Integrated Management of

Childhood Illness
(IMCI)

INSTRUCTOR:
IVY VILLACERAN, RN, MAN, DHCM
IMCI
In (2004- 2006) :
▪ In the Philippines, pneumonia was the 3rd
leading cause of infant deaths
▪ Diarrhea and gastroenteritis of presumed
infectious origin ranked 10th
Statistics:

▪ Globally, more than 50 countries had childhood mortality rates of

more than 100 per 1000 live births in the year 1998
▪ More than 10 million children die each year in developing
countries before they reach their 5th birthday.
▪ Causes of these deaths are due to:
▪ Acute respiratory infections (mostly pneumonia)
▪ Diarrhea
▪ Measles
▪ Malaria
▪ malnutrition
IMCI

▪ WHO/ UNICEF: initiated IMCI strategy offers simple and effective

methods for child survival, healthy growth, and development and is
based on the combined delivery of essential interventions at
community, health facility, and health systems levels.
▪ IMCI process includes preventive as well as curative measures to
address the most common conditions that affect young children.
▪ 3 main components of IMCI:
1. Improvements in case management skills of health care staff
2. Improvements in the health system needed for effective
management of childhood illness
3. Improvements in family and community practices
IMCI case management

▪ Used by the health worker in the management of sick children

from age 1 week up to 5 years
▪ Using an integrated approach, the IMCI protocol guides the health
worker in:
▪ Assessing signs that indicate severe disease
▪ Assessing a child’s nutrition, immunization, and feeding
▪ Teaching parents how to care for a child at home
▪ Counseling parents to solve feeding problems
▪ Advising parents about when to return to a health facility
Elements of the IMCI Case Management

1. Assess a child by checking first for danger signs (or possible

bacterial infection in a young infant), asking questions about
common conditions, examining child, and checking nutrition and
immunization status.
2. Classify a child’s illnesses using a color-coded triage system.
Many children have more than one condition. Each illness is
classified according to whether it requires:
a. Urgent preferral treatment and referral (pink)
b. Specific medical treatment and advice (yellow)
c. Simple advice on home management (green)
3. Identify specific treatments for the child:
▪ If the child requires urgent referral, give essential treatment before
the patient is transferred.
▪ If a child needs treatment at home, develop an integrated
treatment plan for the child and give the first dose of drugs in the
clinic.
▪ If the child should be immunized, give immunizations
4. Provide practical treatment instructions, including teaching the mother or
caretaker on how to give oral drugs, how to feed and give fluids during illness, and
how to treat local infections at home.

5. Assess feeding , including assessment of breastfeeding practices, and counsel

to solve any feeding problems found.

6. When a child is brought back to the clinic as requested, give follow-up care and
if necessary, reassess the child for new problems
Two different sets of charts:

▪Children aged 2 months up to 5 years

▪Children aged 1 week up to 2 months
1st step: Ask the child’s age to select the appropriate case
management chart; “Up to 5 years” means the child has not yet
reached his fifth birthday.
The child who is younger than 2 months is considered a young infant.
2nd step: Ask about the child’s or young infant’s problem, then
ask if this is an initial visit for the problem.

▪ If this is the initial visit, the health worker follows the guidelines for
an initial visit.

▪ A child or young infant on a follow-up visit is given follow-up care

according to the guidelines.