Integrated Management of

Childhood Illness
(IMCI)
  Integrated
 Management
 Childhood
 Illness
5 major killers of children:
•Diarrhea
•
•Acute Respiratory Infections (Pneu
•
•Measles
•
•Malaria
•
•Malnutrition
 The world health organization is concerned
of the unecessary deaths of children below 5
years old in the developing countries. integrated
management for childhood illness is trying to
fight these unecessary deaths. accourding to
WHO, the mose common cause of death among
these under 5 children is:
 A. diarrhea

 B. pneumonia

 C. malaria

 D. malnutrition
Assess the child or young
infant
 Check for General Danger Signs

• Convulsion
• Abnormally sleepy/unconsciousness
• Not able to drink or breastfeed
• Severe vomiting/vomits everything
•

Which of the following is not a
danger sign?
 A. convulsion
 B. inability to drink or breastfeed
 C. lethargy/ unconsciousness
 D. difficulty of breathing
 4 MAIN SYMTPOMS

• Cough or difficult breathing

• Diarrhea
• Ear pain
• Fever
CLASSIFY THE ILLNESS
I M C I Color Coding
Needs urgent attention and referral or
admission for in-patient care.
This is a severe classification

Child needs an appropriate antibiotic,

an oral anti-malarial or other
treatment which can be given in
health center

Does not need specific medication /

treatment such as antibiotic. Can be
manage at home by mother

If the child has only one of the
danger sign implicitly stated in the
IMCI guideline, this child will be
classified under what color?
 A. pink

 B. blue

 C. yellow

 D. green
 CURATIVE

&
TREAT
HOLISTIC CARE
 COUNSEL

HEALTH EDUCATION
 IMCI Case Management
Classification
Focused Assessment
Need to Refer
Danger signs
Main Symptoms
Nutritional status Specific treatment
Immunization status
Other problems Home
management

Counsel & Follow-up Treatment

Counsel caretakers Identify treatment

Follow-up Treat
Causes of Death in children

Under -
nutrition
53 %

Source: CHERG estimates of under-five deaths, 2000-03

IMCI IMPLEMENTATION IN THE Philippines
nInitiationPhase – IMCI adaptation,
meetings with key stakeholders
nEarly implementation phase –

trainings implementation in pilot

areas
nExpansion phase

cascade to other areas

curriculum integration – nursing,
midwifery, medical schools
 Common Problems That Affect the
Quality of Care Provided to Sick Children
at Health Facilities
1. Health worker’s skills

•Incomplete examinations and counseling

•Poor communication between health
workers and parents
•Irrational use of drugs
 Common Problems That Affect the
Quality of Care Provided to Sick Children
at Health Facilities
2. Health system issues

•Location of health services and responsibility

(centralization)
•Availability of appropriate drugs and vaccines
•Supervision/division of labor/organization of
work
 Common Problems That Affect the
Quality of Care Provided to Sick Children
at Health Facilities
3. Community and family practices
•Poor knowledge of when to return to

a healthassistance
•Seeking facility from unqualified
providers
•Poor adherence to health worker advice
and treatment
•Delayed care seeking
Essential package of child survival
interventions
1. Skilled attendance during pregnancy,
childbirth and the immediate postpartum

2. Care of the newborn

3. Breastfeeding and complementary feeding
4. Micronutrient supplementation

5. Immunization of children and mothers

6. Integrated management of sick

children

7. Use of insecticide treated bed nets (in malarious areas)

Objectives of IMCI

nReduce deaths and the frequency and

severity of illness and disability among
children

nContribute
to improved growth and
development
 Important Elements
for Improving Child Health

nImprove case management of sick children

nImprove nutrition
nEnsure immunization
nPrevent injuries
nPrevent other diseases
nImprove psychosocial support and stimulation
 Case Management Process

1. Assess the child or young infant

2. Classify the illness

3. Identify treatment

4. Treat the child or refer

5. Counsel the mother

6. Give follow-up Care

1.
 Which vital sign is important in
classifying a child with pneumonia
from those who do not have?
A. temperature

B. respiratory rate

C. chest indrawing

D. stridor

In home management of a child
with pneumonia, caretaker is
counseled on how not to:
 A. give oral drugs
 B. treat local infection at home

 C. when to return
 D. discontinue feeding

If pneumonia is present with
major signs and symptoms,
treatment will include:
 A. Cotrimoxazole P.O. BID
 B. Amoxicyllin P.O. BID
 C. ORS 240cc/ loose stool
 D. Procaine Penicillin IM OD