What are the components of integrated care provided under IMNCI?

Components of Integrated Care under IMNCI

The IMNCI strategy is built around a framework of integrated care, encompassing several key components. These components are designed to be implemented at all levels of the healthcare system, from community health workers to hospitals.

1. Clinical Assessment and Classification

This is the core of the IMNCI strategy. It involves a systematic approach to assess sick children based on presenting symptoms and signs. The assessment process follows these steps:

• Assess the child’s general danger signs: Looking for signs of severe illness like lethargy, poor feeding, convulsions, or difficulty breathing.
• Assess the child’s weight: Monitoring weight for age to identify malnutrition.
• Assess for localizing signs: Identifying specific symptoms related to pneumonia, diarrhea, malaria, measles, or ear infection.
• Classify the illness: Based on the assessment, the child is classified into one of several categories (e.g., severe pneumonia, non-severe pneumonia, diarrhea with dehydration, severe malnutrition).

2. Integrated Treatment

Treatment is guided by the classification of the illness. IMNCI provides standardized treatment protocols for common childhood illnesses, including:

• Pneumonia: Antibiotics (usually amoxicillin) for both severe and non-severe cases.
• Diarrhea: Oral rehydration therapy (ORT) to address dehydration, zinc supplementation, and continued feeding.
• Malaria: Artemisinin-based combination therapy (ACT) for confirmed malaria cases.
• Measles: Vitamin A supplementation and supportive care.
• Severe Malnutrition: Referral to specialized care and therapeutic feeding.

Importantly, IMNCI emphasizes treating the whole child, addressing multiple illnesses simultaneously. For example, a child with pneumonia and diarrhea would receive treatment for both conditions.

3. Essential Newborn Care

IMNCI places significant emphasis on essential newborn care, which includes:

• Immediate newborn care: Drying, stimulating, and keeping the baby warm.
• Early initiation of breastfeeding: Within the first hour of life.
• Assessment of the newborn: Identifying birth asphyxia, hypothermia, and infections.
• Basic newborn resuscitation: Providing appropriate care for babies who are not breathing adequately.
• Counseling on newborn care: Educating mothers on hygiene, feeding, and danger signs.

4. Counseling on Home Care

Healthcare workers provide counseling to caregivers on how to manage the child’s illness at home, including:

• Signs of worsening illness: Educating parents on when to seek immediate medical attention.
• Proper feeding practices: Encouraging continued breastfeeding and appropriate complementary feeding.
• Hygiene practices: Promoting handwashing and safe water storage.
• Follow-up care: Scheduling follow-up visits to monitor the child’s progress.

5. Referral System

IMNCI recognizes that some children require specialized care that is not available at the primary healthcare level. A well-functioning referral system is crucial for ensuring that these children receive the appropriate treatment. This includes:

• Identifying children who need referral: Based on the severity of their illness.
• Providing appropriate pre-referral treatment: Stabilizing the child before transport.
• Ensuring safe and timely transport: Coordinating with referral facilities.

Component	Description
Clinical Assessment	Systematic evaluation of the child’s condition.
Integrated Treatment	Standardized treatment protocols for common illnesses.
Essential Newborn Care	Care provided to newborns immediately after birth and in the first few weeks of life.
Counseling	Educating caregivers on home care and danger signs.
Referral	Connecting children with specialized care when needed.