Abstract
Integrated Management of Childhood Illness (IMCI), a strategy fostering holistic approach to child health and development, is built upon successful experiences gained from effective child health interventions like immunization, oral rehydration therapy, management of acute respiratory infections and improved infant feeding. The core intervention of IMCI is integrated management of the five most important causes of childhood deaths-acute respiratory infections, diarrheal diseases, measles, malaria and malnutrition. Using a set of interventions for the integrated treatment and prevention of major childhood illnesses, the IMCI strategy aims to reduce death as well as the frequency and severity of illness and disability, thus contributing to improved growth and development. In health facilities, the IMCI strategy promotes the accurate identification of childhood illness (es) in the outpatient settings, ensures appropriate combined treatment of all major illnesses, strengthens the counselling of caretakers and the provision of preventive services, and speeds up the referral of severely ill children. The strategy also aims to improve the quality of care of sick children at the referral level. It also creates a scientifically sound link between the management guidelines at the community level and the management approach in a referral centre. The strategy also envisages actual situations when referral is not possible and offers the best possible options in such circumstances. In the home setting, it promotes appropriate early home care and care-seeking, improved nutrition and prevention, and the correct implementation of prescribed care. In addition to its focus on treatment of illness in the health facility as well as at home, it also provides an opportunity for important preventive interventions such as immunization and improved infant and child nutrition including breastfeeding. The IMCI strategy reduces wastage of resources and avoids duplication of efforts that may occur in a series of separate disease control programs. The essential pillars include improvement in the case management skills of health personnel, improvement in health systems, and improvement in family and community practices. IMCI has been introduced in more than 80 countries and 19 of them have already scaled up IMCI implimentation Even though it is too early to relate the decrease in childhood mortality with the introduction of IMCI inthese countries, there are several indirect indicators which endorse its validity as a comprehensive and effective strategy. IMCI has helped countries to revise and update their child health policies, streamline the essential drug lists for children, increase service utilization, improve quality of care and nutritional counselling, improve health systems and improved family and community practices.
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References
Murray CJL, Lopez AD. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020.Global Burden of Disease and Injury Series, Cambridge, MA, Harvard School of Public Health, 1996 : 1.
Gove S. For the WHO Working Group on Guidelines for Integrated Management of the Sick Child.Butt WHO 1997; 75: 7–24.
Pelletier DL, Frorigillo EA, Habicht P. Epidemiological evidence for a potentiating effect of malnutrition on child mortality.Am J Public Health 1993; 83: 1130–1133.
World Health Organization. Integrated management of the sick child.Bull WHO 1995; 73: 735740.
Fagbule D, Kalu A. Case management by community health workers of children with acute respiratory infections: Implications for National ARI Control Programme.J Trop Med Hyg 1995; 98: 241–246.
World Bank. World Development Report, 1993.
World Health Organization. Management of the Child with a-Serious Infection or Severe Malnutrition: Guidelines for care at the first-referral level in developing countries. WHO, Geneva, 2000.
World Health Organization. Integrated Management of Childhood Illness. WHO/CHD/97.3.A-3.G, WHO, Geneva, 1997.
Chessare JB. Teaching clinical decision-making to pediatricresidents in an era of managed care.Pediatrics 1998; 101: 762–766.
World Health Organization. Improving family and community practices-A component of the IMCI strategy. WHO/CAH/98.2, WHO, Geneva, 1998.
World Health Organization. Guidelines for follow-up after training. WHO/CAH/99.1A &1B, WHO, Geneva, 1999.
Kolstad PR, Burnham G, Kalter HD, Kenya-Mugisha N, Black RE. Potential implications of the integrated management of childhood illness (IMCI) for hospital referral and pharmaceutical usage in western Uganda.Trop Med Int Health 1998; 3: 691–699.
Gove S, Tamburlini G, Molyneux E, Whitesell P, Campbell H. Development and technical basis of simplified guidelines for emergency triage assessment and treatment in developing countries. WHO Integrated Management of Childhood Illness (IMCI) Referral Care Project.Arch Dis Child 1999; 81: 473–477.
Shah D, Sachdev HPS. Evaluation of the WHO/UNICEF algorithm for Integrated Management of Childhood Illness between the age of two months to five years.Indian Pediatr 1999; 36: 767–777.
Gupta R, Sachdev HPS, Shah D. Evaluation of the WHO/ UNICEF algorithm for Integrated Management of Childhood Illness between the age of one week to two months.Indian Pediatr 2000, 37: 383–390.
Alves da Cunha AJL, Alves R, Goúdois E, Orfalhais CS, Sant’ Ana AMG. Profile of Complaints and Cinical Syndromes of Children Under 5 in Rio De Janeiro, Brazil: Implications for the implementations of the Integrated Management of Childhood Illness Strategy.Indian Pediatr 2000, 37: 296–301.
Kalter HD, Schillinger JA, Hossain Met al. Identifying sick children requiring referral to hospital in Bangladesh.Bull WHO 1997; 75 (Suppl 1): 65–75.
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Patwari, A.K., Raina, N. Integrated Management of Childhood Illness (IMCI) : A robust strategy. Indian J Pediatr 69, 41–48 (2002). https://doi.org/10.1007/BF02723776
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DOI: https://doi.org/10.1007/BF02723776