Integrated Management of Childhood illnesses (IMCi)
Under-five mortality remains unacceptably high - 5.6 million in 2016 (WHO). Diarrhea, pneumonia and malaria are still responsible for the majority of mortality in the post-neonatal period, despite internationally recommended and cost-effective treatments. When provided through fixed health facilities only, these treatments are often inaccessible to marginalized children with the greatest need. Integrated Management of Childhood Illnesses (IMCI) addresses this gap in access to lifesaving interventions by ensuring assessment, and referral of sick children to nearby village clinics through trained CHWs to complement fixed or scheduled facility-based services.
The IMCI workflow facilitates an integrated assessment of conditions. It focuses on effective case management and prevention of disease, and contributes to healthy growth and development, including immunization, nutrition and developmental counselling. This helps in reduction of under 5 deaths.
CHWs equipped with the CHT Application screen children under-five in their community for symptoms related to diarrhea, pneumonia, and malaria. CHWs then record which children have a suspected diagnosis, refer to the facility for treatment, and support on-time appointments with automated messaging and proactive follow-up.
The CHT IMCI workflow supports the CHW to:
- Identify symptomatic children at the household level
- Guide CHWs through proper IMCI protocol, including immediate health facility referral
- Customize timely and automated reminders for follow-up
- Tasks for monthly screening for all children under 5 years.
- Guided screening to ensure adherence to PIH danger sign screening protocols
- Referral follow up tasks for referred patients
- Dashboards to monitor IMCI related activities and outcomes
- Supportive supervision ratings to identify gaps and mentorship opportunities
- Register all children under 5 years
- Regularly screen all children under 5 years for danger signs
- Refer any suspected cases to a health facility
- Follow up all referred cases to ensure facility attendance and improvement condition
- Timely identification of all suspected danger signs cases in the community.
- All confirmed cases are treated at the facility
- All children on treatment adhere to treatment
Assumptions
- CHWs aware of the screening protocol
- Facilities are sufficiently stocked
- CHWs are equipped with functional phones
- CHWs have community trust and good relationship with community
Reduce child deaths resulting from childhood diseases.
Once a hierarchy of people and places is established, forms are added at different levels. This diagram indicates the forms that can be filled about a person in the app (in this case, family members at the household level), as well as the person/user who will access these forms and make the reports (CHWs at the CHW Area level). Some forms are accessible as actions from the family member’s profile as actions, others from the CHW’s task list as tasks, and some as either.
IMCI workflows are defined to connect form actions and data with people. Detailed documentation for these forms and task schedules are linked from the workflow diagrams below. Accompanying this documentation are tips and insights into the design decisions made along the way, and suggestions for how and where to customize the forms.
