IMNCI IS THE INDIAN VERSION OF IMCI

NEED TO STRENGTHEN CHILD HEALTH SERVICES

1 WEEK -2 MONTHS OF

AGE

2 MONTHS -5 YEARS

DANGER SIGNS

Limited number of carefully selected clinical

signs are used

A combination of individual signs helps in

classification than diagnosis

Addresses most but not all, of the major

reasons a sick infant or child brought to a

clinic

HOSPITAL REFERRAL

INTIATION OF SPECIFIC TREATMENT

CALL FOR HOME

MANAGEMENT

ASSESSMENT

CLASSIFICATION AND

IDENTIFICATION OF TREATMENT

REFFERAL

COUNSELLINGFOLLOW UP CARE

DIAGNOSIS AND

TREATMENT

ETAT

TEACHING ABOUT ORAL DRUG

ADMINISTRATION

COUNSELLING

OH

CHECK FOR DANGER SIGNS

ASSESS MAIN SYMPTOMS

CHECK FOR OTHER SYMPTOMS

CLASSIFY SYMPTOMS ACCORDING TO COLOR CODE

•PREREFERALTREATMENT

•ADVISE PARENTS

•REFERALL SERVICES

•TREATLOCAL INFECTION

•ORAL DRUGS•ADVISE AND TEACH CARETAKER•FOLLOW UP

HOME CARE TAKER IS COUNSELLED:

•HOW TO GIVEMEDICATIONS•TREAT LOCAL INFECTIONAT HOME•FEEDING•FOLLOW UP

OUTPATIENT HEALTH FACILITY

CHECK FOR POSSIBILE BACTERIL INFECTION

ASSES THE SYMPTOMS OF DIARRHOEA

CHECK FOR FEEDING PROBLEM/MALNUTRITION

CLASSIFY OTHER PROBLEM

CLASSIFY CONDITION ACCORDING TO COLOR CODE

OUT PATIENT HEALTH FACILITY

•PREREFFERALTREATMENT•ADVISE TO PARENTS•REFERAL•EMERGENCY TRIAGE ANDTREATMENT•DIAGNOSISAND TREATMENT

•TREATLOCAL

INFECTION

•GIVE ORAL DRUGS

•ADVISEAND TEACH

CARE TAKER

•FOLLW UP

CARE TAKER IS COUNSELLED ON

HOW TO:•GIVE ORAL DRUGS•TREATLOCALINFECTION

SIGN CATEGORY TREATMENT

•ANY GENERAL DANGER SIGN

•CHEST INDRAWING

•STRIDER IN CALM CHILD

SEVERE PNEUMONIA

OR

VERY SEVERE DISEASE

•GIVE FIRST DOSE OF APPROPRIATE ANTIBIOTIC

•TREAT THE CHILD TO PREVENT LOW BLOOD SUGAR

•REFER URGENTLY TO HOSPITAL

FAST BREATHING PNEUMONIA •Give an appropriate antibiotics for

5 days

•Soothe the throat and relive the

cough with safe remedy

•Advise mother when to return

immediately

•Follow up

NO SIGNS OF PNEUMONIA

NO PNEUMONIA OR COUGH OR COLD

•Cough more than 30 days refer assessment•Relive cough with safe remedy

SIGNS CATEGORY TREATMENT

DEHYDRATION PRESENT SEVERE PERSISTANT

DIARRHOEA

•TREAT DEHYDRATION BEFORE REFERRAL UNLESS THE CHILD HAS ANOTHER SEVERE CLASSIFICATION

NO DEHYDRATION PERSISTANT DIARRHOEA

•Advise the mother on

feeding a child who has:PERSISTENTDIARRHOEA.

• Give

multivitamins/minerals and

zinc for 10 days Follow-

up in 5 days.

Blood in the stool DYSENTRY Treat for 5 days with an

oral antibiotic

recommended for Shigella

in your area.

Follow-up in 2 days.

SIGNS CATEGORY TREATMENT

Two of the following signs:

• Lethargic or unconscious

•Sunken eyes

• Not able to drink or

drinking poorly

Skin pinch goes back very

SEVEREDEHYDRATION If child has no other severe classification:

Give fluid for severe dehydration (Plan

C).

• If child also has another severe

classification:

• Refer URGENTLY to hospital with

mother giving frequent sips of ORS on the

way.

•Advise the mother to continue

breastfeeding

• If child is 2 years or older and there is

cholera in patient’s area, give antibiotic for

cholera.

Two of the following signs: •Restless, irritable • Sunken eyes •Drinks eagerly, thirsty

SOME DEHYDRATION Give fluid, zinc and food for some

dehydration (Plan B). • If child also has a severe classification:

- Refer URGENTLY to hospital with mother giving frequent sips of ORS on the way. •Advise the mother to continue breastfeeding.

Not enough signs to classify as some or severe dehydration

NO DEHYDRATION •Give fluid, zinc and food to treat diarrhea at home (Plan A).

SIGN CATEGORY TREATMENT

•Not able to feed•No attachment at all•Very low weight for age

SEVERE MALNUTRTION •Give Vitamin A if Visible

Sever Wasting and /or Edema

of both feet present.

•Refer URGENTLY to

hospital.

•Treat the child to prevent low

blood

•Not well attached to breast•Not sucking well•Less than 8 breastfeed in 24 hrs•Thrush•Low weight for age

Feeding problem or low weight

•If not well attached ,teach correct positioning•Increase frequency of breast feed•Treat thrush at home•Teach low weight measures at home•Follow up

Not low weight for age ,no feeding problem

No feeding problem •Advise mother to give home care•Advise follow up