IMNCI

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Integrated Management of Neonatal & Childhood Illnesses (IMNCI) : 

Integrated Management of Neonatal & Childhood Illnesses (IMNCI) State Institute of Health and Family Welfare, Jaipur

IMNCI? : 

IMNCI? WHO/UNICEF have developed a new approach to tackling the major diseases of early childhood called the Integrated Management of Childhood Illnesses (IMCI) 2 SIHFW: an ISO:9001 certified institution

Developments related to child health : 

Developments related to child health 1978: EPI 1984: UIP 1985: Oral Rehydration Therapy1 1990: UIP and ORT universalized, ARI as a pilot in26 districts 1992: CSSM 1997: RCH-1 2005: NRHM and RCH II 3 SIHFW: an ISO:9001 certified institution

Why IMNCI : 

Why IMNCI Reduce infant and child mortality rates Improving child health & survival IMR reduced from 114 (1980) to 53 (2008 SRS bulletin) Decline not uniform across states 8 states including Rajasthan are below national average Malnutrition and low birth weight (LBW) are contributors to the about 50% deaths 4 SIHFW: an ISO:9001 certified institution

IMNCI: Status : 

IMNCI: Status 5 SIHFW: an ISO:9001 certified institution

IMNCI Beneficiaries : 

IMNCI Beneficiaries Care of Newborns and Young Infants (infants under 2 months) Care of Infants (2 months to 5 years) 6 SIHFW: an ISO:9001 certified institution

Care of Newborns and Young Infants (infants under 2 months) : 

Care of Newborns and Young Infants (infants under 2 months) Keeping the child warm Initiation of breastfeeding Counseling for exclusive breastfeeding Cord, skin and eye care Recognition of illness in newborn and management and/or referral Immunization Home visits in the postnatal period 7 SIHFW: an ISO:9001 certified institution

Care of Infants (2 months to 5 years) : 

Care of Infants (2 months to 5 years) Management of diarrhoea, ARI malaria, measles, acute ear infection, malnutrition and anemia Recognition of illness and risk Prevention and management of Iron and Vitamin A deficiency Counseling on feeding for all children below 2 years Counseling on feeding for malnourished Immunization 8 SIHFW: an ISO:9001 certified institution

IMNCI Components and Intervention areas : 

IMNCI Components and Intervention areas 9 SIHFW: an ISO:9001 certified institution

IMNCI Components and Intervention areas : 

IMNCI Components and Intervention areas 10 SIHFW: an ISO:9001 certified institution

IMNCI Components and Intervention areas : 

IMNCI Components and Intervention areas 11 SIHFW: an ISO:9001 certified institution

Components of IMNCI : 

Components of IMNCI Training Effective implementation Improvements to the health system Improvement of Family and Community Practices Collaboration/coordination with other Departments 12 SIHFW: an ISO:9001 certified institution

Components of IMNCI : 

Components of IMNCI Training IMNCI is a skill based training in both facility and community settings Broadly, two categories of training are included for medical officers for front-line functionaries including ANM’s and AWW’s 13 SIHFW: an ISO:9001 certified institution

Components of IMNCI : 

Components of IMNCI Effective implementation Improvements to the health system Ensuring availability of the essential drugs Improve referral Referral mechanism Functioning referral centers Ensuring availability of health workers / providers at all levels Ensuring supervision and monitoring through follow up visits 14 SIHFW: an ISO:9001 certified institution

Components of IMNCI : 

Components of IMNCI Effective implementation Improvement of Family and Community Practices Counseling of families and creating awareness which includes: Promoting healthy behaviors IEC campaigns Counseling of care givers and families During home visits identify sickness and focused BCC 15 SIHFW: an ISO:9001 certified institution

Components of IMNCI : 

Components of IMNCI Collaboration/coordination with other Departments Involvement of ANM and AWWs Involvement of grass-root functionaries of other sectors Active involvement of PRI, SHGs and women’s groups 16 SIHFW: an ISO:9001 certified institution

F-IMNCI : 

F-IMNCI From November 2009 IMNCI has been re -baptized as F-IMNCI, (F -Facility) with added component of: Asphyxia Management and Care of Sick new born at facility level, besides all other components included under IMNCI 17 SIHFW: an ISO:9001 certified institution

Institutional Arrangements : 

Institutional Arrangements State Level District Level 18 SIHFW: an ISO:9001 certified institution

State level Institutional Arrangements : 

State level Institutional Arrangements Appoint Nodal Officer Set up a co-ordination Group Arrange logistics Create pool of State level trainers Selection of priority districts Review progress Identify the State Nodal institute for training Improvement in family and community practices 19 SIHFW: an ISO:9001 certified institution

District level Institutional Arrangements : 

District level Institutional Arrangements Appoint District Coordinator Set up an IMNCI Coordination Group Train District Trainers. Develop a detailed plan for implementation Ensure timely supplies & logistics, supervision and follow-up IEC activities 20 SIHFW: an ISO:9001 certified institution

Training in IMNCI : 

Training in IMNCI Focus on Skill Development Hands-on training Visits to hospitals Field visits and visits to the homes of sick children 21 SIHFW: an ISO:9001 certified institution

Training in IMNCI : 

Training in IMNCI Training at two levels In-service training for the existing staff Pre-Service Training 22 SIHFW: an ISO:9001 certified institution

Slide 23: 

23 SIHFW: an ISO:9001 certified institution

Slide 24: 

24 SIHFW: an ISO:9001 certified institution

Training of Trainers : 

Training of Trainers All pediatricians in the district Selected medical officers from CHCs and block PHCs Selected staff nurses and LHVs and CDPO’s and Mukhiya Sevikas from ICDS 25 SIHFW: an ISO:9001 certified institution

Number to be trained : 

Number to be trained Average size District -1800 health staff will need to be trained Number of the staff of other departments should be included in consultation with concerned district officers Staff belonging to PHC areas may be taken up fully before moving to another PHC area 26 SIHFW: an ISO:9001 certified institution

Training Institutions : 

Training Institutions State Level District Level 27 SIHFW: an ISO:9001 certified institution

State Level Training Institutions : 

State Level Training Institutions Identify a Regional Training Centre The Departments of Pediatrics and Preventive & Social Medicine in each college 28 SIHFW: an ISO:9001 certified institution

District Level Training Institutions : 

District Level Training Institutions District hospital for training of medical officers CHCs/operational FRUs etc for training of health workers 29 SIHFW: an ISO:9001 certified institution

Follow-up Training (FUT) : 

Follow-up Training (FUT) The Follow-up Training is designed to improve supportive supervision for 2 days which may either be clubbed with Clinical skills training or conducted within 6-8 weeks of the initial Clinical skills training. 30 SIHFW: an ISO:9001 certified institution

Pre-Service Training : 

Pre-Service Training Training of undergraduate students and interns ANM, AWW, and Staff Nurses’ training schools need to include IMNCI in their training schedules 31 SIHFW: an ISO:9001 certified institution

Funding arrangements : 

Funding arrangements National Level training: by the GoI State Level training: State project funding - NRHM/RCH-II-PIPs District Level training: State project funding -NRHM/RCH-II-PIPs a. At District Training Cell (in the District Hospital) b. At other Training Centres within the District (Maximum two in identified CHCs/PHCs) 32 SIHFW: an ISO:9001 certified institution

Funding arrangements : 

Funding arrangements Translation, printing and supply of training material Field-level Monitoring Support, Follow up and Coordination 33 SIHFW: an ISO:9001 certified institution

Navjat Shishu Suraksha Karykram(NSSK) : 

Navjat Shishu Suraksha Karykram(NSSK) Launched on September 15, 2009 Focuses on: Prevention of Hypothermia Prevention of Infection Early initiation of Breast feeding Basic Newborn Resuscitation 34 SIHFW: an ISO:9001 certified institution

Navjat Shishu Suraksha Karykram(NSSK) : 

Navjat Shishu Suraksha Karykram(NSSK) Objectives: One trained person at institutional facility, where deliveries take place NSSK will train healthcare providers at the district hospitals, CHCs & PHCs 35 SIHFW: an ISO:9001 certified institution

Limitations of IMNCI : 

Limitations of IMNCI Outpatient Facility Based Community activities not given adequate focus Training centre of attention Vertical initiatives in Non IMNCI districts sorely lacking 36 SIHFW: an ISO:9001 certified institution

Slide 37: 

Thank You For more details log on to www. sihfwrajasthan.comor contact : Director-SIHFW on sihfwraj@yahoo.co.in

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