Bestandsaufnahme der Umsetzung der Strategie für ein integriertes Management von Kinderkrankheiten (IMCI) in der Europäischen Region (2018)

REVIEW OF INTEGRATED

MANAGEMENT OF CHILDHOOD ILLNESS (IMCI) IN EUROPE

By: Susanne Carai

Aigul Kuttumuratova

Martin Weber

CONTENTS ... iii

Acknowledgements ... iv

Study team ... iv

Report-writing team ... iv

Acronyms... v

Executive summary ... vi

Background ... vi

Objectives ... vi

Methodology ... vi

Findings ... vii

Conclusion and way forward ... x

Review of Integrated Management of Childhood Illness (IMCI) in Europe ... 1

Background ... 1

Objectives ... 2

Methodology ... 2

Findings ... 4

Taking a closer look: IMCI and the use of antibiotics ... 18

Proposed improvements of IMCI ... 20

Discussion ... 20

Further reflection on review findings: children’s rights ... 23

Conclusion... 25

References ... 27

Annex 1. Integrated Management of Childhood Illness (IMCI) impact model ... 28

Annex 2. Vignettes from selected countries ... 29

Albania – IMCI review ... 29

Armenia – IMCI review ... 33

Azerbaijan – IMCI review ... 38

Georgia – IMCI review ... 43

Kazakhstan – IMCI review ... 46

Kyrgyzstan – IMCI review ... 51

The Republic of Moldova – IMCI review ... 55

The Russian Federation – IMCI review ... 59

Tajikistan – IMCI review ... 63

Turkey – IMCI review ... 66

Ukraine – IMCI review ... 69

Uzbekistan – IMCI review ... 73

Annex 3. Vignettes from selected areas………86 Kosovo (in accordance with United nations Security Council Resolution 1244 (1999)) - IMCI review

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Table 2 (contd)

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Cough Diarrhoea Fever Young infant Counselling, health promotion Nurse without right to

prescribe IMCI minus

Assess, refer fast breathing

Assess, manage watery diarrhoea

Assess and refer Assess and refer, counsel feeding problems

Breast feeding, nutrition, danger signs, when to seek care, care for development Nurse with right to

prescribe/ feldsher IMCI

Treat pneumonia Treat dysentery, treat severe dehydration Family doctor, general

practitioner IMCI plus

Assess child with fever, viral illness, UTI, ear infection, sore throat, urine dip sticks

Paediatrician Differential diagnosis pneumonia, bronchiolitis, asthma

Differential diagnosis persistent diarrhoea, diarrhoea and malnutrition

Differential diagnosis, possible sepsis

Diagnosis of developmental delay, failure to thrive Hospital

Viral tests, x-ray, CRP Viral tests, CRP

Observation &

management of possible sepsis, jaundice, LBW

Lab tests, further diagnostic tests

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IMCI

Introduction/Planning

Training of health workers/follow up visits Improved drug

availability, supervision, other health system

improvements

ITNs,* other family and community interventions

Improved quality of care in

health facilities

Improved careseeking, increased utilization Improved household

compliance/care

Improved health/nutrition

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7

World Health Organization Regional Office for Europe

UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel: +45 45 33 70 00 Fax: +45 45 33 70 01

Email: eucontact@who.int Website: www.euro.who.int

Office for Europe

The World Health Organization (WHO) is a specialized agency of the United Nations created in 1948 with the primary responsibility for international health matters and public health. The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves.

Member States Albania

Andorra Armenia Austria Azerbaijan Belarus Belgium

Bosnia and Herzegovina Bulgaria

Croatia Cyprus Czechia Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal

Republic of Moldova Romania

Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan

The former Yugoslav Republic of Macedonia Turkey

Turkmenistan Ukraine United Kingdom Uzbekistan