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Going to scale: Experience with Community IMCI

Going to scale: Experience with Community IMCI. Meeting of RBM and IMCI Task Forces 24 th –26 th September 2002 Harare, Zimbabwe. Presentation by IMCI AFRO. Community IMCI.

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Going to scale: Experience with Community IMCI

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  1. Going to scale: Experience with Community IMCI Meeting of RBM and IMCI Task Forces 24th–26th September 2002 Harare, Zimbabwe Presentation by IMCI AFRO

  2. Community IMCI … is an integrated child care approach that aims at improving key family and community practices that are likely to have the greatest impact on child survival, growth and development

  3. WHY SHOULD WE FOCUS ON THE HOME? • Healthy life style starts at home • Home is where treatment of sick children start using locally purchased medicine • A big segment of the population in developing countries do not have access to health facilities • Even where access to health facilities is reasonably good, most children die at home without seeking any health care outside the home

  4. IMCI Key Family and Community Practices • documented/greatest impact on mortality • feasible to implement in countries • Cost-effective • address major problems on child health, nutrition and development • Focus on behavior change

  5. Key Family Practices • Growth Promotion &Development • Exclusive breastfeeding for 6m • Appropriate complementary feeding from 6m whilst continuing BF up to 24m • Adequate micronutrients through diet or supplementation • Promote mental and psychosocial development • Home Management • Continue to feed and offer more food & fluids when child sick • Give child appropriate home treatment for infections • Take appropriate actions to prevent and manage child injuries and accidents

  6. Key Family Practices..contd. • Disease Prevention • Proper disposal of faeces, hand washing etc • Child sleeps under ITN • Prevention and care of HIV/AIDS • Prevent child abuse/neglect & taking appropriate action Care Seeking & Compliance Take child to complete full course of immunization before 1st birthday Recognize when child needs treatment outside home and take to HW Follow HW advice about treatment, FU and referral ANC attendance and TT vaccination during pregnancy Active participation of men in childcare and reproductive health activities

  7. Countries with c-IMCI Orientation Meeting • Common understanding • Share information • Identify stake holders • Consensus on way forward IMCI Unit AFRO

  8. COUNTRIES WITH PLAN FOR C-IMCI • Planning at national and district levels • Partners collaboration in planning IMCI Unit AFRO

  9. To understand the current situation at district and national levels C-IMCI SITUATIONANALYSIS (11 countries) Sharing of experience Revise policy and guidelines Identifying the various partners and planning together

  10. Breastfeeding Indicators (%) Source Uganda DHS 2000 Tanzania MCE HH Survey 1999 DRC Situational Analysis 2002

  11. Use of mosquito nets Source Uganda DHS 2000 Tanzania MCE HH Survey 1999 DRC Situational Analysis 2002

  12. Management of sick children at home

  13. Regional level support • Development of Briefing Package for planning of C-IMCI • Developed for use by facilitators/ consultants who would assist countries in the planning for c-IMCI • Pre tested in Benin in February 2002 • Field test conducted , 15 countries (10 Anglophone and 5 francophone) involved • Revision to be done in early October • Manual on the recommendation for home care • CHW’s training manual Other materials to bedeveloped

  14. Situation analysis • What does the community have? • Practices • Community health services • Resources • Previous/existing interventions • Others sectors • Links with the health system • What does the community know? • Information • Knowledge What are the community needs? IMCI/Child Health Strategy Document Strategic Plan for IMCI/Child Health C-IMCI Briefing Package • Selection of priority practices: • Effective • Feasible • Pertinent • Acceptable • Cost effective Community and community interventions Opportunities Constraints Strategy Document for the C-IMCI Recommendations on Priority practices

  15. Countries with C-IMCI in more than 3 Districts Countries with child health related community interventions Community IMCI : Implementation Status IMCI Unit AFRO

  16. KEY FACTORS FOR SCALING UP C-IMCI: LESSONS LEARNT • Advocacy and Resource Mobilization • Showing Impact • Partnership • Documentation and sharing of experience • Building on existing structures • (and not substituting community resources)

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