INTEGRATED MANAGEMENTOF

NEONATAL ANDCHILDHOOD
ILLNESSES(IMNCI) 
 Introduction
• Integration is supposed to tackle the need for
complementarities of different independent
services & administrative structures to achieve
common goals.
• In 1950- the goals were defined in terms of out
comes .In 1960- the process
• In 1990- the economic impact
• At the patient level it means case management.
At the point of delivery it means that multiple
interventions are provided through one delivery
channel. The Indian version of IMCI is known as
IMNCI
Introduction
• Child health programmes need to move beyond
single diseases to addressing the overall
health& wellbeing of the child.

• WHO in collaboration with UNICEF and many

other agencies, institutions, responded to this
challenge by developing a strategy known as
Integrated Management of Childhood
Illnesses(IMCI)

• This strategy has been expanded in India to

include all neonates and renamed as
“Integrated Management of Neonatal
&Childhood Illness (IMNCI)”
 INTRODUCTION
• Most of sick children present with signs
&symptoms related to more than one
condition.
• This overlap means a single diagnosis is not
possible or appropriate, & that treatment
maybe complicated by the need to combine
therapy for several conditions.
• In response to these challenge, WHO &
UNICEF developed a strategy known as IMCI.
This strategy combines improved
management of childhood illness with
aspects of
• Nutrition
• Immunization
• Improvements
COMPONENTS OF IMNCI
In The Case
Management Skills Of Health Staff
Through The Provision Of Guidelines
On IMCI &Through Activities
• To Promote Their Use. Improvements
In The Health System Required For
Effective Managements Of Childhood
Illness.
• Improvements In Family &
Community Practices.
ELEMENTS OF IMNCI
 DEFINITION
 The Integrated Management of Newborn
and Childhood Illnesses (IMNCI) case
management approach offers simple and
effective methods to comprehensively prevent
and manage the leading causes of serious
illnesses and mortality in children below five
years.
 With IMNCI, sick children or young infants
are not only treated for the signs and symptoms
they present within a health facility, but are
also Assessed for the other disease conditions.
IMNCI IS BASED ON THE FOLLOWING PRINCIPLES:

 All sick children aged up to 5 years are

examined for general danger signs
 All young infants are Examined for signs of
very severe disease. These signs indicate the
need for immediate referral or admission to
hospital.
 Children and infants are then assessed for
main symptoms. For the older children, the
symptoms include Cough, difficulty breathing,
diarrhea, fever, TB, HIV, ear infections,
anemia, measles and malnutrition.
IMNCI IS BASED ON THE FOLLOWING PRINCIPLES

A combination of individual signs then lead

to the child’s or young infant’s
classification within one or more symptom
groups.

Essential drugs are then used to treat the

children or young infants. Lastly
counseling of caregivers regarding
Home care, appropriate feeding and fluids
and when to return to facility - immediately
or follow-up, is done.
 Classification

• The classify (signs and classify)

column of the chart lists clinical signs
of illnesses and their classification.
• “Classify” in the chart means the
health worker has to make a decision
on the severity of the illness.
• Healthcare workers will be able to
classify children or young infants
illnesses using the colour-coded
triage system.
• Identify Treatment
• The identify treatment column helps the healthcare workers
to quickly and accurately identify treatments for the
• classifications selected. If a child or young infant has more
than one classification, the healthcare worker must look
• at more than one table to find the appropriate treatments.
• Treat
• The treat column shows how to administer the treatment
identified