Review of Integrated Management of Childhood Illness (IMCI) in Europe (2018)

REVIEW OF INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) IN EUROPE

By: Susanne Carai Aigul Kuttumuratova Martin Weber

CONTENTS ............................................................................................................. iii Acknowledgements ............................................................................................... iv Study team .......................................................................................................... iv Report-writing team .............................................................................................. iv Acronyms................................................................................................................ v Executive summary ............................................................................................... vi Background .......................................................................................................... vi Objectives ............................................................................................................ vi Methodology ........................................................................................................ vi Findings .............................................................................................................. vii Conclusion and way forward ................................................................................... x Review of Integrated Management of Childhood Illness (IMCI) in Europe ........... 1 Background ........................................................................................................... 1 Objectives ............................................................................................................. 2 Methodology ......................................................................................................... 2 Findings ................................................................................................................ 4 Taking a closer look: IMCI and the use of antibiotics ............................................... 18 Proposed improvements of IMCI ........................................................................... 20 Discussion ........................................................................................................... 20 Further reflection on review findings: children’s rights ............................................. 23 Conclusion........................................................................................................... 25 References ........................................................................................................... 27 Annex 1. Integrated Management of Childhood Illness (IMCI) impact model ..... 28 Annex 2. Vignettes from selected countries ......................................................... 29 Albania – IMCI review .......................................................................................... 29 Armenia – IMCI review ......................................................................................... 33 Azerbaijan – IMCI review ...................................................................................... 38 Georgia – IMCI review.......................................................................................... 43 Kazakhstan – IMCI review .................................................................................... 46 Kyrgyzstan – IMCI review ..................................................................................... 51 The Republic of Moldova – IMCI review ................................................................. 55 The Russian Federation – IMCI review ................................................................... 59 Tajikistan – IMCI review ....................................................................................... 63 Turkey – IMCI review ........................................................................................... 66 Ukraine – IMCI review .......................................................................................... 69 Uzbekistan – IMCI review ..................................................................................... 73 Annex 3. Vignettes from selected areas……………………………………………………86 Kosovo (in accordance with United nations Security Council Resolution 1244 (1999)) - IMCI review

  

  

  

Table 2 (contd)

   

s

 

          



    

      

 

 

 

                     



Cough

Diarrhoea

Fever

Young infant

Counselling, health promotion

Nurse without right to Assess, refer fast prescribe breathing IMCI minus

Assess, manage watery diarrhoea

Assess and refer

Assess and refer, counsel feeding problems

Breast feeding, nutrition, danger signs, when to seek care, care for development

Nurse with right to prescribe/ feldsher IMCI

Treat dysentery, treat severe dehydration

Differential diagnosis, possible sepsis

Diagnosis of developmental delay, failure to thrive

Observation & management of possible sepsis, jaundice, LBW

Lab tests, further diagnostic tests

Treat pneumonia

Family doctor, general practitioner IMCI plus

Paediatrician

Assess child with fever, viral illness, UTI, ear infection, sore throat, urine dip sticks Differential diagnosis pneumonia, bronchiolitis, asthma

Differential diagnosis persistent diarrhoea, diarrhoea and malnutrition

Hospital Viral tests, x-ray, CRP

Viral tests, CRP

     

    

IMCI Introduction/Planning Improved drug availability, supervision, other health system improvements

Training of health workers/follow up visits

ITNs,* other family and community interventions

Improved quality of care in health facilities Improved careseeking, increased utilization

Improved household compliance/care

Improved health/nutrition

    

    

  

  

  

   

ï‚·

ï‚·

   

     

7

The WHO Regional Office for Europe The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves.

Member States Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czechia Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan

World Health Organization Regional Office for Europe UN City, Marmorvej 51, DK-2100 Copenhagen Ă˜, Denmark Tel: +45 45 33 70 00 Fax: +45 45 33 70 01 Email: eucontact@who.int Website: www.euro.who.int