The Union Health Ministry's integrated management of neo-natal and childhood illness (IMNCI) strategy, part of the central government's ambitious National Rural Health Mission (NRHM), is getting momentum in the country with several states implementing the strategy successfully.
According to senior officials in the Union Health Ministry, several states including Uttar Pradesh, Tamil Nadu, Maharashtra, Rajasthan, Bihar, Madhya Pradesh, Karnataka and Orissa are implementing the IMNCI strategy as part of the reproductive and child health (RCH) phase-II under the NRHM.
IMNCI has an inbuilt component of care at home for the newborn where the trained health care provider is expected to visit the newborn on the first, third and seventh day after the birth and make an additional three visits for the low birth weight baby on the 14th, 21st and the 28th day. Under IMNCI, ANMs and Anganwadi workers are trained to identify danger signs of a sick newborn child, provide management at home and timely referral to the health care facilities.
Uttar Pradesh runs a comprehensive child survival project where the IMNCI training module has been expanded to include birth preparedness and essential care at birth. Some other states like Maharashtra, Rajasthan, Bihar, Madhya Pradesh Karnataka and Orissa are implementing home based newborn care (HBNBC) in a few districts.
Tamil Nadu is implementing the HBNBC as part of the IMNCI strategy. The Institute of Child Health Centre, which is the state nodal centre for IMNCI, has developed a HBNBC training module in the Tamil language and piloted it in 40 health sub-centres (4 HSCs each in 10 IMNCI phase -I districts) in the year 2009 by the six regional training institutes. An evaluation of the pilot HBNBC training was conducted by the state trainers in July--Aug 2009 and outcome reported in Nov-2009.
Incorporating the recommendations of the evaluation study, the HBNBC training has been upscaled and 27354 personnel have been trained till March-2010. The trained personnel include field health & nutrition workers, self help group members and village health volunteers. The training programme has been expanded, through the district and block training teams to cover all the districts by July -2010.'
The district IMNCI training nodal officers and the IMNCI mentors monitor the quality of the HBNBC training programme and supervise the implementation of the entire IMNCI programme at grass root level.