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    Integrated Management of Childhood Illness (IMCI) PDF

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    LOVELY ANN GIGANTE
    This document provides information on the Integrated Management of Childhood Illness (IMCI) strategy. IMCI was initiated by the Department of Health, WHO, and UNICEF to reduce childhood mortality from major diseases. It focuses on case management of pneumonia and diarrhea through preventive and curative community interventions. The IMCI process involves assessing children for general danger signs, classifying illnesses, identifying treatments, treating or referring children, and counseling mothers. It uses evidence-based guidelines to manage common childhood illnesses with a limited number of essential drugs. The selection of the appropriate case management chart depends on the child's age, with different charts for infants under 2 months and children 2 months to 5 years old.

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    Integrated Management of Childhood Illness (IMCI) PDF

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    LOVELY ANN GIGANTE
    118 views7 pages
    This document provides information on the Integrated Management of Childhood Illness (IMCI) strategy. IMCI was initiated by the Department of Health, WHO, and UNICEF to reduce childhood mortality from major diseases. It focuses on case management of pneumonia and diarrhea through preventive and curative community interventions. The IMCI process involves assessing children for general danger signs, classifying illnesses, identifying treatments, treating or referring children, and counseling mothers. It uses evidence-based guidelines to manage common childhood illnesses with a limited number of essential drugs. The selection of the appropriate case management chart depends on the child's age, with different charts for infants under 2 months and children 2 months to 5 years old.

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    This document provides information on the Integrated Management of Childhood Illness (IMCI) strategy. IMCI was initiated by the Department of Health, WHO, and UNICEF to reduce childhood mortality from major diseases. It focuses on case management of pneumonia and diarrhea through preventive and curative community interventions. The IMCI process involves assessing children for general danger signs, classifying illnesses, identifying treatments, treating or referring children, and counseling mothers. It uses evidence-based guidelines to manage common childhood illnesses with a limited number of essential drugs. The selection of the appropriate case management chart depends on the child's age, with different charts for infants under 2 months and children 2 months to 5 years old.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    118 views7 pages

    Integrated Management of Childhood Illness (IMCI) PDF

    Uploaded by

    LOVELY ANN GIGANTE
    This document provides information on the Integrated Management of Childhood Illness (IMCI) strategy. IMCI was initiated by the Department of Health, WHO, and UNICEF to reduce childhood mortality from major diseases. It focuses on case management of pneumonia and diarrhea through preventive and curative community interventions. The IMCI process involves assessing children for general danger signs, classifying illnesses, identifying treatments, treating or referring children, and counseling mothers. It uses evidence-based guidelines to manage common childhood illnesses with a limited number of essential drugs. The selection of the appropriate case management chart depends on the child's age, with different charts for infants under 2 months and children 2 months to 5 years old.

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    of 7

    SYSTEMS PLUS COLLEGE FOUNDATION

    Angeles City
    COLLEGE OF NURSING

    Nursing Care Management 113: COMMUNITY HEALTH NURSING 2


    (Community and Population Group as Clients)
    2nd Semester, S.Y. 2020-2021

    HANDOUT: Integrated Management of Childhood Illness (IMCI)

     Childhood mortality:
    a global and national perspective
      Mortality (Children  5y/o)
     Causes:
     Pneumonia: 19%
     Diarrhea: 17%
     Malaria: 8%
     Measles: 4%
     HIV: 3%
     Neonatal/Perinatal causes & Others : 47%
     Malnutrition – highest attributable causal/ associated factor

     Ten (10) Leading Causes of Child Mortality


    By Age-Group (1-4)
    No. & Rate/100,000 population
    Philippines, 2010

     Causes:
    1. Pneumonia
    2. Diarrheas and gastoenteritis of presumed infectious origin
    3. Congenital anomalies
    4. Septicemia
    5. Other diseases of the nervous system
    6. Accidental drowning and submersion
    7. Dengue Fever and Dengue- hemorrhagic fever
    8. Chronic lower respiratory diseases
    9. Meningitis
    10. Leukemia

     According To WHO
    - 50 developing countries still have childhood mortality rates of over 100 per 1000 live births
    - 10 Million children die each year in developing countries before they reach their 5th birthday.
    - Statistics will still be the same in the year 2020, unless significant efforts are made to control
    fatal conditions.

     In the Philippines…
     Acute Respiratory Infection
     1 for every 10 children – (+) S/Sx of ARI
     24% - (+) fever
     46% - taken to a health facility
     Urban areas
     Mothers with high educational attainment
     Under wealthiest quintile
     Diarrhea
     Increased prevalence from 7% (1998) to 11% (2003), 9.3% in 2010
     Prevalent in CAR (20%)
     On most developing countries…
     Diagnostic supports are MINIMAL or even NON-EXISTENT
     Drugs and Medical equipment are scarce
     Irregular outflow of patients
     DOH health essential package
     skilled attendance during pregnancy, childbirth & the immediate postpartum.
     care of the newborn
     breastfeeding and complementary feeding
     micronutrient supplementation
     immunization of children and mothers
     Integrated management of childhod illnesses (IMCI)
     use of insecticide-treated bed nets (in malaria areas)
     Integrated Management of Childhood Illness
     Strategy deals with the management of common childhood illnesses thru preventive and curative
    interventions involving family members and community.

    IMCI
     Initiated by:
     DOH
     WHO
     UNICEF
     One of the pillars in the DOH essential package of child survival interventions focusing in the case
    management of Pneumonia & Diarrhea

     OBJECTIVES
    - To significantly reduce the global mortality and morbidity associated with the major causes of
    disease in children  5y/o
    - To contribute to a healthy growth and development of children

     COMPONENTS
    - Improving case management skills of community health workers
    - Improving the heath care delivery system in implementing IMCI
    - Improving family and community health practices

    INTEGRATED CASE MANAGEMENT PROCESS


     Core of IMCI strategy
     consists of Clinical Guidelines
     Based on:
     Expert Clinical Opinion
     Research Results
     utilizes an EVIDENCED BASED-SYNDROMIC approach

    CASE MANAGEMENT PROCESS


    1. Assess the child or young infant
     History Taking
     Physical Assessment
    2. Classify the illness
     Decision on the severity of illness
    3. Identify treatment
     Based on the severity of illness with its corresponding treatment regimen
    4. Treat the child and or Refer
     Giving of treatment in the RHU
    5. Counsel the mother
     Health Education
     Follow-up check up
    6. Give follow-up care

    Principles of integrated care


     All sick children must be examined for “general danger signs”
     All sick children must be routinely assessed for major symptoms
     age 2 months up to 5 years:
    1. cough or difficulty of breathing,
    2. diarrhea
    3. fever
    4. ear problem
     week up to 2 months:
    1. bacterial infection and diarrhea
     Routinely assessment for nutritional and immunization status, feeding problems, and other
    potential problems.
     Only a limited number of carefully-selected clinical signs are used.
     A combination of individual signs leads to a child’s classification(s) rather than a diagnosis.
     “pink” - hospital referral or admission
     “yellow” - initiation of treatment
     “green” - home treatment
     The IMCI guidelines address most, but not all, of the major reasons a sick child is brought to a
    clinic.
     IMCI management procedures use a limited number of essential drugs and encourage active
    participation of caretakers in the treatment of children.
     An essential component of the IMCI guidelines is the counseling of caretakers about home care,
    including counseling about feeding, fluids and when to return to a health facility.

    SELECTION OF APPROPRIATE CASE MANAGEMENT CHART


     Decide which age group the child is in
     Age 1 week up to 2 months
    1. Assess, Classify and Treat the Sick Young Infant chart
     Age 2 months up to 5 years
    1. Assess and Classify the Sick Child Age 2 Months up to 5 years chart
     Management of the sick child aged 2 months up to 5 years old
     Assess and Classify

    *Describes on how to assess and classify sick children so that signs of disease are not overlooked

    1. Ask the mother what the Child’s Problems are


    A. Greet the mother appropriately and ask her to sit with her child.
    Secure name, child’s age in months as of the last birthday: basis for case mgmt.
    Age 1 week up to 2 months
     Assess, Classify and Treat the Sick Young Infant chart
    Age 2 months up to 5 years
     Assess and Classify the Sick Child Age 2 Months up to 5 years chart

    B. Ask the mother what the child’s problems are and record in the recording form
    *Listen Carefully to what the mother tells you
    *Use words the mother understands
    *Give the mother time to answer questions
    *Ask additional questions when the mother is not sure about her answer
    C. Determine if this is an initial visit or a follow-up visit for this problem
    INITIAL VISIT- child’s 1st visit for THIS episode of an illness/problem
    - child was seen a few days ago for a DIFFERENT illness
    FOLLOW-UP VISIT- child was seen a few days ago for the SAME illness

    2. Check for the General Danger Signs


    *Check ALL sick children for General Danger Signs
    a. child is not able to drink/breastfeed
    b. child vomits everything
    c. child has had convulsions
    d. child is abnormally sleepy/difficult to awaken

    *A child with a danger sign has a serious problem and most of these need URGENT referral

    ASK: Is the child able to drink/breastfeed?


    a. Too weak to drink
    b. Not able to suckle or swallow a drink/breastmilk (with clear nose)
     If the child’s nose is blocked during breastfeeding, he/she may have difficulty
    sucking, therefore clear it.
     If the child can breastfeed after clearing his/her nose, he/she doesn’t have this
    danger sign

    ASK: Does the child vomit everything?


     Child is not able to hold anything down at all
     What goes down comes back up
     A child who vomits everything is not able to hold down foods, fluids, and oral
    drugs: (+) danger sign
     A child who vomits several times but can hold down some fluids does not have this
    general danger sign

    ASK: Has the child had convulsions during this illness?


     Arms and legs stiffen as muscles contract
     May lose consciousness
     Not be able to respond to spoken directions or handling even if eyes are open
     Fits
     Spasms
     Jerky movements
     Child may shiver when fever rapidly progresses but will not lose consciousness

    LOOK: See if the child is abnormally sleepy/difficult to awaken (lethargic)


     Not awake & alert when he/she should be
     Drowsy & doesn’t show interest to what is going on around him/her
     Does not look at his/her mother
     Does not watch your face when you talk
     May stare blankly
     Appears not to notice what is going on around him/her
     Does not respond when he/she is touched, spoken to or shaken
     If the child is sleeping and has cough/DOB, count the number of breaths first
    before you try to wake the child

    If the child has a general danger sign, complete the rest of the assessment immediately because
    the child has a SEVERE problem. There must be NO delay on his/her treatment.
    ASK: Does the child have cough/DOB?
     No  look to see the child
     Yes  ask the next question

    ASK: For how long?


     Cough/DOB ( 30 days) – CHRONIC
     Maybe a sign of TB, asthma, whooping cough or another problem
    COUNT: breaths in one minute
     to see for fast breathing (FB)
     MUST be quiet and calm during the counting
     MUST NOT be frightened, crying, and angry

    BREATHING MATRIX
    2 months – 12 months: fast breathing is 50bpm or 
    12 months – 5 years: fast breathing is 40bpm or 
    Note: The child who is exactly 12 months old has fast breathing if you count 40 breaths/min or more

     LOOK: for Chest Indrawing


     When the child breathes IN
     Look at the lower chest wall (lower ribs)
     (+) Chest Indrawing if the lower chest wall goes in when the child breathes IN, clearly
    visible and present ALL the time
     Refer to Page 15 of your workbook

     LOOK & LISTEN for Stridor


     Harsh noise made when the child breathes IN in a CALM situation
     Due to swelling of the larynx, trachea and epiglottis (croup)  w/c interferes with air
    entering the lungs
     Position ear near the child’s mouth when the child breathes IN
     CLEAR THE NOSE for accurate findings
     Wheezing noise when the child breathes out is NOT Stridor.

    Classification tables
    A. PINK ROW
    -a severe classification that needs urgent attention
    -for referral
    B. YELLOW ROW
    -needs appropriate antibiotic or other treatments
    -includes teaching the mother how to give oral drugs or treat local infection at home.
    C. GREEN ROW
    -does not need medical treatment such as antibiotic
    -teach mother how to care for child at home

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