developing Countries, 19991
CAUSES IN INDIA
Projections based on the 1996 analysis indicate
that common childhood illnesses will continue
to be major contributors to child deaths through
the year 2020 unless greater efforts are made to
control them.
HOW THESE CONDITIONS CAN BE
IMPROVED ?

THE SOLUTION
Experience and scientific evidence show that improvements
in child health are not necessarily dependent on the use of
sophisticated and expensive technologies, but rather on
effective strategies that are based on:
1. A holistic approach,
2. Available to the majority of those in need,
3. Which take into account the capacity and structure of
health systems,
4. As well as traditions and beliefs in the community.
During the mid-1990s, the World Health Organization (WHO), in
collaboration with UNICEF and many other agencies, institutions
and individuals, responded to this challenge and came up with a
strategy that:

1. An integrated approach is needed to manage sick children to

achieve better outcomes.

2. Child health programmes need to move beyond tackling single

diseases in order to address the overall health and well-being
of the child.

And was named INTEGRATED MANAGEMENT OF

CHILDHOOD ILNESS.
 This strategy has been expanded in India and
renamed as ‘Integrated Management of
Neonatal and Childhood Illness (IMNCI)’.

 IMNCI strategy is one of the main interventions

under RCH II/ NHM, that focuses on preventive,
promotive and curative aspects of program.
PRINICIPLES OF IMNCI
 Depending on a child’s age, various clinical signs
and symptoms differ in their degrees of reliability
and diagnostic value and importance. Therefore,
the IMNCI guidelines recommend case
management procedures based on two age
categories:
 Young infants age up to 2 months
 Children age 2 months up to 5 years
 ASSESS “possible bacterial infection /
jaundice” in young infants up to two
months of age. Then they must be
routinely assessed for diarrhoea.
 Children of age 2 months up to 5 years must be
examined for “general danger signs”
 Routine assessment for nutritional and
immunization status, feeding problems, and
other potential problems.
 Limited number of carefully selected
clinical signs are used based on their
sensitivity and specificity to detect disease.
 Individual signs are used for classification of
the disease.

 Classification(s) indicate the severity of

condition(s) and are colour coded.
Admission/Referral

Specific treatment

Home Management
 Limited number of essential drugs and
encourage active participation of caretakers.
 IMNCI addresses most, but not all, of the
major reasons a sick infant or child is
brought to a clinic.
 Counselling of caretakers.
REFRENCES
 World Health Organization. World Health Report 1999 making a difference. Geneva, WHO, 1999.
 Murray CJL and Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability
from diseases injures, and risk factors in 1990 and projected to 2020. Geneva, World Health Organization, 1996.
 Ford, N., Williams, A., Renshaw, M. and Nkum, J. (2005). Communication Strategy for Implementing Community
IMCI. Journal of Health Communication, 10(5), pp.379–401.
 Mason, E., Scherpbier, R. and Lawe-Davies, O. (2009). WHO position statement on IMCI. The Lancet, 374(9692),
pp.782–783.
 ‌ oy, R. (1998). Editorial. Integrated management of childhood illness (IMCI). Journal of Tropical
M
Paediatrics, 44(4), 190–191. https://doi.org/10.1093/tropej/44.4.190

 Chaudhary, N., Mohanty, P.N. and Sharma, M. (2005). Integrated management of childhood illness (IMCI) follow-
up of basic health workers. The Indian Journal of Paediatrics, 72(9), pp.735–739.
 Thompson, M.E. and Harutyunyan, T.L. (2009). Impact of a community-based integrated management of childhood
illnesses (IMCI) programme in Gegharkunik, Armenia. Health Policy and Planning, 24(2), pp.101–107.

 Patwari, A.K. and Raina, N. (2002). Integrated Management of Childhood Illness (IMCI) : A robust strategy. The
Indian Journal of Paediatrics, 69(1), pp.41–48.
 Duke, T. (2009). Child survival and IMCI: in need of sustained global support. The Lancet, 374(9687), pp.361–362.