HANDBOOK IMC Integrated Management of Childhood IIIness & World Health iS.) organization De Adolescent Health unicef &How to adapt the Model IMCI Handbook Note: Do not include this seton inthe adapted IMC Handbook ‘The WHO/UNICEF guidelines for tered Management o Cidhood ness (MCI) offer simple and effective methods to prevent and manage the leading causes of serous illness and mortality in young children. The clinical guidlines promote evidence-based assessment and treatment, wing a syndromic approach that supports the rational effective and affordable use of drugs. The guidelines include methods for checking a child's immunization and nutrition status; teaching parents how to give treatments at home;assessng a chil’ feding and counseling to solve feeding problems; and advising parents about when to return toa heath faclty.The approach is designed for use in outpatent clinical settings with ited diagnostic tools limited medications and limited opportunites to practice complicated clinical procedures Ineach county the IMCl inl guidelines ae adapted 1m To cover the most serious chdhood llhessesypcaly een at first-level heh facts, 1B To make the guidelines consistent with national treatment guidelines and other policies, and [To make the guidelines feasible to Implement through the heath sytem and by familes caring fr their children at home. The MCI charts and related in-service training materials provided by WHO and UNICEF are considered tobe agenerc’ version. This model IMCI handbookis also a generic document. The WHO Department of Child and Adolescent Health and Development (CAH) created tis handbook ‘ohelp teaching institutions incorporate IMCI into academic programmes for doctors, nurses and other heath professionals Before the handbook can be used, however it neds tobe adapted in two ways: 1B Technical Adaptation: All text, chartsand illustrations inthe model handbook should be carefully reviewed and, needed, revised to make them consistent withthe nationally adapted IMcluidetnes. IB Pedagogical Adaptation: The mdel handbook should be modkfed to correspond tothe teaching/learning methods used by a faculty. For example, faculty may choose to revise o re format the handbooks a stand-alone document, oto incorporate the contents ofthe handbook into other materials or textbooks The two step process of adaptation wil ensure that the content ofthe handbooks consistent with a country’ national MCI guidelines, and that its style and format are compatible with 2 faculty's approach to teachingTechnical Adaptation ‘When the IMC strategy was intially introduced in your country, a national task force adapted the generic [IMC guidelines and created inservice training material. The in-service training materials normally include an MCI chartbooket, ICI mother’ card, set ofIMCI training modules, photograph booket, video, and wall charts. The nationally adapted ICI charts and in-service training modules should be teferred to when making technical adaptations to this handbook. countries where the guidelines have bbeen adapted, the IMClin-service training materials canbe requested fom the Ministry of Health aperitif he model HCH handbok are avaiable fram WHO CAB.” ach section ofthe model MIC handbook should be adapted inthe fllowing ways: (Forward. tis recommended to include some information and/or graphs about the main causes of tildhood motbiity and mortality na country and to add some countryspectic information about the need fo, o¢ appropriateness of the IMC| approach, 1S Part IsIntegrated Management of Childhood Ilness(IMCI). This section of the handbook (Chapters 1 through 3) does at require technical adaptation 1H Part I: The Sick Child Age2 Months Up to 5 Years: Assess and Classify. The echnical guidelines In this section of the handbook (Chapters 4 through 13) should agre with those in the nationally adapted INC raining module called Asses ond Gass te Sek Chid Age 2 Monts Upto 5 Yes. Like the ‘module Part Ilo the handbook describes the types and combinations of dinical signs used to assess ‘main symptoms of common childhood illnesses, and provides action-oriented dasifiations foreach ‘main symptom. Wen adapting the IMCI clinical guideline, iis ily thatthe national IMCI tak force ‘modified the assessment process andthe classifications fr certain main symptoms. Some changes villtherefore be needed in the handbook to make al main symptoms, clinical sign and cassifca- tions consistent with those inthe national IMI charts and training modules. The chapter inthe hhandbook on Fever (Chapter 9) may requite particular revisions, because common illnesses associated with fever tend tobe country specificn adltion to revising the tet, pieces ofthe national MCL charts shouldbe inserted onthe pages indicated in the model handbook. The format ofthe case recording frm used inthe examples alo shouldbe revised to match the national MCI ecording form. 1B Part Il The Sick Young Infant Age 1 Week Up to 2 Months: Assess and Classify. The technical infomation in this ection Chapter 14 through 15 should agree with Chapter 1, Assess and Classify the SickYoung Infant, inthe national IMC module titled Management ofthe Sick Young infant Age T Week Upto 2Months. This ection will requie adaptations very sir to Pat In order to ensure that all main symptoms, nical signs and classifications are consistent with the national IMC charts and training modules. The format ofthe case recording form used in the examples shouldbe revised to ‘match the national receding frm for young infant. [H Part IV: Identify Treatment. the technical guidelines inthis section (Chapters 16 through 18) should agree with those Inthe nationally adapted MII module called det Treatment, AND to CChapter2, Identify Appropriate Teatment,In the madul called Management the SickYoumg nan ge 1 * Wor ath Orgznzatn esate of CMa Mbt Heath rd Deepen (AML Aue Ap 20,121 Gene.