This paper assessed the progress of IMNCI in India, identified the programme bottlenecks, and also assessed the effect on coverage of key newborn and. Integrated Management of Neonatal and Childhood Illnesses (IMNCI). ” Close to 50 per cent of newborn deaths in India occur during the first seven days of birth. India: Students’ Handbook for IMNCI (Integrated Management of Neonatal and Childhood Illness). Ministry of Health and Family Welfare, Government of India;.

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Guidelines – Governnment of India

Each component training, supervision, supplies, and performance had a set of five indicators, i. During these visits, the health workers assess the newborns, ensure breastfeeding, counsel on warmth and danger-signs, treat local infections, and refer to appropriate facilities for possible serious bacterial infections. Information onimplementation was, for example, available only from 99 of the districts.

Programme bottlenecks in training, supervision, and supplies A systematic assessment of the programme implementation was carried out among seven early-implementing districts across seven states. Performance indiw health workers after training coverage and quality. Coverage of home-visits Implementation status based on reports from 99 districts No.

What was the quality of care they provided to sick infants and children? Performance of trained health workers and community health workers Coverage of home-visits After training, the community health workers recorded the home-visits in a case record form. Based on assessment of the quality of training from 70 training programmes for frontline workers across 14 states, the median quality inndia was 88 out of It was recommended that public accountability should be enhanced to infia and address the bottlenecks of delivery Support Center Support Center.

Many young lives are lost due to parents failing to recognise warning signs and sick children not being taken to health facilities imnc time, and because imnvi mothers do not have sufficient knowledge on the protective value of breastfeeding.

Except for the indicator—percentage of children fully immunized—the net change in the coverage levels of all other indicators was higher among the intervention districts than among the control districts.

The guidelines relied on the detection of cases using simple clinical lndia without laboratory tests and offered empirical treatment. Effectiveness in improving coverage ofnewborn and childcare practices Table 5 summarizes the comparison between changes in the coverage of key indicators between the IMNCI districts and the control districts. Most deliveries take place at home. While doing so, it seeks to answer the following questions: Results of an initial evaluation of IMCI implementation in Tanzania showed significantly improved supervision in implementing districts inddia in control districts.


Courageous teen crafts rescue to save mother and her baby. However, it was reported subsequently that even integrated and decentralized approaches to supervision in Tanzania and Uganda proved too ambitious, particularly with respect to the need to include clinical observations and feedback as part of all supervisory visits 1417 Only two states, i.

This paper assessed the progress of IMNCI in India, identified the programme bottlenecks, and also assessed the effect on coverage of key newborn and childcare practices.

International Institute for Population Sciences. Each training programme is run for eight days.

Last, but most importantly, being intensive in nature focusing on a very large number of CHWs, the programme would require significant time to start making an impact on infant mortality rates. Conclusions India has made significant investments in terms of time, effort, and money to roll out the IMNCI programme in the country.

A detailed report on progress in training was available for 99 During the same period, the frontline workers also assessedolder children and advised referral to about Programme bottlenecks in the following domains: Since the IMNCIprogramme in India is largely dependent on frontline workers, supervision of a large number of workers scattered across a large number of villages is even more challenging.

The referral health centre in Kukshi block of Dhar is now just one of several with an efficient maternity ward.

Assessment of Implementation of Integrated Management of Neonatal and Childhood Illness in India

Description of intervention Training The IMNCI training programme focuses on building of individual skills and includes practice sessions in the field and in the hospital. Summary report on causes of deaths: Of these births, 72, IMNCItraining module for workers, In three states, the trained supervisors assessed the performance of a sample of community workers during home-visits to newborns using a standard checklist. The number of workers trained per year per district ranged from to 1, across different states, with a median of Some weeks before the national and state immunisation days, UNICEF provides support at the district and sub-district levels in identifying areas where services need to be urgently provided and in ensuring their delivery.


There is a need to explore these approaches and adapt these in different states and districts.

Of 1, health workers who observed across three districts in three states, 1, Recognizing newborn care as critical for improving child survival, it was strengthened in IMNCI by increasing the newborn-care component of the training programme and including prevention and management of health conditions in the first week of life. Community health worker incentives and disincentives: Tribal women become torchbearers of education in Lalitpur district.

It focuses on strengthening homebased care and provides special care for under-nourished newborns. However, the health-system strengthening component of the programme was poorly implemented Ingle GK, Malhotra C. There are also potential ways to improve the supplies and logistics for the IMNCI-trained workers, such as stocking supplies with Village Health and Sanitation Committees, as has been tried in an ongoing randomized controlled trial in India that aims to assess the effectiveness of IMNCI on newborn and child mortality Bhandari N.

One of the trained frontline workers is engaged and trained as supervisor to support her peers, with some allowance for mobility. One of the major reasons for the slow decline in the IMR is the stagnation in neonatal mortality.

Based on the early experience of IMNCI implementation in different states of India, measures need to be taken to improve supportive supervision, availability of essential supplies, and monitoring of the programme if the strategy has to translate into improved child survival imdia India.

Poor supervision and monitoring and poor availability of logistics and supplies were the major bottlenecks in programme implementation. Office of Registrar General.