PART I:

INTRODUCTION
TO IMCI
 IMCI
 A joint WHO/UNICEF initiative since
1992
 Integrated guidelines
 Strategy for reducing mortality and
morbidity associated with major
causes of childhood illness
Adapted to address most common life-
threatening conditions in each
country
 Focused on first level health facilities
 OBJECTIVES OF IMCI
 To reduce significantly global
morbidity and mortality associated
with the major causes of illnesses in
children

 To contribute to healthy growth and

development of children
 COMPONENTS OF IMCI

1. Improving case management

skills of health workers
2. Improving the health system to
deliver IMCI
3. Improving family and
community health practices
 THE CASE MANAGEMENT
PROCESS
= used to assess and classify two
age groups:

1.age up to 2 months
2.age 2 months up to 5 years
 THE CASE MANAGEMENT
PROCESS
Presented on a series of charts,
describing the following steps:
1. Assess the child or young infant
2. Classify the illness
3. Identify the treatment
4. Treat the child
5. Counsel the mother
6. Give follow up care
PART II :
THE INTEGRATED
CASE
MANAGEMENT
PROCESS
 ASSESS The Child:

 Check for DANGER SIGNS

(or possible infection).
 Ask about MAIN SYMPTOMS.
 Assess further. Check nutrition
and immunization status.
 Check for other problems
4 GENERAL DANGER SIGNS

 Convulsion
 Abnormally
sleepy/unconsciousness
 Not able to drink or breastfeed
 Severe vomiting/vomits everything

CANS
 4 MAIN SYMPTOMS

 Cough or difficult breathing

 Diarrhea
 Ear pain
 Fever
ABCDEF
 CLASSIFY The Child’s Illness

• Use the color-coded triage system to

classify the child’s main symptoms and
his or her nutrition or feeding status.
SEVERE

MODERATE

MILD
I. IDENTIFY URGENT PRE-
REFERRAL TREATMENT(S)
needed prior to referral of the child
according to classification

II. TREAT The Child:

Give urgent pre-referral
treatment(s) needed.
III. REFER The Child:
• Explain to child’s caretaker the need
for referral.
• Calm caretaker’s fears and help
resolve any problems.
• Write a referral note.
• Give instructions and supplies
needed to care for the child on the
way to the hospital
I. IDENTIFY TREATMENT
needed for the child’s classifications:
identify specific medical treatments
and/or advice
II. TREAT The Child:
• Give first dose of oral drugs in the clinic.
• Teach the caretaker:
- how to give oral drugs at home
- possible side effects and adverse
reactions
- proper storage of drugs
- how to treat local infections at home
• If needed, give immunizations.
III. COUNSEL The Mother:
• Assess:
- the child’s feeding
- breastfeeding practices
• Solve feeding problems, if present.
• Advise the caregiver regarding:
- feeding and fluids during illness
- when to return to a health facility.
• Counsel the mother about her own health
IV. FOLLOW-UP CARE:
• Give follow-up care when the
child returns to the clinic

• Re-asses the child for new

problems.
PART III:
THE SICK CHILD
AGE 2 MONTHS TO 5
YEARS
GENERAL DANGER SIGNS
DEFINITIONS:

Wheeze
high-pitched, musical, variable sounds with breathing
most prominently during expiration.
generated by gas flowing through narrowed or irregular airways.
most commonly associated with asthma.

Stridor
shorter, crowing sound
evident during inspiration and expiration
louder and longer during inspiration.
mechanical or functional narrowing of the larynx or subglottic
airways.
viral/bacterial infections and aspirated foreign bodies
Acute Diarrhea
 Less than 14 days

Persistent Diarrhea
 4 days or more
Dysentery
 Most commonly caused by shigella
 Presents as bloody stool
CRITERIA FOR
DEHYDRATION

Sensorium
Sunken eyes
Thirst
Skin turgor
PART IV:
THE SICK YOUNG
INFANT UP TO 2
MONTHS
PART V:
COUNSELING
PART VI:
FOLLOW–UP
CARE
PART VII:
SYNTHESIS