integrated management of neonatal childhood illness
TRANSCRIPT
INTEGRATED MANAGEMENT OF
NEONATAL CHILDHOOD ILLNESS
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THE INEQUITIES OF CHILD HEALTH
•Over the last 3 decades the annual number of deaths among children less than 5 years of age has decreased by almost a third. However, this reduction has not been evenly.
•Distributed throughout the world. Every year more than 10 million children die in Developing countries before they reach their fifth birthday.
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THE INEQUITIES OF CHILD HEALTH Seven in 10 of these deaths are due to
acute respiratory infections (mostly pneumonia), diarrhoea, measles, malaria, or Malnutrition and often to a combination of these illnesses.
In India, common illnesses in children under 3 years of age include fever (27%)
Acute Respiratory infections (17%)
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THE INEQUITIES OF CHILD HEALTH•Diarrhoea (13%) And malnutrition (43%) –
and often in Combination (National Family Health Survey. Infant Mortality Rate continues to be high per year.
•Neonatal mortality contributes to over 64% of infant deaths and most of these deaths occur during the first week of life.
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GOALS OF IMNCI•Standardized case management of sick
newborns and children.•Focus on the most common causes of
mortality.•Nutrition assessment and counselling for
all sick infants and children.
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GOALS OF IMNCI Home care for newborns to :
•Promote exclusive breastfeeding.
•Prevent hypothermia.
•Improve illness recognition & timely care seeking
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PRINCIPLES OF IMNCI
•All sick children under five years of age must be examined for condition which indicate immediate referral or hospitalization
•Children must be routinely assessed for major symptoms, nutritional and immunization status, Feeding problems and other potential problems
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PRINCIPLES OF IMNCI•Only limited number of carefully selected
clinical signs are used based on evidence of their sensitivity and specificity to detect disease
•Based on the presence of selected clinical signs the child is placed in “classification”.
•classifications are not specific diagnosis but categories that are used to determine the treatment
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PRINCIPLES OF IMNCI•Classifications are color coded and
suggest referral (pink), treatment in healthy facility (yellow) or management at home (green).
•IMNCI guidelines address most common , but not all pediatric problems
•A limited number of essential drugs are use
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT
•Many well-known prevention and treatment strategies have already proven effective for saving young lives.
• Childhood vaccinations have successfully reduced deaths due to measles
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT
•Prompt treatment of malaria has allowed more children to recover and lead healthy lives.
•Even modest improvements in breastfeeding practices have reduced childhood deaths.
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT
•While each of these interventions has been successful, accumulating evidence suggests that an integrated approach is needed to manage sick children to achieve better outcomes.
•Child health programme need to move beyond single diseases to addressing the overall health and well-being of the child.
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT•An integrated approach is needed to
manage sick children to achieve better outcomes.
•Child health programme need to move beyond tackling single diseases in order to address the overall health and well-being of the child.
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT
•The guidelines represent an evidence-based, syndromic approach to case management that includes effective and affordable use of drugs and diagnostic tools.
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RATIONALE FOR AN INTEGRATED EVIDENCE-BASEDSYNDROMIC APPROACH TO CASE MANAGEMENT
An evidence-based syndromic approach can be used to determine the:
health problem the child may have;• severity of the child’s condition; and actions that can be taken to care for
the child (e.g. refer the child immediately, manage with available resources, or manage at home).
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COMPONENTS OF THE INTEGRATED APPROACH•The IMNCI strategy includes both
preventive and curative interventions that aim to improve practices in health facilities, the health system and at home.
At the core of the strategy is integrated case management of the most common neonatal and childhood
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COMPONENTS OF THE INTEGRATED APPROACH•The strategy includes three main
components: Improvements in the case-management
skills of health staff through the provision of locally-adapted guidelines on Integrated Management of Neonatal and Childhood Illness and activities to promote their use;
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COMPONENTS OF THE INTEGRATED APPROACH•Improvements in the overall health
system required for effective management of neonatal and childhood illness;
• Improvements in family and community health care practices.
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IMNCI CASE MANAGEMENT PROCESS STEPS OF CASE MANAGEMENT
PROCESS:-• Assess the young infant or child.• Classify the illness.• Identify the treatment• Counsel the mother • Provide follow up care.
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Bibliography•K.K.Gulani community health nursing
principal & practice, kumar publishers, page no. 379-380.
•B.T. vasvanthappa community health nursing, j.p.publishers page no. 265-267
•Preventive & social medicine k. park 18th edition, page no. 345-346.
•Joan m. cookfair nursing care in the community, published by mosby, second edition. Page no. 520-524.
•www google. Com. Pub.
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Thank you
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