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Imci pwede ky doc zen

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Imci pwede ky doc zen

  1. 1. Integrated Management of Childhood Illness •Child Health: Global Profile •IMCI Rationale, objectives, components •Principles of integrated care •IMCI Case Management Process
  2. 2. •Children in low-middle income countries 10x more likely to die before reaching 5th birthday •More than 50 countries had childhood mortality rates over 100 per 1,000 live births
  3. 3. •7 in 10 ten deaths are due to ARI , diarrhea, measles, malaria or malnutrition •Major contributors to child deaths through the year 2020
  4. 4. Study of 163 countries, SAVE THE CHILDREN, 2001 53 million women give birth each year without professional help Global child death rates have been reduced by 14% over the past decade Eight babies in the first month of their lives die every minute world-wide
  5. 5. Causes of Death in Children Under- nutrition 53%
  6. 6. • Many sick children poorly assessed • Improperly treated • Parents poorly advised Health Care : First –Level Facility
  7. 7.  *scarce supply of drugs and equipment •minimal/ non-existent diagnostic support
  8. 8. • Few opportunities for MD to practice complicated procedures •Reliance on history of signs and symptoms
  9. 9. WHO/UNICEF/DOH Regional Child Survival Strategy and Assessment of Philippine Situation
  10. 10. •Infant and young child feeding Lack of access to safe water & sanitation Underlying Factors
  11. 11. High fertility, poor birth spacing
  12. 12. Community and environment
  13. 13. •Lack of access to basic social services •Inadequate care for women
  14. 14. Reasons for an IMCI Strategy •Most children have more than one condition at one time • Illnesses are interrelated • Illnesses should not be only tested, but also prevented
  15. 15. • Poor quality of care at all levels • Vertical delivery mechanisms characterized by low efficiency
  16. 16. Objectives •Reduce illness, disability and death from common childhood illnesses
  17. 17. To promote improved growth and development among under-5 children
  18. 18. An evidence- based syndromic approach can be used to determine the: Health problem/s Severity of the condition Actions
  19. 19.  Improving the health system to deliver IMCI IMCI Components Improving case management skills of health workers
  20. 20. Improving family and community practices
  21. 21. Principles of Integrated Care IMCI guidelines address most, but not all, of the major reasons a sick child is brought to a clinic.
  22. 22. A combination of individual signs leads to a child’s classification/s rather than a diagnosis
  23. 23. Counseling of caretakers an essential component
  24. 24. IMCI management use a limited number of essential drugs
  25. 25. All sick children must be examined for “general danger signs” -- immediate referral or hospital admission
  26. 26. All sick children must be routinely assessed for: 2 mos.-5 yrs. Old: (cough/difficult breathing, diarrhea, fever, ear problem) 1 week-2 mos: (bacterial infection and diarrhea)
  27. 27. Nutritional, immunization status, feeding problems , care for development and other problems
  28. 28. Only a limited number of carefully- selected clinical signs are used (sensitivity and specificity to detect disease)
  29. 29. A combination of individual signs leads to a child’s classification/s rather than a diagnosis; classifications are color-coded
  30. 30. IMCI Case Management Process Classify Assess Identify Treatment Treat/Refer Counsel Follow-Up Classify Identify Treatment Treat/Refer Counsel Assess Follow-Up Assess Identify Treatment
  31. 31. Check for General Danger Signs Convulsions Lethargy/unconsciousness Inability to drink/breastfeed Vomiting Assess Main Symptoms Cough/difficulty breathing Diarrhea Fever Ear Problems Assess Nutrition , Immunization status , Care for Development and Other Problems
  32. 32. Classify conditions/identify treatment actions Pre-referral Treatment Advise Parents Refer Child Urgent Referral OUT-PATIENT HEALTH FACILITY REFERRAL FACILITY Emergency Triage & Treatment (ETAT) Diagnosis Treatment Monitoring & Follow-up
  33. 33. OUT-PATIENT HEALTH FACILITY Treatment at OP Health Facility •Treat Local Infections • Give oral drugs • Advise/teach caretaker • Follow-Up OUT-PATIENT HEALTH FACILITY Treatment at OP Health Facility
  34. 34. HOME Caretaker is counseled on: Home treatment Feeding & fluids When to return immediately Follow-up Home Management
  35. 35. Vertical” health programmes and an individual health worker Separate disease specific clinical guidelines & trg. materials National programmes conduct disease specific trg. courses “Integration” of clinical guidelines by the health worker
  36. 36. IMCI and an Individual Health Worker Integrated clinical guidelines & trg. materials National programmes collaborate in integrated training courses Integrated clinical case management
  37. 37. For many sick children a single diagnosis may not be apparent or appropriate  Presenting complaint  Cough and/or fast breathing  Lethargy/ unconsciousness  Measles rash  “Very sick” young infant  Possible cause/ associated condition  Pneumonia, Severe anemia, P. falcifarum malaria  Cerebral malaria , Meningitis, Severe dehydration,Very severe Pneumonia  Pneumonia, Diarrhea, Ear Infection  Pneumonia , Meningitis, Sepsis
  38. 38. Interventions included in IMCI guideline for first-level health workers Conditions covered by case mgt. Interventions Preventive interventions Generic Version ARI, Diarrhea, Dehydration, Persistent Diarrhea, Dysentery, Meningitis, Sepsis, Malaria, Measles, Anemia, Malnutrition, Ear Infection Immunizations during sick child visits, Nutrition counseling, Breastfeeding support, Vit. A supplementation Using the IMCI Adaptation Guide HIV/AIDS, Dengue Hemorrhagic Fever, Wheeze, Sore Throat Periodic Deworming
  39. 39. Mgt.of sick children Nutrition Immunization Other Disease prevention Growth & Devt. IMCI as a key strategy For improving child health
  40. 40. IMCI Vision All Filipino children have access and equity to quality health care services supported with empowered families and communities capable of sustained actions that will ensure a child friendly environment conducive to development of the full potential of the child by 2025.
  41. 41. “ Lo, children are an heritage of the LORD..” Psalm 127: 3a “..And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.” Matthew 25:40
  42. 42. Resources • WHO. Department of Child and Adolescent Health and Development. Model Chapter for Textbooks –IMCI , 2001 • September, 2001 •DOH Report presented during IMCI National Program Implementation Review, December 2006 • •topics/prevention_care/child/imci/en/index.html • • • • •

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