KARACHI, May 26: A decline has been registered in the childhood mortality rate among children under five from 135 to 101 per 1,000, and 76 per 1,000 among those below one year of age. Yet, these continue to be significantly poor health care indicators with reference to most parts of the world.

Experts on Thursday said the situation called for an urgency to formulate efficient mechanism for appropriate implementation of the IMCI strategy at varied levels across the country. They were speaking at the Integrated Management of Childhood Illness (IMCI) pre-workshop planning meeting of health care managers from five towns of Karachi.

Health managers from Gadap, Malir, Orangi, Saddar, and Gulshan-i-Iqbal towns attempted to formulate a strategy, and finalise a list of participants, who would work later as facilitators for proposed master trainer workshops. It may be mentioned that the IMCI is a combined WHO-UNICEF approved strategy for reduction of childhood mortality in Pakistan. The very strategy has already been successfully implemented in 95 developing countries.

They also reviewed implementation strategy in health facilities and monitoring of the project. The head of the Paediatrics Department, DUHS/CHK and Provincial Coordinator for IMCI - Sindh, Prof Iqbal Memon, on the occasion said that the IMCI held extreme relevance in context of Pakistan.

Elaborating his stance, he said paediatrics was not a separate and major examination subject under the MBBS programme taught at medical institutes throughout the country, with the exception of University of Karachi. Prof Iqbal said it was noticed that doctors generally were unaware of the body dynamics of children, adding that it may not be rare to notice that many physicians could still not be conscious of the importance of vaccination and immunisation against many preventable diseases.

Therefore, he said the IMCI strategy was essential since it focussed on prevention through coordination and mutual confidence on the part of health care providers, mothers, public representatives and policy makers.

He also highlighted the significance of follow-up prerequisite to ensure facility utilisation right from first-level health care facility to tertiary care hospitals. Dr Qazi Mujtaba Kamal referred to a similar strategy of a six-day training programme for lady health visitors with much higher and direct accessibility to mothers.

He also mentioned that IMCI pilot projects had been undertaken in Nawabshah and other selected cities of the country. Dr Asif Aslam of UNICEF while mentioning that the reported decline in mortality and morbidity rates among local kids was based on estimates also said that 50 per cent of infant mortality occurred among neonates.

Unfortunately neonatal mortality had not reduced in the same proportion as witnessed in children under five, he said, adding that it was why the government of Pakistan, WHO and UNICEF had embarked upon the IMCI strategy. — APP