DEFINITION:

IMNCI is an integrated approach to child health that

focuses on the well being of the whole child. It
focussed primarily on the most common causes of
child mortality-diarrhea, pneumonia, measles,
malaria, and malnutrition, illness affecting children
aged 1 week – 2 months, 2 months -5 year including
both preventive and curative elements to be
implemented by families.
 Beneficiaries of IMNCI
*care of young infants for new borns(under 2months)
*young children(2months-5yrs)
GOAL
To assess current statues of child survival
indicators and process indicators for
existing programme activities in
intervention and compassion districts.
OBJECTIVES
*To determine baseline mortality among
children under 5yrs of age(NMR,IMR,USMR)

*To determine prevalence of fever,loose stools,cough

and any other illness(morbidity density)in two
weeks prior to day of field survey among children
under 5yrs of age.

*To assess effective programme coverage for specified

disease condition(cough with fast
breathing)occuring in two weeks prior to day of
field survey
*Causes of under 5 mortality and path way analysis of
events prior to death and recovery of sick under 5
children

*Sickness management practices at house

hold,community level and health facility level.

*Sickness and care providing competencis of health care

providers(doctors,health workers and other
community level non convectional service providers)

*Health system support for man power,legistics,referal

mechanism,intersectoral coordination,social
moliblisation and monitoring and supervision.
COMPONENTS
*HEALTH WORKER COMPONENT
Case management skills

*HEALTH SERVICE COMPONENT

Improvement in overall health

*COMMUNITY COMPONENT
Improvements in family and community health care
practices
IMPLEMENTATION OF IMNCI
*adopting an integrated approach to child health and
development in the national health policy.

*adapting the IMNCI clinical guidelines to countries

needs, available drugs, policies and to the local foods
and language used by the population.

*up grading care in local clinics by training health workers

in new method examine and treat children and to
effectively council parents.

*making up grade care possible by insuring that enough

of the right low-cost medicines and simple equipment
are available.
*strengthening care in hospitals for those children too
sick to be treated in an out patient clinic

*developing support mechanism within communities

for preventing disease,for helping families to care for
sick children and for getting children to clinics or
hospitals when needed.
PRINCIPLES
*All sick young infants upto two months must be assessed
for baerial infection/jaundice and major symptoms of
diarrhea

*all sick children 2months to 5yrs must examine for general

danger signs which indicate the need for referral or
admission to a hospital

*all young infants and child 2months-5yrs of age must be

routinely assessed for nutritional and immunisation
status,feeding problems and other potential problems
*Only a limited number of care fully selected clinical
signs are used based on evidence of drugs sensitivity
and specificity to detect disease.

*A combination of individual signs leads to an infants

or childs classification rather than diagnosis.
CLASSIFICATION ACCORDING TO COLOR
CODE

COLOR CLASSIFICATION
*pink Hospital referral or admission
*yellow Initiation of special treatment
*green Home management
TRAINING IN IMNCI
Training is at 2 levels

*Inservice training for the existing staff

*Pre service training
CARE OF CHILDREN ACCORDING
TO IMNCI
0-2 MONTHS
*keeping the child warm
*intiation of breast feeding.
*counselling for exclusive breast feeding.
*cord,skin and eye care.
*recognition of illness in newborn and management
and/referral.
*immunisation
*home visit in the post natal period.
2MONTHS-5YRS
*management of diarrhea,ARI,malaria,measels,acute
ear infecton,mal nutrition and anemia.
*recognition of illness and risk.
*prevention and management of iron and vitaminA
deficiency
*counselling on feeding for all chilkdren below 2yrs.
*counselling on feeding for malnutrished.
*immunization
Assessment of sick young infant
upto 2 months

Possible bacterial infection / jaundice

Does the infant have diarrhea

Feeding problems

Immunization status
Checking for bacterial
infection/jaundice
IN CASE OF DIARRHEA
Checking skin turgor
FEEDING PROBLEM
TEACHING & COUNSELING
 Teach mother to keep infant warm.

Teach correct position for breast feeding

Advice on home care of young infant

Advice mother to return immediately if danger signs

present
Assessment of young child
2 months – 5 years
General danger signs

Ask about main symptoms [coughing/ breathing

difficulty]

 diarrhea

Malnutrion

Anamia

Immunization - prophylactic vit A, iron & folic

acid supplement
In case of diarrhea
In case of fever
MALNUTRITION
ANEMIA
IMMUNIZATION
AGE VACCINE

Birth BCG , OPV ,Hepatitis

6 WEEKS BCG(if not given). OPV-1,HIB 1, DPT 1

10 WEEKS- POV -2 , DPT 2, HEP B 2

14 WEEKS OPV 3, DPT 3, HEP B 3

9MONTHS MEASLES , VIT A

16- 18 MONTHS DPT, OPV,VIT A

Vit A Prophylaxis
 9 months - 1 lakh unit

16 – 36 months - 2 lakh unit

TREAT DEHYDRATION - ORS
IRON & FOLIC ACID
AGE / WEIGHT PAEDIATRIC TABLET

4-24 MONTHS (6-12 KG) 1 TABLET

2 YRS - 5 YRS ( 12 – 19 KG) 2 TABLET

VITAMIN A

6 – 12 MONTHS 1 ML

12 – 5 YRS 2 ML
 FEEDING RECOMMENDATION
0-6 MONTHS
Breast feed as often as child want

Do not give any other food

Continue breast feeding if child is sick

6 – 12 months
Breast feed as often

Give smashed roti, rice, bread, biscuit, undil: milk

or vegetables
Keep child on your lap

Wash childs hand before feeding

12 – 2 yrs
Breast feed as often

Offer family food

Sit by the side of child

Wash hands with soap

> 2 years
Give family food

Ensure that child finishes the serving

Teach child to wash hands

CONCLUSION
IMNCI strategy has emerged as a promising approach
to deal with issues related to child survival.

Major strength is it use evidence based management

decisions

This approach could help country to achieve

millenium goal.