Nurses Practicing Integrated Management of
Childhood Illness (IMCI) in Fiji
Litia Ruban, Fiji
21st November, 2012
Presentation Outline
1.
2.
3.
4.
Objectives of IMCI
Introduction
Implementation of IMCI
Component
Way Forward
Integrated Management of Childhood
Illness (IMCI) Objectives
 To
reduce significantly global mortality
and morbidity with the major causes of
disease in children through an
integrated approach.
 To
contribute to healthy growth and
development of children
Introduction
As according to UNICEF Child Mortality Report 2011, the global
under-five mortality rate since 1990
has dropped 35 percent—from
88 deaths per 1,000 live births in 1990
to 57 in 2010.
The rate of decline in under-five mortality has accelerated—
from 1.9 percent a year over 1990–2000 to 2.5 percent a year
over 2000–2010—but remains insufficient to reach MDG 4,
particularly in Sub- Saharan Africa, Oceania, Caucasus and
Central Asia, and Southern Asia.
Only three years remain to achieve Millennium Development Goal 4
(MDG 4), which calls for reducing the under-five mortality rate by
two thirds between 1990 and 2015
•
Introduction
Where is Fiji NOW on the Road “To reduce Child Mortality and
Morbidity by 2/3 in the Year 2015”?
Fiji’s Level and Trends of Child Mortality for the Last 20
years
Under five
mortality
rate(deaths per
1000 live births)

Millennium
Development
Goal target for
2015
Average rate of
reduction
(percent)
Number of
under five
deaths
(thousands)
Infant mortality
rate (deaths
per 1000 live
births)
Number of
infants deaths
(thousands)
Neonatal
mortality rate
(deaths per
1000 live
births)
Number of
neonatal
deaths
(thousands)
1990
2010
2015
1990 -2010
1990
2010
1990
2010
1990
2010
1990
2010
1990
2010
30
17
10
2.8
1
0
25
15
0
0
12
8
0
0
Source: Levels and Trends of Child Mortality, Report 2011, Estimates Developed by the UN Inter
Agency Group for Child Mortality Estimation (IGME)
Introduction
Comparing Fiji’s levels and trends of CMR to other Pacific Islands
Country
Under five
mortality
rate(deaths
per 1000 live
births)
Millennium
Development
Goal target
for 2015
Average rate
of reduction
(percent)
Number of
under five
deaths
(thousands)
Infant
mortality rate
(deaths per
1000 live
births)
Number of
infants
deaths
(thousands)
Neonatal
mortality rate
(deaths per
1000 live
births)
Number of
neonatal
deaths
(thousands)
1990
2010
2015
1990 -2010
1990
2010
1990
2010
1990
2010
1990
2010
1990
2010
Fiji
Australia
Cook Islands
Marshall
Islands
30
9
20
51
17
5
9
26
10
3
7
17
2.8
2.9
4
3.4
1
2
0
0
0
1
0
0
25
8
17
40
15
4
8
22
0
2
0
0
0
1
0
0
12
5
9
19
8
3
5
12
0
1
0
0
0
1
0
0
Papua New
Guinea
90
61
30
1.9
12
12
65
47
9
10
30
23
4
5
Samoa
Solomon
Tonga
Tuvalu
Vanuatu
New Zealand
27
45
25
57
39
11
20
27
16
33
14
6
9
15
8
19
13
4
1.5
2.6
2.2
2.7
5.1
3.0
0
1
0
0
0
1
0
0
0
0
0
0
23
36
21
44
31
9
17
23
13
27
12
5
0
0
0
0
0
1
0
0
0
0
0
0
10
18
11
22
16
4
8
12
8
14
7
3
0
0
0
0
0
0
0
0
0
0
0
0
•
Source: Levels and Trends of Child Mortality, Report 2011, Estimates
Developed by the UN Inter Agency Group for Child Mortality Estimation
Introduction
In terms of Child Morbidity
.
What has Fiji done on the Road “To reduce
Child Mortality and Morbidity by 2/3 in the
Year 2015”?
WHO and UNICEF launched
IMCI strategy in the mid – 1990s
to reduce deaths from diarrhea,
pneumonia, malaria, measles and
malnutrition in children younger
than 5 years
The Ministry of Health, Fiji
works in collaboration with
WHO/UNICEF to strengthen the
implementation of Integrated
Management of Childhood Illness
(IMCI).
Fiji Implementing IMCI Component
1. Improving case management skills of
health workers
- standard guidelines – upgrading case
management & counselling skills
-training (pre-service and in-service)
- follow-up after training
2. Improving the health system to deliver
IMCI
- essential drug supply and management
- organization of work in health facilities
- management and supervision
3. Improving family and community
practices
Implementing IMCI Components
 Improving
case management skills of
health workers (mainly nurses)
IMCI Training in Fiji




National and outreach training done are mainly
for the registered nurses while few were doctors
and sisters. More than 1000 nurses had been
trained from then till to date.
2003, the IMCI component was in cooperated
into the nursing curriculum during the curriculum
review
First pre service class to take this up was in 2004
and they graduated in 2007
April,2009 ICAAT training was conducted to
both pre services/post services at Fiji School of
Nursing.
Total trained per Year in the
Preservice Level……
GRAD/YEARS
FIJI
OTHER PACIFIC TOTAL
ISLANDS
2007
171
3
174
2009
84
10
94
2010
97
5
102
2011
109
2
111
2012
110
5
115
2013
147
3
150
TOTAL
718
28
746
Total trained per Year in the Post
Service Level……
PROGRAM
2009
Fiji
Adv.Dip.Npract.
10
PGDip.Midwifery
2010
OPac
Fiji
OPac
Fiji
OPac
Fiji
10
5
60
45
50
T
O
T
OPac
15
15
Bach.PHNur
TOTAL
2012
10
PGCert.Mental
Health Nur
Post Basic PH
2011
25
70
70
19
5
74
5
2
2
IMCI Components
 Improving
the health system to
deliver IMCI
IMCI SET UP IN CLINICAL AREAS
 ------------
IMCI Components
 Improving
practices
family and community
Limitations
 Inadequate
 Lack
resources
of Management, Coordination
andSupervisory Systems
 Lack of analysis on child health data.
From now
2015
PHC Strengthening &
revitalization
Child Health- IMCI
CHILD SURVIVAL
Maternal and
Neonatal
HealthCare
Strengthening Health
Information System
Vinaka Vakalevu