Child Survival

Integrated Management of Neo-natal and Childhood Illness

The Integrated Management of Childhood Illness programme was introduced in Mozambique a decade ago to foster better family care practices for children.

The programme was updated in 2006 to add two components – HIV and AIDS and neonatal care. It is now called the Integrated Management of Neo-natal and Childhood Illness (IMNCI).

With UNICEF support, the programme has been scaled up significantly over the past ten year, from 29 districts in 1998 to 130 districts in 2008 – out of a total of 145 districts.

The IMNCI approach is one of the key pillars of the Accelerated Child Survival and Development strategy in Mozambique. The programme has three main components:

Building the capacity of health professionals to treat children
Strengthening the health system
Improving family and community health practices

In health facilities, IMNCI promotes an integrated holistic approach to the case management of sick children, looking at the top causes of child mortality in Mozambique – malaria, pneumonia, diarrhoea, malnutrition and measles.

At community level, the programme focuses on preventive and promotive care and has been essentially implemented by non-governmental organisations.

As part of the strategy, the Ministry of Health has also developed a special consultation service for ‘at-risk’ children in health centres. At-risk children include those exposed to or living with HIV, malnourished children, pre-mature and low birth weight babies, twins, orphans or children with other difficulties.

This special consultation plays a key role in following up ‘at risk’ children discharged from therapeutic feeding, children of mothers attending the prevention of mother-to-child transmission services and children living with HIV.

The way forward

The strengthening and expansion of the IMNCI programme is a key strategy of the Ministry of Health to reduce child deaths, with a target of at least 80 per cent of health facilities implementing IMNCI by 2009.

From 2009-2011, UNICEF will continue to support the Ministry of Health and other partners to scale up the IMNCI programme, including the ‘at-risk’ child consultation service and the community-based component of the programme in two main areas.

Strengthening capacity of care givers, including both families and health staff

Strengthen the capacity of health workers in care and treatment of childhood diseases by increasing the number of health workers trained in IMNCI; strengthen referral care in hospitals and conduct supportive supervision.
Support the implementation of the integrated community-based neo-natal and child health interventions (community IMNCI) in target areas (8 provinces, including 90 districts), with emphasis on introducing treatment by community health workers of common illnesses such as malaria, diarrhoea and pneumonia.

Strengthening planning and service delivery capacity at district level

Provide material and logistic support for community management of neonatal illnesses.
Support social communication activities on neo-natal and child health to promote good care practices and prompt appropriate treatment seeking.
Strengthen follow-up of malnourished children and children born to HIV-positive mothers through implementation of the special consultation for at-risk children, including orientation of health workers and procurement of essential drugs not available in the standard drug kits for treatment of opportunistic infections.
Produce and disseminate updated guidelines for the healthy child and at-risk child consultations.
Provide maternity wards in 66 target IMNCI districts with neonatal resuscitation kits.

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