IMCI (Integrated Management of Childhood Illness)

- Is an integrated approach to child health that focuses on the well being of the whole child.
- Aims to reduce death, illness and disability and to promote growth and development among
children under 5 years of age
- Includes curative and preventive elements that are implemented by families and communities
and by health facilities

OBJECTIVES OF IMCI

 Reduce death, frequency and severity of illness and disability

 Contribute to improved growth and development

PRINCIPLE OF THE IMCI CASE MANAGEMENT GUIDLEINES

 All sick children aged up to 5 years are examined for general danger signs and all sick young
infants are examined for very severe disease. These signs indicate immediate referral or
admission to hospital
 The children and infants are then assessed for main symptoms. All sick children are routinely
assessed for nutritional and immunization and deworming status and other problems
o For older children, the main symptoms include: cough or DOB, diarrhea, fever and ear
infection
o For young children, local bacterial infection, diarrhea and jaundice.
 Only a limited number of clinical signs are used
 A combination of individual signs leads to a child’s classification within one or more symptom
groups rather than a diagnosis
 IMCI management procedures are limited number of essential drugs and encourage active
participation of caretakers in the treatment of children
 Counseling of caretakers on home care, correct feeding and giving fluids, and when to return to
clinic is an essential component of IMCI

FOCUS OF IMCI:

1. Improving case management skills of health workers

 Keep communication open and honest (active listening skills, paraphrasing
comments for clarity, avoiding negative messages
 Expand critical thinking skills (nurses are expected to make decisions and solve
problems – they must be good in analysis, evaluation, problem-solving and
deductive reasoning)
 Serve as a mentor and seek a mentor (being a mentor helps nurses impart their
personal experiences to new staffs, while having a mentor help give guidance)
2. Improving over-all health systems
 See your patients
 Make it easy to schedule an appointment
  Manage patients’ demands
3. Improving family and community health practices

BENEFITS OF THE IMCI STRATEGY:

1. Address major child health problems because it systematically address the most important
causes of children illness and death
2. Respond to demands
3. Promotes prevention as well as cure because IMCI emphasizes important preventive
interventions such as immunization and breastfeeding
4. Is cost-effective - most cost-effective interventions in low and middle income countries
(World Bank)
5. Improve cost-saving
6. Improve equity – IMCI improves inequity in global health care

STEPS IN THE IMCI CASE MANAGEMENT PROCESS:

1. Assess the child’s illness

2. Classify the illness based on signs
3. Treat the child
4. Counsel the caretaker
5. Follow-up

5 LEADING CAUSE OF DEATH IN CHILDREN (PREVENTABLE AND TREATABLE)

1. Pneumonia
2. Diarrhea
3. Malaria
4. Measles
5. Malnutrition

IMMUNIZATION – is the process whereby a person is made immune or resistant to an infectious

disease, typically by the administration of a vaccine

- Vaccine stimulates the body’s own immune system to protect the person against subsequent
infection or disease

EXPANDED PROGRAM ON IMMUNIZATION

- Established in 1976 to ensure infants/children and mothers have access to routinely

recommended infant/childhood vaccines
- 6 VACCINE PREVENTABLE DISEASES INCLUDED IN EPI:
o Tuberculosis
o Poliomyelitis
o Diphteria
 o Tetanus
o Pertussis
o Measles

GOAL OF EPI:

- To reduce the morbidity and mortality among children against the most common vaccine-
preventable diseases ***
- To immunize all infants/children against the most common vaccine-preventable diseases
- To sustain the polio-free status of the Philippines
- To eliminate measles infection
- To eliminate maternal and neonatal tetanus
- To control diphtheria, pertussis, hepatitis B and german measles
- To prevent extra pulmonary tuberculosis among children

BIRTH - BCG at Hepatitis B (4 dozes, every 4 months)

6 weeks old, recommended po ang DPT, Hepa B, Hib, Polio. (6in1 po sa private, 5 in 1 at oral polio sa
center), PCV, at rotavirus.

Bago po ang 24 weeks (6months) or 32 weeks (8months) kailangan matapos ang 2 or 3 doses ng
rotavirus (depende sa brand).

By 6 months dapat mayroon na 3 doses ng DPT, Hepa B, Hib, Polio at PCV.

6 months flu vaccine.

9months binibigay ang Measles or MMR. Pwede mas maaga kung may outbreak.

1 year old pwede na po bigyan ng Hepatitis A, Japanese B encephalitis, Varicella, at MMR.

2 years old

Typhoid, Meningococcal (may brand na pwede mas maaga)

4 years old

Booster ng TDaP at Polio

Ang FLU po ay yearly ibinibigay.

Ag HPV (cervical cancer) ay binibigay as early as 9 years old.

Ang mga bakuna po na available sa Health Center ay yung mga kasama lang sa EPI (Expanded Program of
Immunization). BCG, Hepa B, DPT, Hib, Polio, PCV, Rotavirus at Measles/MMR. Bukod po sa mga
bakunang yan, private clinics/pediatrician na po ang nagbibigay.