Integrated management of childhood illness
In South Africa, UNICEF’s community-based Integrated Management of Childhood Illness (IMCI) programme helps improve child care practices by involving communities at the household level in all efforts to reduce preventable childhood diseases, especially in children less than 5 years of age. The programme is aimed at the most vulnerable children living under economically and socially constrained circumstances. UNICEF, in agreement with the government of South Africa focuses on three provinces in the country: Eastern Cape, Limpopo and Kwa Zulu-Natal, where most of the poorest of the poor reside and where unemployment rates are excessively high. Infant mortality Currently the official Infant Mortality Rate (IMR) stands at 45 per 1000 live births (DHS 1998) even though some estimates, e.g a 2002 survey by the Medical Research Council (MRC) put it at 95 per 1000 live births mainly due to deaths related to the HIV/AIDS epidemic. It is expected that the impact of HIV and AIDS on women, in particular, will worsen as the epidemic progresses. Projections of the path of the HIV and AIDS epidemic suggest that the overall prevalence rate of HIV will reach almost 25 % in the general population by 2010. Community-based action for improved child health UNICEF, in partnership with the Government, has for the past three years spearheaded the implementation of the community-based IMCI, in all nine provinces of the country. All have now implemented community IMCI in at least one district and are beginning to scale up their programmes with plans for rolling out to at least four districts per province. UNICEF's work to improve children's basic health care first considers the development challenges posed by each of the three focus provinces – Eastern Cape, Kwa Zulu-Natal and Limpopo – and work, so far, has focused on conducting a participatory rapid assessment survey on key family practices suited to the capacity of health workers from those communities. In Limpopo: the assessment survey used a unique methodology, simplified language and streamlined content to make questionnaires more friendly for participating rural communities. Networks of community health committees and of organisations working with children have been established in four pilot districts and cooperate closely with the district government. In Eastern Cape: the focus has been on training community health workers in the IMCI practices, with participants from diverse backgrounds using the human rights approach in working with children and communities. In Kwa Zulu-Natal: UNICEF's human rights approach to programming is used to engage provincial authorities, non governmental organisations (NGOs) and key government departments in prioritising children’s rights. An integrated task team now co-ordinates all children’s issues at municipal level and a joint municipal and community action plan is being finalized. Key Partners Training & Resources in Early Education (TREE) Community responsiveness programmes The O’Dowd Outreach
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