1 . What is IMCI Strategy?

IMCI aims to reduce childhood mortality and improve the quality of care for major
childhood illnesses, especially at first-level health facilities.

2. Why do we need to have an integrated approach?

IMCI gives you instructions
The charts will also give instructions about treatment
IMCI instructions also provide advice on counselling

3. Discuss the aim of the IMCI strategy

The goal of IMCI is to decrease childhood deaths, reduce how often children are
sick,reduce the severity of illness, and improve growth and development in the
children you care for.

4. Explain the components of the IMCI Strategy

Your case management and counselling skills
Your knowledge of, and ability to follow, national health guidelines
The way your facility and health system manages childhood illness
Family and community practices, particularly in giving home treatment, preventing
disease, and minimizing health risks around the home

5. Outline the requirements needed to facilitate each of the components

ASSESS
IMCI uses simple signs to detect cases. As few clinical signs as possible are used.
These signs are based on
expert clinical opinion and research results. That means detection of conditions
for treatment is based on
your observations.
You will ASSESS all sick infants and children for:
1. Signs of serious illness that requires urgent referral, then
2. Signs of common health conditions, and then
3. Nutrition status, immunization status, and other problems.
CLASSIFY
You will classify each health condition using colour-coded IMCI charts. You will
classify based on the
history given, signs the child shows, and tests as indicated. The chart also
identifies treatment for the
condition. These classifications cover the most likely diseases, and reflect your
national treatment guidelines.
The three colour-coded classifications also tell you where to give these
treatments:
✔ RED: very serious condition requires urgent pre-referral treatment and referral
✔ YELLOW: serious condition needs treatment and advice in the clinic
✔ GREEN: less serious condition needs home treatment and advice
Some children will show signs from multiple boxes. You will always use the more
severe classification.
For example, if a child shows signs from a red and yellow box, you will use the
red. If a child has multiple
conditions, he will have a classification for each condition.
TREAT
After classifying all conditions, you will review all treatments identified in each
classification. Then you will
develop an integrated treatment plan. If a child requires urgent referral, give
essential treatment before
the patient is transferred. If a child needs treatment at the clinic, you will
often give the first dose in the
clinic. Give immunizations if needed. You will advise caregivers on home treatment.
COUNSEL
A critical component of IMCI is counselling caregivers on home treatment (e.g.
treating local infections,
giving oral drugs), feeding and fluids, breastfeeding, and other well child care.
Then counsel the caregiver
about her own health. Advise the caregiver to return for follow-up on a specific
date. Teach caregivers
when to return immediately if child shows signs of severe illness.
PROVIDE FOLLOW-UP CARE
When a child returns to the clinic as requested, give follow-up care as required.
Re-examine conditions to
see if the issues are improving, the same, or worsening. Use the full IMCI process
again to check the child for
new problems.ASSESS
IMCI uses simple signs to detect cases. As few clinical signs as possible are used.
These signs are based on
expert clinical opinion and research results. That means detection of conditions
for treatment is based on
your observations.
You will ASSESS all sick infants and children for:
1. Signs of serious illness that requires urgent referral, then
2. Signs of common health conditions, and then
3. Nutrition status, immunization status, and other problems.
CLASSIFY
You will classify each health condition using colour-coded IMCI charts. You will
classify based on the
history given, signs the child shows, and tests as indicated. The chart also
identifies treatment for the
condition. These classifications cover the most likely diseases, and reflect your
national treatment guidelines.
The three colour-coded classifications also tell you where to give these
treatments:
✔ RED: very serious condition requires urgent pre-referral treatment and referral
✔ YELLOW: serious condition needs treatment and advice in the clinic
✔ GREEN: less serious condition needs home treatment and advice
Some children will show signs from multiple boxes. You will always use the more
severe classification.
For example, if a child shows signs from a red and yellow box, you will use the
red. If a child has multiple
conditions, he will have a classification for each condition.
TREAT
After classifying all conditions, you will review all treatments identified in each
classification. Then you will
develop an integrated treatment plan. If a child requires urgent referral, give
essential treatment before
the patient is transferred. If a child needs treatment at the clinic, you will
often give the first dose in the
clinic. Give immunizations if needed. You will advise caregivers on home treatment.
COUNSEL
A critical component of IMCI is counselling caregivers on home treatment (e.g.
treating local infections,
giving oral drugs), feeding and fluids, breastfeeding, and other well child care.
Then counsel the caregiver
about her own health. Advise the caregiver to return for follow-up on a specific
date. Teach caregivers
when to return immediately if child shows signs of severe illness.
PROVIDE FOLLOW-UP CARE
When a child returns to the clinic as requested, give follow-up care as required.
Re-examine conditions to
see if the issues are improving, the same, or worsening. Use the full IMCI process
again to check the child for
new problems.
6. Name the main symptoms which children (age 2-5) are assessed for
Cough or difficult breathing
• Fever
• Malnutrition and anaemia
• Check immunizations
• Diarrhoea
• Ear problems
• HIV status
• Others
7. Name the main symptoms which infants age up to 2 months are assessed for.
• Jaundice
• Diarrhoea
• HIV status or mother’s HIV status
• Feeding problem and growth
• Check immunizations
• Assess other problems and mother’s health
8. What are the benefits of IMCI?
IMCI guides you through comprehensive care. This ensures that you will examine.
With the IMCI instructions, you might find health issues that you would not have
otherwise.
IMCI also helps you to give rapid and affordable interventions.
9. Enumerate the essential IMCI recommended Drugs

1. Artemether/Lumefantrine
2. Amodiaquine Tabs (200mg)
3. Quinine (inj.) (vials) (600mg/2ml)
4. Amoxycillin Tabs (250mg)/syrup 250 mg or 125/5 ml
5. Chloramphenical (inj) 1g vials
6. Chloramphenical syrup (600ml bottles) 125mg/5mls
7. Gentamicin (vials (80mg/2ml)
8. Crystalline penicillin 100,000 units vials
9. ORS 500ml sachet
10. Hartmanns solution 500ml bottles
11. Nalidixic acid (250mg tabs)
12. Metronidazole (200mg tabs)
13. Erythromycin (250mg tabs)
14. Mebendazole 500 mg tabs
15. Iron 200mg
16. Cotrimoxazole (80mg:400mg)
17. Folic Acid tabs (5mg)
18. Paracetamol tabs (500mg)
19. Gentian Violet
20. Mycostatin (20ml)
21. Diazepam – vials
22. 10% glucose ½ litre bottle
23. Salbutamol (tabs) 2mg
24. Salbutamol inhaler
25. Salbutamol nebulization solution (50ml bottle)
26. Vitamin A (capsules) soft gelatmous 100,000 and 200,000 units
27. Essential Non pharmaceuticals
10. Read the case study below and answer the questions
10.1 What do you think of the services provided to this child at?

Health Centre
health center is one of a network of clinics staffed by a group of general
practitioners and nurses providing healthcare services to people in a certain area.
At that time Reno is already experiencing diarrhea and vomitting and he was not
seen in the health center so there are no services provided to him. The health
center didn't prioritize the sick child and the health center should provide an
assessment and medication in order not to worsen the condition or refer the child
to a hospital or to a pediatrician.

Provincial Hospital
By the time Reno was rushed in the provincial hospital emergency room he was
already lethargic and they are not the priority if they will not pay the
registration form before checking Reno's condition. The services provided to Reno
is very poor even if its a provincial hospital they should always give priority to
those who are very sick and they must be seen first immediately as soon as
possible.

0.2 Does the facility have a system of sorting out very sick children and having
them seen urgently?

If yes, describe the system in place.

If no, do you think you can help to implement one?