INTEGRATED MANAGEMENT OF
CHILDHOOD ILLNESSES
WHAT IS IMCI?
IMCI is an integrated approach to child health that focuses on the
well-being of the whole child. IMCI aims to reduce death, illness and
disability and to promote improved growth and development among
children under five years of age. IMCI include curative and preventive
elements that are implemented by families and communities and by
health facilities.
The strategy was developed by World Health Organization and
UNICEF and is used by most countries in the world.
PRINCIPLES OF THE IMCI CASE
MANAGEMENT GUIDELINES
• 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. For older
children, the main symptoms include: cough or difficulty breathing, diarrhea, fever
and ear infection. For young children, local bacterial infection, diarrhea and
jaundice. All sick children are routinely assessed for nutritional and
immunization and deworming status and other problems
• 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 use 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 of fluids, and when
to return to clinic is an essential component of IMCI
OBJECTIVES OF IMCI
• Reduce death and frequency and severity of illness and disability
• Contribute to improved growth and development
WHAT ARE THE BENEFITS OF THE
IMCI STRATEGY?
1. Addresses major child health problems because it systematically
address the most important causes of children illness and death.
2. Responds 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. Promotes cost-saving.
6. Improves equity – IMCI improves inequity in global health care.
WHAT ARE THE FOCUS OF IMCI?
• Improving case management skills of health workers
• Improving over-all health systems
• Improving family and community health practices
WHAT ARE THE STEPS IN THE IMCI
CASE MANAGEMENT PROCESS?
1. ASSESS THE CHILDS ILLNESS
2. CLASSIFY THE ILLNESS BASED ON SIGNS
3. IDENTIFY TREATMENT
4. TREAT THE CHILD
5. COUNSEL THE CARETAKER
6. FOLLOW-UP
WHY AN INTEGRATED APPROACH?
Ten million children die each year and majority of these deaths are
caused by 5 preventable and treatable conditions
namely: pneumonia, diarrhea, malaria,
measles and malnutrition. Three (3) out of four (4) episodes of
childhood illness are caused by these five conditions
Most children have more than one illness at one time. This overlap
means that a single diagnosis may not be possible or appropriate.
IMCI COVERAGE
1. Birth to two months (0-2 months) – Sick Young
Infant
2. 2 months – 5 years old - Sick Child
Rationale for IMCI
Majority of deaths are caused by 5 preventable and treatable conditions namely:
1. Pneumonia
2. Diarrhea
3. Malaria
4. Measles
5. Malnutrition
3 out of 4 (3/4) episodes of childhood illnesses are caused by these 5 conditions
THE IMCI CASE MANAGEMENT
PROCESS
Assess the child/young infant’s illness
> Ask the mother/primary caretaker of the child’s problem
Check for general danger signs
Ask the mother/ caretaker about the four main symptoms
1. Cough/ Difficulty of breathing
2. Diarrhea
3. Fever
4. Ear Problem
Plus check for Malnutrition, Anemia and HIV Infection
Classify the illness
Using the “color-coded triage system”
Identify specific treatment and need for referral
Treat the child
Counsel the mother
Simple Home Management (Green Row)
Give follow-up care