Transcript F-IMNCI - Kathmandu meeting

Facility-based
Integrated Management of
Neonatal and Childhood Illness
India
Child Health-Approach in RCH-II
• The IMNCI approach is
the centrepiece of
newborn and child
health strategy in RCH II.
IMNCI: What Does It Offer?
• Assessment & classification of all children
presenting to the physician
• Initiating treatment for all children
– Counseling
– Initiate Drug treatment
– Pre-referral treatment and referral advice for
serious conditions
– Management where referral is not possible
IMNCI: What it does not offer?
• Management of serious sick child:
severe pneumonia, severe febrile illness,
severe malnutrition, severe persistent
diarrhoea, sick young infant with sepsis
Severe Jaundice
• Care at Birth for all newborns
• Management of Birth asphyxia
• Emergency Triage & Assessment
Evaluation: Facility based
Care
Human resources
Number
Skills
Team approach
MANAGEMENT OF
Newborn
(Health system & skill issue)
• Care at birth weak
• Non-availability of
protocols
•Referral link to SBA for
sick newborn
• Issues of logistics
MANAGEMENT OF
SICK CHILDREN
• Non availability of
protocols
• Pneumonia and
malnutrition emerging
threats
• Linkages with IMNCI
classifications
• Utilization of
equipments
Multi skilling of personnel, lab and Equipment supply and standards of Management
Core competencies
IMNCI
Facility based care
1
Understand the IMNCI process and
rationale and know how to use the
IMNCI chart
Care at birth
2
Communicate with care-taker
ETAT (Emergency Triage and
Treatment)
3
Danger signs in children and
severe signs in newborns and
young infants
Using essential equipment
4
Main symptoms of key killer
diseases in U5 (NB and CH)
Essential Procedures
5
Malnutrition and anaemia
Manage referrals
6
Immunization* and vitamin A
supplementation
Severe Acute malnutrition
7
Infant & young child feeding
Infant & young child feeding
FACILITY CARE : Components
Principle: Avoid delay in initiating treatment. – ETAT
Care at Birth for newborn
Management Of
Sick Newborns
Management Of
Sick Children
Management Of
Severe Malnutrition
Structure of
New Package
SAM
Fever
Diarrhoea
ARI
Equipments
Procedures
ETAT
LBW
Sick- New
Born
Post-natal
Care
Care at Birth
ETAT (NB)
IMNCI
Referral
Management
Combining the two packages
Advantage
Disadvantage
• True integration
• Take care of problems of calling
participants for repeated trainings
(Transfers and Job profile)
• Addresses issues missing in IMNCI
- Care at birth
- Initiation of breast
feeding
- Inpatient
management of sick young infant
and sick child
• Addresses issues needing attention
such as SAM and ETAT
• Longer duration of training
• Venue selection with stringent
criteria
• Multiple facilitators with special skills
• Need for redesigning the training
tools
• operationalisation issues especially
where IMNCI has been rolled out
Unified package
Duration - 11 days
- 6 days for Outpatient management
- 5 days for facility-based management