CHN - RLE - IMNCI

7/10

______ deaths are due to five preventable & treatable conditions, which are pneumonia, diarrhea, malaria, measles, and malnutrition or a combination of these.

19,000 children

Almost __________ under 5 yrs old die everyday across the world.

India, Nigeria, Congo, Pakistan, and China

50% of Children's death happens at?

India

Which country has the highest child mortality rate?

IMCI or Integrated Management of Childhood Ilnesses

were adapted & the Indian version is Integrated Management of Neonatal and Childhood Illnesses (IMNCI).

IMCI/IMNCI

Its main intervention under RCH-II or NRHM focuses on preventive, promotive, and curative aspects of the program

IMNCI

It is an integrated approach to child health that focuses on the wellbeing of the child. It aims to reduce death, illness, and disability & to promote improved growth and development among children under 5 yrs old

1. Improving Case Management of Skills of Healthcare Staff

2. Improving overall health systems

3. Improving family and community health practices

3 Main components of IMNCI

Evidence-Based, Syndromic approach

______________ to case management includes rational, effective, and affordable use of drugs & diagnostic tools.

Bacterial Infection or Jaundice

Sick & young infants must be assessed for possible?

Diarrhea

a routine assessment for the major symptom, _______, must be done

General Danger Signs

indicate need for immediate referral or admission to a hospital for children

Cough, DOB, Diarrhea, Fever, and Ear Problems

Sick children aged 2 months to 5 years must be routinely assessed for major symptoms such as:

Pink/Red

Needs urgent hospital referral or admission

Yellow

Needs specific medical Rx or advice

Green

Can be managed at home

Counseling of Caretakers

One of the essential component of IMNCI is the ___________ about home care, feeding, fluids, and when to return to health facility

1. Promote Exclusive Breastfeeding

2. Prevent Hypothermia

3. Improve Illness Recognition and Timely Care Seeking

Home care for newborns, based in the IMNCI, are the?

Assess

___________ child by checking for danger signs by history and examination

Classify

_________ child's illness according to color coded triage system

Color-Coded Triage System

Classification of illness severity using colors.

Identify

________ specific treatments as a part of CMP

Counsel

________ the mother about breastfeeding, her own health, and to follow instructions on the further child care

Follow Up Care

reassess the child for new problems

Assess, Classify, Identify, Counsel, and Follow Up Care

5 parts of the Case Management Process

Chest Indrawing, Nasal Flaring, Grunting, Bulging Fontanelle, Ear Pus, SKin Pustules, and Jaundice

When Assessing Young Infant aged up to 2 months, look and listen for?

Ampicillin and Gentamicin

If the infant has a possible serious bacterial infection, give first dose of ?

IM

The route of administration for Ampicillin and Gentamicin

Local Bacterial Infection (Yellow)

Umbilicus red or draining pus, there's pus discharge and <10 skin pustules

Oral Cotrimoxazole or Amoxycillin

What medication should we give for a Local bacterial Infection

Severe Jaundice (Pink)

Palms and soles are yellow when their age is <24 hrs or >14 days

Jaundice (Yellow)

When the palms and soles of a Young Infant aged up to 2 months, they have?

Severe Dehydration (Red/Pink)

When the Young Infant aged up to 2 months has 2 of the ff:

1. Lethargic

2. Unconscious

3. Sunken Eyes

4. Poor Skin Turgor

they have?

Some Dehydration (Yellow)

When the Young Infant aged up to 2 months has 2 of the ff:

1. Restless

2. Irritable

3. Sunken Eyes

4. Poor Skin Turgor

they have?

Severe Persistent Diarrhea (Red or Pink)

When the Young Infant aged up to 2 months has diarrhea lasting 14 days or more, they have?

Severe Dysentery

When the Young Infant aged up to 2 months has blood in stools, they have?

MUAC or Mid Upper Arm Circumference1

Used to determine the weight and age of the Young Infant aged up to 2 month

4 minutes

If the infant has not fed in the previous hour, ask the mother to put her infant to her breast. Observe her breastfeed for?

● No attachment at all ● Not well attached ● Good attachment

Assess the breastfeeding of the Young Infant aged up to 2 months and classify it using?

Slow and deep with pauses

Sucking of the Young Infant aged up to 2 months on their mother's breast should be?

Blocked Nose

Clear _______ since it interferes with breastfeeding

Thrush

Look for ulcers or white patches ______ for Young Infant aged up to 2 month

BCG, OPV (0), Hep B1

Immunization schedule at Birth

DPT1, OPV1, Hep B2

Immunization schedule at 6 weeks

2 days

If the infants has the ff:

- Local bacterial infection ● Jaundice ● Diarrhea ● Any feeding problem ● Thrush

return for follow up in?

14 days

If the infants has the ff:

1. Low weight for age

return for follow up in?

Immediately

If the infants has the ff:

● Poor breastfeeding or drinking ● Sicker ● Has fever or feels cold to touch ● Tachycardic ● Has DOB ● Has yellow palms & soles ● Has diarrhea with bloody stool

return for follow up?

Vomiting, Lethargy, Unconsciousness, Convulsion, Inability to drink or breastfeed

The general danger signs

Severe Pneumonia or Very Severe Disease (Pink or Red)

When the Sick Child aged 2 mons to 5 yrs has:

Any general danger

Chest indrawing

Stridor in calm child

they have?

Pneumonia (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

Fast Breathing

they have?

Severe dehydration (Pink or Red)

When the Sick Child aged 2 mons to 5 yrs has:

1. Lethargic or Unconscious

2. Sunken Eyes

3. Not able to drink or drinking poorly

4. Poor Skin turgor

they have?

Some Dehydration

When the Sick Child aged 2 mons to 5 yrs has:

1. Restless, Irritable

2. Sunken Eyes

3. Drinks eagerly, thirsty

4. Poor Skin turgor

they have?

Severe Persistent Diarrhea (Red/Pink)

When the Sick Child aged 2 mons to 5 yrs has:

1. Dehydration Present

they have?

Very Severe Febrile Disease (Pink or Red)

When the Sick Child aged 2 mons to 5 yrs has:

1. Any general danger sign

2. Stiff Neck

3. Bulging Fontanelle

they have?

Malaria (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

1. Fever by history or feels hot. Temp above 37.5

they have?

Severe Complicated Measles (Pink or Red)

When the Sick Child aged 2 mons to 5 yrs has:

1. Any General Danger Signs

2. Clouding of Cornea

3. Deep or Extensive Mouth Ulcers

they have?

Measles with Eye or Mouth Complications (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

1. Pus draining from the eye

2. Mouth Ulcers

they have?

Mastoiditis (Pink or Red)

When the Sick Child aged 2 mons to 5 yrs has:

1. Tender Swelling behind the ear

they have?

Acute Ear Infection (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

1.Pus is seen draining from the ear and discharge is reported for less than 14 days

2. Ear Pain

they have?

Chronic Ear Infection (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

1.Pus is seen draining from the ear and discharge is reported for more than 14 days

they have?

Severe Malnutrition or Severe Malaria (Pink / Red)

When the Sick Child aged 2 mons to 5 yrs has:

1. Visible Severe Wasting

2. Severe Palmar Pallor

3. Edema on both feet

they have?

Anemia or Very Low Weight (Yellow)

When the Sick Child aged 2 mons to 5 yrs has:

1. Some palmar or pallow

2. Very low weight for age

they have?

Exclusive Breastfeeding

Feeding recommendations for up to 6 months

Breastfeeding = 1 katori serving (3 times a day if breastfed or 5 times a day if not)

Feeding recommendations for 6 mons to 12 mons

Breastfeeding + food from family pot + 1 1/2 katori serving (5 times a day)

Feeding recommendations for 12 mos to 2 yrs

family food + 3 meals daily + twice nutritious foods

Feeding recommendations for 2 yrs and older

F-IMNCI

Integration of the existing IMNCI package and the Facility Based Care package.

Asphyxia Management and Care for Sick Newborn at facility level

Components of F-IMNCI

C-IMNCI

It is component 3 of the IMCI package. It aims to improve family & community practices by promoting those practices with the greatest potential for improving child survival, growth, and development.

C-IMNCI

It seeks to strengthen the linkage between health services & communities to improve selected family & community practices and support community-based activities.

Comprehensive Child Survival Project (CCSP)

the IMNCI training module has been expanded to include birth preparedness & essential care at birth

Uttar Pradesh

Who runs the CCSP

IMNCI, ANC (Ante-Natal Care), HBNBC (Home Based Newborn Care), and BCC (Behavior Change communication)

4 components of CCSP