IMCI
Part 1: Assess & Classify Child
- Ask mother about the child’s problem.
o Avoid using words that suggest judgement.
o Head is level with the mother’s head.
o Pay attention.
o Remove barriers.
o Make the mother feel that you have time.
- Check for general danger signs:
o The child is not able to drink or breastfeed.
o Vomits everything.
o Has convulsions, had convulsions now.
o Lethargic or unconscious.
- Assess main symptoms:
o Cough
o Difficulty of breathing
o Fever
Essential Needs of All Newborns
- Warmth
- Breastfeeding
- Love and Safety
- Infection Control
- Management of infection after birth.
Check for Jaundice
- Increase bilirubin level
Pathologic Jaundice:
- Earlier, less than 24 hours.
Physiologic Jaundice
- Occurs after 2r hours.
EINC
- Tagline for essential intrapartum and newborn care.
- Package of EBP that is recommended by the DOH,
Philippine Health Insurance Corporation and WHO as the
standard of care in all births by skilled attendants in all
government.
- Basic component of the Department of Health’s Maternal,
Newborn and Child Health and Nutrition (MNCHN)
strategy as an expression of the national commitment to
achieve United Nations Millennium Development Goals
(MDG) 4 and 5 by the year 2015.
o MTG 4 & 5
 4 – reduce child mortality by 2/3
between 1990 and 2015 the under 5
mortality rate.
 5 – Target 5A: Reduce by three
quarters, between 1990 and 2015, the
maternal mortality ratio.
o Target 5B – Achieve by 2015, universal access to
reproductive health.
- 3.4 million pregnancies occur every year.
- 11 mothers die of pregnancy – related causes every day.
- Leading cause of maternal deaths:
o PPH
o HPN
o Abortion related complications.
- 40, 000 newborns die each year from causes that are most
preventable such as complications of:
o -
Mission
- To improve maternal and newborn health care services in
the Philippines through evidenced based and time bound
protocol.
National Polices for Maternal and Newborn Care
- To ensure that care of a certain standard to all mothers
and babies.
- Most current and of the highest standard such that in
providing care, the dignity of every mother and child is
respected and maintained, and when receiving care.
Health Policies for EINC
- DOH describe methods for providing standard maternal
and newborn care to the general population and demand
that monitoring and evaluation systems be put in place for
these strategies.
DOH Policies
A.
- Revitalization of the Mother-Baby Friendly Hospital
Initiative in Health Facilities with Maternity and Newborn
Care Services.
- Facility that fully protect, promote and support.
B.
- Implementing Health Reforms for the Rapid Reduction of
Maternal and Neonatal Mortality. (Adm. Order No. 2008-
0029)
- End goal is to rapidly reduce maternal and neonatal death.
- 3 Major Pillars:
o Emergency Obstetric Care
o Skilled Birth Attendants
o Family Planning
C.
- Adopting New Facilities and Protocol On Essential
Newborn Care
- Adm. Order No. 2009-0025
- Issued December 7, 2009
- Outlines specific policies and principles to follow for all
health care providers involved in newborn health care.
D.
- The Aquino Health Agenda: Achieving Universal Health
Care for All Filipinos.
- Adm. Order No. 2010-0036
- Millennium Development Goal – 8 international
development goals that all 193 United Nation Member
have agreed to achieve by the year 2015.
4 Steps to Save Newborn Lives:
1. Immediate and thorough drying of the newborn.
2. Early skin-to-skin contact between mother and newborn.
3. Properly timed cord clamping and cutting (1-3 minutes)
4. Non separation of newborn and mother for early
breastfeeding.
WHO Guidelines
A. .
- Baby Friendly Hospital Initiative: revised, Updated, and
Expanded for Integrated Care.
- Section 4: Hospital Self-Appraisal and Monitoring, Jan.
2006.
- Launched by WHO and UNICEF in 1991
- Promotes practices that protect, promote, and support
breastfeeding.
B.
- Pregnancy, Childbirth, Postpartum and Newborn Care: A
Guide for Essential Practice
Integrated Management of Pregnancy and Childbirth, 2006
- Aims to provide evidenced based recommendations to
guide health care professionals in giving high-quality care
 during pregnancy, delivery and in the postpartum period, Means of implementation, Mol inter-governmentally
thereby making pregnancy and childbirth safer. monitoring and follow up not negotiated, global architecture
C. defined in advance and monitoring system being
- WHO Recommendations for the Prevention of Postpartum shaped.
Hemorrhage, 2006.
- (1) Active management of the 3rd stage of labor should be 1000 Days
offered by skilled attendants. - Pregnancy/ Prenatal – 270 days
- (2) Use of oxytocin for prevention of PPH - First 6 months of life of an infant – 180 days
- (3) Cord should not be clamped earlier than is necessary. - From 6 months up to 2 years 550 days
- (4) Delivery of placenta by controlled traction. - Total of 1000 Days.
D. SDGs Public Health Nursing and MCH Nursing
- Newborn Care Until the First Week of Life Clinical Practice - Global goals #1, 2, and 3 are the three of the 17
Pocket Guide, 2009 sustainable development goals related to health.
Sustainable Developmental Goals Recommended Practice During Labor Based on EINC
- Adopted in Sept. 2015 at an historic UN Summit. - Less need for pain relief
- Build on the success of the Millennium Developmental - Duration of labor shorter
Goals, aiming to go further by ending all forms of poverty, - Upright position or position of choice during first stage of
fighting inequalities and tacking climate change. laborer.
- Apply to low, middle, and high income countries alike. - Routine use of partograph
- Governments are expected to take ownership and
establish national frameworks for achieving the gals.
- The clock already started on January 1, 2016.
What is Sustainable Development?
- Meets the needs of the present without compromising the
ability of future generations to meet their own needs.
- Call for concerted efforts toward building an inclusive
sustainable and resilient future for people and planet.
- Relies on three interconnected elements that are crucial to
the wellbeing of individuals and societies, economic
growth, social inclusions, and environmental protection.
- Requires eradicating poverty in all it forms and
dimensions.
SDG
1. No Poverty
a. Underweight
b. Stunting
c. wasting
2. No starvation and Hungry
a. Achieve food security and improved nutrition
and proote sustainable agriculture
3. Good health
a. Maternal mortality ratio
4. Quality Education
5. Gender equality
6. Clean water sanitation
7. Affordable and clean energy
8. Decent work and economic growth
9. Industry, Innovation, and Infrastructure
10. Equality in Social Class
11. Sustainable cities and communities
12. Responsible consumption and Production
13. Climate action
14. Life below water
15. Life on land
16. Peace and prosperity
17. To achieve global partnership

MDG
Mainly for developing
countries
8 solid goals for development
From UN secretariat
SDG
Universal – for ALL countries
17 goals, 169 targets,
integrating 3 dimensions of SD
Negotiated by member states
with stronger country
ownership