SYNERGY ONLINE: Bulletins and News Briefs from
The Canadian Society for International Health: [log in to unmask]
---------------------------------------------------------------------PAHO
SEEKS CANADIAN PARTNERSHIPS for the Plan for the Regional Implementation of
the Integrated Management of Childhood Illness (IMCI) Strategy in the
Countries of the Region of the Americas, 1997-2000
---------------------------------------------------------------------
* Development Of Materials And Instruments
* Coordination Structures And Operational Plans
* Personnel Training On IMCI & PEPIN
* Monitoring And Evaluation Activities
* Data Base System And Information Dissemination
Working Proposal for the Canadian Cooperation
EXECUTIVE SUMMARY
The implementation of the Integrated Management of Childhood Illness (IMCI)
strategy in the Region of the Americas has become an alternative to improve
childhood health care at the first level of health services and the
community level in order to reach the goals established in the "World
Summit for Children of 1990."
Background
Acute respiratory infections, diarrheal diseases, malnutrition and
intestinal parasites continue to be important health problems that affect
children under five years of age in developing countries. Malaria and
measles, at the same time, equally contribute to the burden of disease and
death for this age group in many of these countries. Together, these
problems are the cause of the majority of deaths that occur annually in
children under five.
The burden that this morbidity represents in the health services requires a
great amount of human and logistic resources that are not always available.
Combining this burden to those previously mentioned, the lack of
standardized criteria for the management of these cases decreases the
quality of care, resulting in an overuse of diagnostic technologies and
medications. This, in turn, increases the cost of health care and exposes
children to potential risks, such as the development of resistant bacteria
from the unnecessary use of antibiotics.
Components
IMCI
Designed as a care strategy to be utilized in basic health services, IMCI
predominantly includes the major causes of illness and death in children in
developing countries (see Annex 1). Systemized through a flow chart of
algorithms, IMCI includes standardized diagnostic and treatment methods
adapted to the needs and norms of each country. The basic objectives of
IMCI include decreasing mortality and morbidity together with improving the
quality of care for children.
Also included in the strategy are health promotion and prevention aspects,
namely counseling for parents, immunization against measles and other
vaccine preventable diseases, the control of risk factors (such as those
related to breastfeeding and adequate nutrition), and the special component
of the Standardized Protocol for the Control of Intestinal Parasitic
Diseases in Children (PEPIN).
PEPIN
The PEPIN component, an integrated IMCI action, is directed towards
children between 2 and 14 years of age within community and health
services. This component consists of making initial diagnosis of intestinal
helminthiasis in selected sentinel sites in accordance with areas of high
prevalence of these infections. The objective is to establish an
epidemiological profile to implement monitoring and the later evaluation
activities of the intervention.
The PEPIN protocol provides massive treatment with a single dose of
mebendazole at least two times a year for three years, at the community
school-based or health services level. Other elements of the protocol are
prevention, which include the improvement of hygiene and environmental
sanitation as well as health promotion, communication and education
activities targeted to the community through parents, teachers and
community leaders.
Purpose and requirements
The extension of IMCI the implementation has been limited to the
institutional level because resource allocation has been restricted.
Inter-country and sub-regional activities are proposed to be financed by
USAID and activities at the institutional level (health services) will be
financed by the Spanish Cooperation Agency. In the PEPIN component, the
Regional IMCI Unit has investigated the feasibility of organizing
activities with non-governmental organizations and private sector
cooperation, particularly in the provision of medications and health
education.
One of the most important stages in the IMCI strategy and the PEPIN
component implementation process is its application at the community health
workers (CHW) and at other community based personnel levels. This issue is
not yet included in our current resource allocation. PAHO does not have
the necessary financial resources to provide assistance at this level nor
the development of instruments to fulfill the three basic IMCI objectives
(decreasing mortality and morbidity together with improving the quality of
care for children).
The present proposal is directed to prioritize the implementation of IMCI
with emphasis on the PEPIN component at the community level and
strengthening the participation of all sectors within the implementation
process.
Methodology
The proposal considers planning and organization of the child health care
in the health facilities as principal project activities. At the community
level, emphasis will be placed on health promotion and education using the
resources and skills of the private sector organizations and
non-governmental organizations.
To accelerate the implementation process, the active participation of
diverse international organizations is being sought and, in particular,
collaboration with Canadian cooperation agencies, through their country
level counterparts and/or other non-governmental organizations financed by
Canadian agencies.
It is envisioned that this participation could be through direct technical
assistance for the organization, planning, and execution of activities at
the regional, national, and district levels, and in specific activities
such as the distribution of materials, health personnel training,
counseling for research, and the provision of supplies for the application
of strategies.
In view of the countries' emerging demand to receive technical and
logistical assistance necessary to implement these strategies, and
officially incorporate them into national maternal and child health
policies, the PAHO Regional IMCI Unit of the Communicable Disease Program
is taking this opportunity to apply interventions to play a significant
social and economic impact on the populations of the countries in the
Region of the Americas
IF YOU ARE INTERESTED IN COLLABORATING IN THIS PROPOSAL, PLEASE CONTACT THE
CANADIAN SOCIETY FOR INTERNATIONAL HEALTH FOR FURTHER INFORMATION:
Canadian Society for International Health
170 Laurier Avenue West, Suite 902, Ottawa, Ontario K1P 5V5
Telephone: 613-230-2654 Ext: 302; Fax: 613-230-8401
E-mail: [log in to unmask]; www: http://www.csih.org
---------------------------------------------------------------------
This document is available, with full formatting and accents, at:
Ce document est disponible, avec les accents et la mise en page a:
http://www.csih.org/syn_indx.html
|
