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Integrated Management of Newborn and Childhood Illness (IMNCI) Strategy and its Implementation in Real Life Situation

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Abstract

To meet the sustainable development goals (SDG) target of reducing under-five mortality to 25 per 1000 live births, concerted efforts are required to end all preventable deaths of newborns and children under 5 y of age. There is evidence to support Integrated Management of Neonatal and Childhood Illness (IMNCI) as a cost- effective strategy which can improve child survival. IMNCI has 3 components- capacity building of health workers, health system strengthening and improving community and family practice. For best results, all three components of the IMNCI strategy should be implemented in a coordinated fashion. IMNCI implementation in india has been uneven. The main focus has been on capacity building and with little attention on system strengthening or improving community practices. Ill- sustained funding and poor monitoring and supervision system were additional factors which are major challenges. Since evidence based interventions remain same, IMNCI remains as relevant today as before. It would be appropriate to redesign it as per current needs and implement it with more planning with committed budget and inbuilt measures of quality improvement along with supportive supervision.

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References

  1. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & Trends in Child Mortality: Report 2017, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. New York: United Nations Children’s Fund; 2017.

  2. Millennium Development Goals. Final country report of India. Social statistics division. Ministry of statistics and Programme Implementation. Govt of India 2017. Available at: www.mospi.gov.in. Accessed 27 Nov 2017.

  3. Transforming our world: the 2030 agenda for sustainable development. New york: United Nations; 2015. Available at: https://sustainabledevelopment.un.org/post2015/transformingourworld. Accessed 20 Sept 2018.

  4. Sachs J, Schmidt-Traub G, Kroll C, Lafortune G, Fuller G. SDG index and dashboards report 2018. New York: Bertelsmann Stiftung and Sustainable Development Solutions Network (SDSN); 2018.

    Google Scholar 

  5. Gove S. Integrated management of childhood illness by outpatient health workers: technical basis and overview. The WHO working group on guidelines for integrated Management of the Sick Child. Bull World Health Organ. 1997;75:7–24.

    PubMed  PubMed Central  Google Scholar 

  6. Mohan P, Kishore B, Singh S, Bahl R, Puri A, Kumar R. Assessment of implementation of IMNCI in India. J Health Popul Nutr. 2011;29:629–38.

    PubMed  PubMed Central  Google Scholar 

  7. Division of child health and immunization, ministry of health and family welfare. Monthly Programme Monitoring Sheets. New Delhi: Government of India; 2014.

  8. Operational Guidelines for Facility Based Integrated Management of Neonatal and Childhood illness (F-IMNCI). National Rural health, Ministry of Health and Family Welfare, Government of India. Available at: http://nhm.gov.in/images/pdf/programmes/child-health/guidelines/operational_guidelines_for_fimnci.pdf. Accessed 18 August 2018.

  9. UNICEF Annual Report. India: UNICEF; 2016. Available at https://www.unicef.org/about/annualreport/files/India_2016_COAR.pdf. Accessed 10 Sept 2018.

  10. Revised Home Based Newborn Care Operational Guidelines. New Delhi: Ministry of Health and Family Welfare, Government of India; 2014.

  11. Bryce J, Victora CG, Habicht JP, Black RE, Scherpbier RW. Programmatic pathways to child survival: results of a multi-country evaluation of integrated Management of Childhood Illness. Health Policy Plan. 2005;20:i5–17.

    Article  PubMed  Google Scholar 

  12. Rakha MA, Abdelmoneim A-NM, Farhoud S, et al. Does implementation of the IMCI strategy have an impact on child mortality? A retrospective analysis of routine data from Egypt. BMJ Open. 2013;3:e001852.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Armstrong Schellenberg JR, Adam T, Mshinda H, et al. Effectiveness and cost of facility-based integrated Management of Childhood Illness (IMCI) in Tanzania. Lancet. 2004;364:1583–94.

    Article  PubMed  Google Scholar 

  14. Huicho L, Dávila M, Gonzales F, Drasbek C, Bryce J, Victora CG. Implementation of the integrated Management of Childhood Illness strategy in Peru and its association with health indicators: an ecological analysis. Health Policy Plan. 2005;20:i32–41.

    Article  PubMed  Google Scholar 

  15. Bhandari N, Mazumder S, Taneja S, Sommerfelt H, Strand TA; IMNCI Evaluation Study Group. Effect of implementation of integrated management of neonatal and childhood illness (IMNCI) programme on neonatal and infant mortality: cluster randomized controlled trial. BMJ. 2012;344:e1634.

  16. Gera T, Shah D, Garner P, Richardson M, Sachdev HS. Integrated management of childhood illness (IMCI) strategy for children under five. Cochrane Database Syst Rev. 2016;6:CD010123.

    Google Scholar 

  17. Indian Institute for Population Sciences (IIPS) and MoHW. National Family Health Survey −4, 2017. Available at: http://rchiips.org/nfhs/pdf/NFHS4/ India.pdf. Accessed 10 September 2018.

  18. The analytic review of the Integrated Management of Childhood Illness strategy: final report. DFID WHO, 2003.

  19. Nguyen DTK, Leung KK, McIntyre L, Ghali WA, Sauve R. Does integrated management of childhood illness (IMCI) training improve the skills of health workers? A systematic review and meta-analysis. PLoS One. 2013;8:e66030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Zhang Y, Dai Y, Zhang S. Impact of implementation of integrated Management of Childhood Illness on improvement of health system in China. J Paediatr Child Health. 2007;43:681–5.

    Article  PubMed  Google Scholar 

  21. Gouws E, Bryce J, Habicht JP, et al. Improving antimicrobial use among health workers in first-level facilities: results from the multi-country evaluation of the integrated Management of Childhood Illness strategy. Bull World Health Organ. 2004;82:509–15.

    PubMed  PubMed Central  Google Scholar 

  22. Department of Child and Adolescent Health and Development. World Health Organization (2002). The multi-country evaluation of IMCI effectiveness cost and impact (MCE). Geneva, Switzerland: Department of Child and Adolescent Health and development, World Health Organization; Progress report may 2001–April 2002. Report no. WHO/FCH/CAH/0216.

  23. Akber Pradhan N, Rizvi N, Sami N, Gul X. Insight into implementation of facility-based integrated management of childhood illness strategy in a rural district of Sindh, Pakistan. Glob Health Action. 2013;6:20086. https://doi.org/10.3402/gha.v6i0.20086.

    Article  Google Scholar 

  24. Mazumdar S, Taneja S, Bahl R, et al. Effect of implementation of integrated Management of Neonatal and Childhood Illness programme on treatment seeking practices for morbidities in infants: cluster randomised trial. BMJ. 2014;349:g4988.

    Article  Google Scholar 

  25. Arifeen SE, Hoque DM, Akter T, et al. Effect of the integrated Management of Childhood Illness strategy on childhood mortality and nutrition in a rural area in Bangladesh: a cluster randomised trial. Lancet. 2009;374:393–403.

    Article  PubMed  Google Scholar 

  26. Prinja S, Bahuguna P, Mohan P, et al. Cost effectiveness of implementing integrated management of neonatal and childhood illnesses program in district Faridabad, India. PLoS One. 2016;11:e0145043.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Prinja S, Mazumder S, Taneja S, et al. Cost of delivering child health care through community level health workers: how much extra does IMNCI program cost? J Trop Pediatr. 2013;59:489–95.

    Article  PubMed  Google Scholar 

  28. Adam T, Manzi F, Schellenberg JA, Mgalula L, de Savigny D, Evans DB. Does the integrated management of childhood illness cost more than routine care? Results from the United Republic of Tanzania. Bull World Health Org. 2005;83:369–77.

  29. Bryce J, Gouws E, Adam T, et al. Improving quality and efficiency of facility-based child health care through integrated Management of Childhood Illness in Tanzania. Health Policy Plan. 2005;20:i69–76.

    Article  PubMed  Google Scholar 

  30. Goga AE, Muhe LM. Global challenges with scale-up of the integrated management of childhood illness strategy: results of a multi-country survey. BMC Public Health. 2011;11:503.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Patel S, Rudan I , Waters D, et al. Integrated Management of Childhood Illness (IMCI) in the 21st century: integration into health systems. UNICEF,New York: 2016.

  32. World Health Organization. Towards a Grand Convergence for Child Survival and Health: A Strategic Review of Options for the Future Building on Lessons Learnt from IMNCI. 2016. http://www.who.int/iris/handle/10665/251855.

  33. Neogi SB, Sharma J, Chauhan M, et al. Care of newborn in the community and at home. J Perinatol. 2016;36:S13–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Tripathy P, Nair N, Sinha R, et al. Effect of participatory women's groups facilitated by accredited social health activists on birth outcomes in rural eastern India: a cluster-randomised controlled trial. Lancet Glob Health. 2016;4:e119–28.

    Article  PubMed  Google Scholar 

  35. Boschi-Pinto C, Labadie G, Dilip TR, et al. Global implementation survey of integrated Management of Childhood Illness (IMCI): 20 years on. BMJ Open. 2018;8:e019079.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Magge H, Anatole M, Cyamatare FR, et al. Mentoring and quality improvement strengthen integrated management of childhood illness implementation in rural Rwanda. Arch Dis Child. 2015;100:565–70.

    Article  PubMed  Google Scholar 

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Acknowledgements

The author acknowledges valuable inputs provided by Prof. A K Patwari.

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Correspondence to Satinder Aneja.

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Aneja, S. Integrated Management of Newborn and Childhood Illness (IMNCI) Strategy and its Implementation in Real Life Situation. Indian J Pediatr 86, 622–627 (2019). https://doi.org/10.1007/s12098-019-02870-2

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