Pre-service component of Integrated Management of Childhood Illness in Nepal

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Pre-service component of Integrated Management of
Childhood Illness in Nepal

• Prof. Pushpa Raj Sharma
• Focal Person

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IMCI Pre-service Achievements

• 1995 IMCI introduced in the country.
• 1998 IMCI review/planning meeting.
• IOM identified as a place to introduce IMCI as
  Pre-service training.
• Focal person identified.

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A meeting was held in the faculty to introduce
the IMCI in the paediatric teaching and faculty
accepted to introduce IMCI to 17th batch of
students ,1998.
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IMCI Pre-service training in IoM

•  Achievements
• Country review meeting of IMCI in 1998 ?
  recommendation to explore for options to
  include IMCI in the pre-service training, then
  IoM was identified as a possible site to
  introduce the IMCI pre-service training,
• A meeting of paediatric faculty members and
  representatives of SEARO and HQ/Geneva, a focal
  person was identified in 1998.

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Two days workshop was held in the Institute as a
no-cost basis to brief the IMCI strategy to the
faculty member 9-10 December 1998 A meeting
was held in the faculty to introduce the IMCI in
the paediatric teaching and faculty accepted to
introduce IMCI to 17th batch of students
,1998. Two Faculty members trained in the Inter
Country Course on IMCI 2000
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9 Days Teachers Training on IMCI for Nursing
Campuses of IOM and Community Medicine of the
Maharajgunj Campus of the IOM. Organized by the
Department of Child Health 2001 IMCI introduced
in the Nursing Curriculum. In August , 2003 all
house officers, PG residents and one faculty
member trained in 11 days course of IMCI
Organized by the Department of Child Health, IOM.
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Paediatric teaching

• At the 2nd phase (third year) and in the 3rd
  phase (fourth year) at the Department of Child
  Health. The teaching faculty consists of 3
  professors, 1 associate professor and 2 lecturers
• Teaching / learning activities
• 3rd year
• Class room teaching three days a week to develop
  the cognitive skill.
• Clinical teaching done as a bedside clinical
  teaching where they develop psychomotor skills,
  problem based learning
• Students come in the group of 15 for three months

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Paediatric teaching
4th year Junior intern along with the
Postgraduate residents and house
officers. Bedside procedures, emergencies,
inpatients and outpatients, seminars and clinical
discussions. Supervised by consultants, bedside
clinical procedures, assists postgraduate
residents in emergencies, inpatient ward and give
treatments from the outpatient dpt. -5th year
(Senior internship) Time allocated for theory
105 hours, practical 347 hours
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IMCI IN OPD with prior readings from module
Morning Case Discussion
Classroom Introduction emphasizing signs used for
IMCI and its scientific basis

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Teaching/Learning Materials 

• Achievements
• Adopted generic version, Develop by the
  Department 
• Theory classes
• Slides of ARI and Readings on Diarrhoea
  developed by the WHO, Transparencies of the
  standard IMCI course, Handbook of paediatric
  problems published by HLMC, Generic IMCI
  handbook with adaptation, IMCI Teachers guide
  for theory classes, IMCI chart booklet used in
  standard IMCI course.
• OPD sessions
• Chart booklet, Picture book of standard IMCI
  course, Enlargement of charts, Video of standard
  IMCI course, Case recording forms of IMCI
  standard course, Teachers guide for OPD
  sessions
• Problem solving seminar
• - Case histories of the standard 11 days
  course.
• Assessments
• Generic MCQ with adaptation. Generic observation
  checklist with adaptation.
•    

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Assessment of students

• The students scores were as follows a.
  Psychomotor Skill Range of Score ( of Golden
  standard) Assessment 80 -100
  Classification 90 -100 Identify
  treatment 90 -100. b. Cognitive skill
  Total score Range of Score  Case management
  process 8 5 - 7 Assessment 28 22 - 28 Feeding
  problems 6 5 - 6 Treatment 8 6 -
  8 Counseling 6 6 - 8 Follow-up 8 7 - 8
  

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IMCI Pre-service Achievements

• First IMCI pre-service meeting 8-9 March, 2001
• 11 Days training 17-27th Sept. 2001
• 5 days training 8-12 October 2001
• First Follow-up of IMCI teaching in the different
  medical colleges April 2003.

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IMCI Pre-service Achievements

• IOM introduces IMCI in Nursing Campuses 2002
• Training of teachers of Paramedical schools 2002
• Publication of the IMCI Students Module in
  Nepali 2002
• Agreement on introducing IMCI in CTEVT
• 2003.

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IMCI Pre-service Achievements

• IMCI pre-service workshop in BPKIHS, Dharan 2002
• IMCI incorporated in the Undergraduate teaching
  in BPKIHS
• Follow-up of IMCI pre-service undergraduate
  teaching in different medical colleges of the
  country
• -28th August, 2003.

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• Challenges
• Still it needs to be introduced in the curriculum
  of Kathmandu university
• One of the main difficulty is the continuous
  supply of the IMCI handbook, case recording forms
  and assessment tools. The department does not
  have enough funds to supply freely to the
  students.  

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Thank you

• If you want to share other information with
  pediatricians please use www.prsharma.com.np