Department of Pediatrics, School of Medical Sciences & Research, Sharda University, Greater Noida, UP, India.
Indian J Pediatr. 2019 Jul;86(7):622-627. doi: 10.1007/s12098-019-02870-2. Epub 2019 Feb 18.
To meet the sustainable development goals (SDG) target of reducing under-five mortality to 25 per 1000 live births, concerted efforts are required to end all preventable deaths of newborns and children under 5 y of age. There is evidence to support Integrated Management of Neonatal and Childhood Illness (IMNCI) as a cost- effective strategy which can improve child survival. IMNCI has 3 components- capacity building of health workers, health system strengthening and improving community and family practice. For best results, all three components of the IMNCI strategy should be implemented in a coordinated fashion. IMNCI implementation in india has been uneven. The main focus has been on capacity building and with little attention on system strengthening or improving community practices. Ill- sustained funding and poor monitoring and supervision system were additional factors which are major challenges. Since evidence based interventions remain same, IMNCI remains as relevant today as before. It would be appropriate to redesign it as per current needs and implement it with more planning with committed budget and inbuilt measures of quality improvement along with supportive supervision.
为了实现降低每千名活产婴儿五岁以下死亡率至 25 的可持续发展目标（SDG），需要共同努力，杜绝所有可预防的新生儿和五岁以下儿童死亡。有证据表明，新生儿和儿童疾病综合管理（IMNCI）是一种具有成本效益的战略，可以提高儿童的生存率。IMNCI 有 3 个组成部分——卫生工作者的能力建设、加强卫生系统以及改善社区和家庭实践。为了取得最佳效果，应协调实施 IMNCI 战略的所有三个组成部分。印度的 IMNCI 实施情况参差不齐。主要重点一直放在能力建设上，而对加强系统或改善社区实践的关注较少。资金供应不足且监测和监督系统不佳是另外两个主要挑战。由于基于证据的干预措施仍然相同，因此 IMNCI 今天仍然和以前一样相关。根据当前的需求对其进行重新设计，并在承诺的预算和内置质量改进措施以及支持性监督下，更有计划地实施，这是恰当的。
