IMCI Newsletter IMCI Newsletter IMCI Newsletter IMCI Newsletter Performance Report for January to December 2011 Performance Report for January to December 2011 Issue 4 | March 2013 Management Information System (MIS) Directorate General of Health Services (DGHS) Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]Management Information System (MIS) Directorate General of Health Services (DGHS) Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]Management Information System (MIS) Directorate General of Health Services (DGHS) Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]Contents Messages and Editorial P.02 Introduction P.03 Data and Method P.04 Limitation of the data P.05 Results P.05 Conclusion P.16 Annexure P.16
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IMCI NewsletterIMCI NewsletterIMCI NewsletterIMCI NewsletterPerformance Report for January to December 2011Performance Report for January to December 2011
Issue 4 | March 2013
Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]
Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]
Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]
Contents
Messages and Editorial P.02
Introduction P.03
Data and Method P.04
Limitation of the data P.05
Results P.05
Conclusion P.16
Annexure P.16
Director General Directorate General of Health Services
Mohakhali, Dhaka
Our country made a significant progress in child
mortality reduction and received the UN MDG Award
for its success in MDG4. IMCI program is playing the
vital role to sustain and improve universal child
immunization.
It is indeed a great pleasure for me to know that MIS
of DGHS is going to publish the 4th issue of IMCI
Newsletter. This newsletter is a very useful
publication as it enables us to get facility based
graphical data on childhood illness of the whole
country in a concised and understandable way.
I hope that this newsletter will give some
programmatic direction to policy-makers and program
managers and to understand the current situation to
undertake interventions for the future about the IMCI
services in Bangladesh. Finally, I would like to thank
everyone who worked hard directly and behind the
screen for publishing this newsletter successfully.
Professor Dr. Khondhaker Md. Shefyetullah
Additional Director General(Planning and Development)
& Line Director,Management Information System (MIS)Directorate General of Health Services
Mohakhali, Dhaka
Our country has made a remarkable progress in
improving the health of children. In fact, as per
recent estimate, we already achieved MDG4. The
recognition to Bangladesh's success in improving
child health came much earlier through the UN
MDG4 Award in 2010.
It is my great pleasure that the 4th issue of the
IMCI newsletter is going to be published from the
Department of MIS-Health of DGHS. The contents
of this newsletter will not only include the result of
the performance assessment of IMCI services in
facilities but will also encompass other areas of
child and neonatal health, including community
IMCI. The team associated with this newsletter
made very sincere efforts to improve the quality of
the contents than those of the previous issues. An
attempt was made to analyze the data received
during the reporting period to understand the care-
seeking and morbidity pattern of the sick under-
five children attending the IMCI-designated
facilities. I like to thank the entire team of IMCI
section for their sincere support and cooperation in
publishing this newsletter. I also wish to
congratulate the entire team of MIS-Health whose
relentless work and efforts have made this
possible. I also convey my thanks to all the
managers, doctors, paramedics, and other service
providers and staffs who helped in various ways
and thus enabled us to publish this newsletter.
I express my gratefulness to the Director General of
Health Services and Director, PHC, for their continuous
support and advice in accomplishing our tasks. I
extend my special thanks to UNICEF for their
cooperation as well as technical and financial support
in publishing this newsletter. I congratulate the editorial
board for their success in reviewing the contents of this
newsletter despite various constraints. The attempt will
be successful if we can use the information for the
betterment of our children who deserve quality and
equitable health services.
Professor Dr. Abul Kalam Azad
Director, Primary Health Care& Line Director, Maternal, Neonatal, Child
and Adolescent Health (MNC&AH)Directorate General of Health Services
Mohakhali, Dhaka
I am happy to know that the Management Information
System (MIS) of the Directorate General of Health
Services (DGHS) is going to publish the 4th issue of IMCI
Newsletter. This publication has now become a necessary
source of information containing statistics on child health
aspects of the health sector.
I congratulate the MIS-Health and IMCI program as well
as the health managers and service providers at different
levels for their reporting from the IMCI facilities for
publication of the newsletter. I would like to give thanks to
our development partners, specially UNICEF, UNFPA and
WHO for their financial and technical support for this
important task in the child health sector.
I expect that the IMCI Newsletter will be helpful for all
concerned and the Newsletter will be published regularly.
Dr. Syed Abu Jafar Md. Musa
Message
Editorial NoteMessage
02
IntroductionMortality in children younger than 5 years (under-5 mortality) remains high in Bangladesh at 57 in 1000 live-births, despite declines over the past decade. Pneumonia, diarrhoea, malnutrition, and measles account for more than half (52%) of these deaths. Integrated Management of Childhood Illness (IMCI) is a strategy developed and promoted by WHO and UNICEF for reducing childhood morbidity and mortality and promoting healthy growth and development. In 1998, the Government of Bangladesh adopted Integrated Management of Childhood Illness (IMCI) strategy to reduce these deaths and improve child health and development. The IMCI strategy through HPNSDP was designed to include coordinated activities within two objectives: (1) to reduce morbidity and mortality associated with the major causes of diseases in under five children through quality case management, and (2) too promote healthy growth and development by preventing diseases and promoting healthy practices through counseling the mother and caretakers.
Newborn HealthReducing Neonatal mortality and ensure health of the newborn is one the main target of IMCI section. National Neonatal Strategy & Guidelines has developed and Standard Operation Protocol (SOP) has formulated. Implementation of Neonatal Action Plan has started. Twelve Special Care Newborn Unit (SCANU) in the District Hospitals and Medical Colleges are functioning. A total of 41 SCANU will be established by 2015.
IMCI has 3 (three) components1. Improving case management skills of health workers2. Improving the health system3. Improving family and community practices
A large number of childhood morbidity and mortality (every year around 10 million children die before they reach their fifth birthdays) in the developing countries is caused by five conditions: acute respiratory infections (mostly pneumonia), diarrhoea, measles, malaria, or malnutrition. The Integrated Management of Childhood Illness (IMCI) strategy encompasses a range of interventions to prevent and manage this major childhood illness, both in health facilities and in the home. . In spite of various disease-specific control programs in operation, there has not been significant reduction in childhood morbidity and mortality. In response to this challenge, WHO/UNICEF proposed a comprehensive single efficient and effective approach to manage childhood illnesses, i.e. Integrated Management of Childhood Illness (IMCI).
After adaptation of WHO generic modules Bangladesh had piloted the IMCI strategy in 3 Upazilas (Matlab, Chandpur, Dhamrai, Dhaka and Kahaloo, Bogra) in the year 2002. After completion of pilot activities in December 2002 a joint National-International Experts Review of early implementation phase was held in February 2003. Based on the recommendations of the review, Bangladesh has started expansion of IMCI. Facility IMCI has expanded in 410 Upazilas up to December 2012. Ten training centers for IMCI have been established where the Clinical Management Training (11-days CMT) is ongoing for all types of service providers (doctors, nurses, paramedics) from selected upazilas. We have also started the process of developing and introducing community-IMCI. A national strategy paper on community IMCI has been prepared to provide directions and guidelines on the introduction, adaptation and implementation of C-IMCI. C-IMCI has expanded in 150 upazilas.
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IMCI protocol has incorporated in under graduate medical curriculum. All the Government Medical Colleges and most of the Private medical colleges are following the protocol. Initiative has taken to incorporate this protocol in Nursing Institute and Medical Assistant Training Schools (MATS) curriculum.
During the HPNSDP (2011-2016) implementing period, the main activities regarding IMCI program will be: strengthening the delivery of neonatal and child health services through facility-based IMCI; expanding facility-IMCI for out-patient sick child services; achieving saturation to cover 482 upazilas, 59 District Hospitals (DH) and 19 Medical College Hospitals (MCH) in 64 districts with adequate quality IMCI services; strengthening referral care (including Emergency Triage Assessment and Treatment) for sick under-five children in all UHCs/DHs; ensuring growth promotion with counseling on appropriate feeding practices, including exclusive breastfeeding and combining monitoring and supervision of IMCI and EPI at the facility and community levels.
Data and MethodThe childhood diseases covered by IMCI program in Bangladesh have been classified into 10 broad categories, viz. (i) very severe disease, (ii) pneumonia, (iii) no pneumonia-cough and cold, (iv) diarrhea, (v) fever-malaria, (vi) fever-no malaria, (vii) measles, (viii) ear problem, (ix) malnutrition, and (x) others. IMCI is provided through facility-based treatment as well as through home-care. The latter is called Community IMCI Program. Currently facility-based IMCI is being delivered (in 410 upazilas) from 50 districts. Community-based IMCI is running in 150 upazilas. UNICEF and WHO jointly provide technical and financial assistance to the Ministry of Health and Family
Welfare for implementing the IMCI program. Various other development partners and NGOs also collaborate with the Government.
The Management Information System (MIS) of the Directorate General of Health Services (DGHS) tries to capture the data from IMCI services provided in different IMCI facilities. Recently, a web-based software (District Health Information System [DHIS]) has been developed by MIS, DGHS, with the help of GIZ to collect IMCI service data from different levels of designated IMCI facilities. All the IMCI-designated facilities are to send IMCI performance report to the MIS of DGHS every month for compilation, analysis, monitoring, and tracking of the progress of the program and dissemination. Community IMCI program has been implemented by NGOs and monitored by DGHS. The IMCI program districts are listed below: Barisal division: Barisal, Bhola and Patuakhali; Chittagong division: Brahmanbaria, Bandarban, Chandpur, Chittagong, Comilla, Cox's Bazar, Khagrachhari, Laxmipur, and Rangamati; Dhaka division: Dhaka, Gazipur, Gopalganj, Jamalpur, Kishoreganj, Madaripur, Mymensingh, Narsingdi, Netrokona, Shariatpur, Sherpur, and Tangail; Khulna division: Bagherhat, Chuadanga, Jessore, Narail, Khulna, and Shatkhira; Rajshahi division: Bogra, Chapainawabganj, Naogaon, Natore, Joypurhat, Pabna, Rajshahi, and Sirajganj; Rangpur division: Dinajpur, Ghaibandha, Kurigram, Lalmonirhat, Nilphamari, Panchgarh, Rangpur, and Thakurgaon; and Sylhet division: Hobiganj, Maulvibazar, Sunamganj, and Sylhet. In 2011, data were collected from the 50 IMCI program districts because these 50 districts were fully functional during the reporting period. The rest of the districts were included at the mid or last part of the year 2011. All reports covered 2,560,909 children "out-
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patient and emergency disease-encounters" (a child may have multiple illnesses). An attempt has been made to analyze data on these children to understand their morbidity pattern. In this newsletter, results of analysis of the data received from facilities have been presented.
Limitations of the DataThis newsletter is based on the monthly IMCI reports received by MIS-Health from the IMCI upazilas. The morbidity status of the children was analyzed; the cases were assessed as per the IMCI protocol. This newsletter captures data only on the children who attended the IMCI facilities. A number of children visit private doctors, some take help from traditional healers, or some even do not take any treatment. Those children were not included in the report.
ResultsA. Coverage of IMCI FacilitiesOut of 482 upazilas, 405 were covered as IMCI upazila up to December 2011. Among the covered upazilas, all of Rajshahi, Rangpur and Sylhet divisions were included. The lowest coverage (60.0%) were in Barisal division (Table 1).
Table 1. Distribution of IMCI upazilas in seven
divisions
05
Division
Total
no. of
districts
Total
no. of
upazilas
Total no. of
received
data from
IMCI
districts
Total no. of
received
data from
IMCI
upazilas
% of
upazila
data
coverage
Barisal 6 40 3 24 60.0
Chittagong 11 99 9 84 84.8
Dhaka 17 122 12 90 73.8
Khulna 10 59 6 45 76.3
Rajshahi 8 66 8 66 100.0
Rangpur 8 58 8 58 100.0
Sylhet 4 38 4 38 100.0
Total 64 482 50 405 84.0
Table 2. Distribution of IMCI patients and disease patterns in 2011 in Bangladesh
Sl.
no. Diseases/Medical Condition
0-28
day(s)
29-59
days
2-12
months 1-5 year(s) Total
% of
total
patients
A.1 Male 29097 55440 367573 732261 1184371 50.7
A.2 Female 29156 54111 351478 718878 1153623 49.3
A Total (A1+A2) 58253 109551 719051 1451139 2337994 100.0
B.1 Very severe disease 9609 15713 15394 15299 56015 2.4
B.2 Pneumonia 0 0 85488 118988 204476 8.7
B.3 No pneumonia-cough and cold 0 0 280830 506152 786982 33.7
B Total (B1-B10) 44019 91167 828823 1596900 2560909 109.5
C Refer 4849 7358 14557 20408 47172 2.0
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B. IMCI diseases by age-groupsThe distribution of the IMCI diseases among the children aged below 5 years by age-groups, viz. 0-28 day(s), 29-59 day(s), 2-12 month(s) and 1-5 year(s) has been shown in Figure 1. The data were received from IMCI facilities in 50 districts in 2011. It is seen that children from 1 to 5 year(s) age-group constituted the largest IMCI service recipients (62.1%), followed by 2 to 12 months age-group (30.8%). Of the total under-five children, 2.5% were at the neonatal age. Age-group 29 to 59 days comprised 4.7% of the total children receiving services from the IMCI facilities.
Figure 1. Distribution of children with IMCI
diseases by age-group in Bangladesh 2011
(N=2,337,994)
Figure 2. Percent distribution of male children
with IMCI diseases by age-group in Bangladesh
2011 (n=1,184,371)
Figure 3. Percent distribution of female
children with IMCI diseases by age-group in
Bangladesh 2011 (n=1,153,623)
Figure 4. Percent distribution of children with
very severe diseases by age-group (n=56,015;
2.4% of total)
Figure 5. Percent distribution of children with
pneumonia by age-group (n=204,476; 8.7% of
total)
06
0-28 day(s),
n=58253,
2.5%29-59 days,
n=109551,
4.7%
2-12 months,
n=719051,
30.8%1-5 years,
n=1451139,
62.1%
0-28 day(s),
n=29097,
2.5%
29-59 days,
n=55440,
4.7%
2-12 months,
n=367573,
31.0%1 - 5 years,
n=732261,
61.8%
0-28 day(s),
n=29156,
2.5%
29-59 days,
n=54111,
4.7%
2-12 months,
n=351478,
30.5%1-5 years,
n=718878,
62.3%
0-28 day(s),
n=9609,
17.2%
29-59 days,
n=15713,
28.1%2-12 months,
n=15394,
27.5%
1-5 year(s),
n=15299,
27.3%
2-12 months,
n=85488,
41.8%
1-5 year(s),
n=118988,
58.2%
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Figure 6. Percent distribution of children with
'no pneumonia-cough and cold' by age-group
(n=786,982; 33.7% of total)
Figure 7. Percent distribution of children with
'diarrhea' by age-group (n=348,680; 14.9% of
total)
Figure 8. Percent distribution of children with
'fever-malaria' by age-group (n=6,894; 0.3% of
total)
Figure 9. Percent distribution of children with
'fever-no malaria' by age-group (n=476,532;
20.4% of total)
Figure 10. Percent distribution of children with
'measles' by age-group (n=3,264; 0.1% of
total)
Figure 11. Percent distribution of children with
'ear problem' by age-group (n=108,890; 4.7%
of total)
07
2-12 months,
n=280830,
35.7%
1-5 year(s),
n=506152,
64.3%
0-28 day(s),
n=6109,
1.8%
29-59 days,
n=18640,
5.3%
2-12 months,
n=110946 ,
31.8%
1-5 year(s),
n=212985 ,
61.1%
2-12 months,
n=2107,
30.6%
1-5 year(s),
n=4787,
69.4%
2-12 months,
n=156785 ,
32.9%
1-5 year(s),
n=319747 ,
67.1%
0-28 day(s),
n=201 ,
6.2%29-59 days,
n=407,
12.5%
2-12 months,
n=1059,
32.4%
1-5 year(s),
n=1597,
48.9%
0-28 day(s),
n=2835,
2.6%29-59 days,
n=7916,
7.3%
2-12 months,
n=31740,
29.1%1-5 year(s),
n=66399,
61.0%
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Figure 12. Percent distribution of children with
'malnutrition' by age-group (n=112,813; 4.8%
of total)
Figure 13. Percent distribution of children with
'others illness' by age-group (n=456,363; 19.5%
of total)
Figure 14. Percent distribution of 'referred
children' by age-group (n=47,172; 2.0% of
total)
Figure 4 to 14 show the distribution of the IMCI diseases among children aged 0 day to 5 years. It is seen that the number and percentage of patients increased with age in case of each disease. Caution is needed to interpret this situation. This trend should be related to more attendance of the older children in the IMCI facilities than the younger ones.
Table 2 presents the distribution of the IMCI diseases within each age-group. Among the total children, the problem of respiratory tract was the leading cause of morbidity (cough and cold: 33.7%; pneumonia: 8.7%). Fever (malaria or no malaria), and diarrhea were the morbidities of 20.7% and 14.9% of the children respectively. Similar pattern of morbidities was also observed among children of all age-groups.
C. Number distribution of cases with IMCI diseases by age-groupsFigure 15 to 19 show the burden of each of the age group (based on the number of children visiting IMCI facilities) shared by the IMCI facilities in various IMCI diseases.
Figure 15. Distribution of various diseases
among neonates of 0-28 days (n=58,253; 2.5%
of total)
08
0-28 day(s),
n=4663,
4.1%
29-59 days,
n=11199,
9.9%
2-12 months,
n=32200 ,
28.5%
1-5 year(s),
n=64751,
57.4%
0-28 day(s),
n=20602,
4.5%
29-59 days,
n=37292,
8.2%
2-12 months,
n=112274 ,
24.6%
1-5 year(s),
n=286195 ,
62.7%
0-28 day(s),
n=4849,
10.3%
29-59 days,
n=7358,
15.6%
2-12 months,
n=14557,
30.9%
1-5 year(s),
n=20408,
43.3%
4,849
20,602
4,663
2,835
201
-
-
6,109
-
-
9,609
Refered
Others illness
Malnutri on
Ear problem
Measles
Fever-no malaria
Fever-malaria
Diarrhea
No pneumonia-cough and cold
Pneumonia
Very severe diseases
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Figure 16. Distribution of various diseases
among post-neonatal babies of 29-59 days
(n=109,551; 4.7% of total)
Figure 17. Distribution of various diseases
among infants of 2-12 months (n=719,051;
30.8% of total)
Figure 18. Distribution of various diseases
among children of 1-5 years (n=1,451,139;
62.1% of total)
Figure 19. Distribution of various diseases
among 0 day to 5 years old children
(N=2,337,994)
D. Percent distribution of IMCI patients by division in 2011In Barisal division, a total of 120,977 children received service from IMCI facilities; of them 61, 819 were male and the rest were female.
09
Refered
Others illness
Malnutri on
Ear problem
Measles
Fever-no malaria
Fever-malaria
Diarrhea
No pneumonia-cough and cold
Pneumonia
Very severe diseases
7,358
37,292 11,199
7,916
407
-
-
18,640
-
-
15,713
Refered
Others illness
Malnutri on
Ear problem
Measles
Fever-no malaria
Fever-malaria
Diarrhea
No pneumonia-cough and cold
Pneumonia
Very severe diseases
14,557
1,12,274
32,200
31,740
1,059
1,56,785
2,107
1,10,946
2,80,830 85,488
15,394
Refered
Others illness
Malnutri on
Ear problem
Measles
Fever-no malaria
Fever-malaria
Diarrhea
No pneumonia-cough and cold
Pneumonia
Very severe diseases
20,408
2,86,195
64,751
66,399
1,597
3,19,747
4,787
2,12,985
5,06,152 1,18,988
15,299
Refered
Others illness
Malnutri on
Ear problem
Measles
Fever-no malaria
Fever-malaria
Diarrhea
No pneumonia-cough and cold
Pneumonia
Very severe diseases
47,172
4,56,363
1,12,813
1,08,890
3,264
4,76,532
6,894
3,48,680
7,86,982
2,04,476
56,015
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Figure 20. Percent distribution of male children
with various illnesses by age-groups in Barisal
division in 2011 (51.1% of total)
Figure 21. Percent distribution of female
children with various illnesses by age-groups in
Barisal division in 2011 (48.9% of total)
Figure 22. Percent distribution of total children
with various illnesses by age-groups in Barisal
division in 2011
In Chittagong division total of 443,826 children received service from IMCI facilities,
of them 225, 615 were male, and 218, 211 were female.
Figure 23. Percent distribution of male children
with various illnesses by age-groups in
Chittagong division in 2011 (50.8% of total)
Figure 24. Percent distribution of female
children with various illnesses by age-groups in
Chittagong division in 2011 (49.2% of total)
Figure 25. Percent distribution of totalfemale
children with various illnesses by age-groups in
Chittagong division in 2011
10
0-28 day(s),
n=1355,
2.2%29-59 days,
n=2928,
4.7%
2-12 months,
n=19370,
31.3%1-5 year(s),
n=38166,
61.7%
0-28 day(s),
n=1269,
2.1%
29-59 days,
n=2959,
5.0%
2-12 months,
n=18544,
31.3%
1-5 year(s),
n=36386,
61.5%
0-28 day(s),
n=2624,
2.2%
29-59 days,
n=5887,
4.9%
2-12 months,
n=37914,
31.3%
1-5 year(s),
n=74552,
61.6%
0-28 day(s),
n=6934,
3.1%
29-59 days,
n=11239,
5.0%
2-12 months,
n=68024,
30.2%
1-5 year(s),
n=139418,
61.8%
0-28 day(s),
n=6906,
3.2%
29-59 days,
n=10465,
4.8%
2-12 months,
n=65038,
29.8%1-5 year(s),
n=135802,
62.2%
0-28 day(s),
n=13840,
3.1%
29-59 days,
n=21704,
4.9%
2-12 months,
n=133062,
30.0%
1-5 year(s),
n=275220,
62.0%
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In Dhaka division, a total of 623,630 children received service from IMCI facilities; of them 323,183 were male, and the rest were female (300,447).
Figure 26. Percent distribution of male children
with various illnesses by age-groups in Dhaka
division in 2011 (51.8% of total)
Figure 27. Percent distribution of female
children with various illnesses by age-groups in
Dhaka division in 2011 (48.2% of total)
Figure 28. Percent distribution of total children
with various illnesses by age-groups in Dhaka
division in 2011
In Khulna division, a total of 147, 480 children received service from IMCI facilities; of them 75, 324 were male, and the rest were female (72,156).
Figure 29. Percent distribution of male children
with various illnesses by age-groups in Khulna
division in 2011 (51.1% of total)
Figure 30. Percent distribution of female
children with various illnesses by age-groups in
Khulna division in 2011 (48.9% of total)
Figure 31. Percent distribution of total children
with various illnesses by age-groups in Khulna
division in 2011
11
0-28 day(s),
n=5757,
1.8%
29-59 days,
n=13262,
4.1%
2-12 months,
n=104736,
32.4%1-5 year(s),
n=199428,
61.7%
0-28 day(s),
n=4862,
1.6%
29-59 days,
n=11519,
3.8%
2-12 months,
n=95291,
31.7%
1-5 year(s),
n=188775,
62.8%
0-28 day(s),
n=960,
1.3%29-59 days,
n=1781,
2.4%
2-12 months,
n=23503,
31.2%
1-5 year(s),
n=49080,
65.2%
0-28 day(s),
n=829,
1.1%
29-59 days,
n=1610,
2.2%
2-12 months,
n=22870,
31.7%1-5 year(s),
n=46847,
64.9%
0-28 day(s),
n=1789,
1.2%
29-59 days,
n=3391,
2.3%
2-12 months,
n=46373,
31.4%1-5 year(s),
n=95927,
65.0%
IMCI NewsletterIMCI NewsletterPerformance Report for January to December 2011
Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]
0-28 day(s),
n=10619,
1.7%
29-59 days,
n=24781,
4.0%
2-12 months,
n=200027,
32.1%
1-5 year(s),
n=388203,
62.2%
In Rajshahi division, a total of 525,849 children received service from IMCI facilities; of them 262,176 were male, and the rest were female (263,673).
Figure 32. Percent distribution of male children
with various illnesses by age-groups in Rajshahi
division in 2011 (49.9% of total)
Figure 33. Percent distribution of female
children with various illnesses by age-groups in
Rajshahi division in 2011 (50.1% of total)
Figure 34. Percent distribution of total children
with various illnesses by age-groups in Rajshahi
division in 2011
In Rangpur division, a total of 216,906 children received service from IMCI facilities; of them 109,143 were male, and the rest were female (107,763).
Figure 35. Percent distribution of male children
with various illnesses by age-groups in Rangpur
division in 2011 (50.3% of total)
Figure 36. Percent distribution of female
children with various illnesses by age-groups in
Rangpur division in 2011 (49.7% of total)
Figure 37. Percent distribution of total children
with various illnesses by age-groups in Rangpur
division in 2011
12
0-28 day(s),
n=7367,
2.8%
29-59 days,
n=13651,
5.2%
2-12 months,
n=79527,
30.3%1-5 year(s),
n=161631,
61.6%
0-28 day(s),
n=8147,
3.1%
29-59 days,
n=13818,
5.2%
2-12 months,
n=78572,
29.8%1-5 year(s),
n=163136,
61.9%
0-28 day(s),
n=15514,
3.0%
29-59 days,
n=27469,
5.2%
2-12 months,
n=158099,
30.1%
1-5 year(s),
n=324767,
61.8%
0-28 day(s),
n=2056,
1.9%29-59 days,
n=4661,
4.3%
2-12 months,
n=33090,
30.3%1-5 year(s),
n=69336,
63.5%
0-28 day(s),
n=2339,
2.2%
29-59 days,
n=5026,
4.7%
2-12 months,
n=32146,
29.8%
1-5 year(s),
n=68252,
63.3%
0-28 day(s),
n=4395,
2.0%
29-59 days,
n=9687,
4.5%
2-12 months,
n=65236,
30.1%
1-5 year(s),
n=137588,
63.4%
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In Sylhet division, a total of 259,326 children received service from IMCI facilities; of them 127,111 were male, and the rest were female (132,215).
Figure 38. Percent distribution of male children
with various illnesses by age-groups in Sylhet
division in 2011 (49.0% of total)
Figure 39. Percent distribution of female
children with various illnesses by age-groups in
Sylhet division in 2011 (51.0% of total)
Figure 40. Percent distribution of total children
with various illnesses by age-groups in Sylhet
division in 2011
E. Percent distribution of IMCI cases with various illnesses by division in 2011Figure 41. Percent distribution of children with various illnesses by age-group in Barisal division in 2011
13
0-28 day(s),
n=4668,
3.7%
29-59 days,
n=7918,
6.2%
2-12 months,
n=39323,
30.9%
1-5 year(s),
n=75202,
59.2%
0-28 day(s),
n=4804,
3.6%29-59 days,
n=8714,
6.6%
2-12 months,
n=39017,
29.5%1-5 year(s),
n=79680,
60.3%
0-28 day(s),
n=9472,
3.7%29-59 days,
n=16632,
6.4%
2-12 months,
n=78340,
30.2%
1-5 year(s),
n=154882,
59.7%
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Figure 44. Percent distribution of children with various illnesses by age-group in Khulna division in 2011
Figure 43. Percent distribution of children with various illnesses by age-group in Dhaka division in 2011
Figure 42. Percent distribution of children with various illnesses by age-group in Chittagong division in 2011
14
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Figure 46. Percent distribution of children with various illnesses by age-group in Rangpur division in 2011
Figure 47. Percent distribution of children with various illnesses by age-group in Sylhet division in 2011
Figure 45. Percent distribution of children with various illnesses by age-group in Rajshahi division in 2011
15
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Table 3. Distribution of IMCI patients and diseases patterns by division in Bangladesh, 2011
Figure 48. Percent distribution of children with various illnesses by age-group in Bangladesh, 2011
ConclusionThe newsletter represents the general picture of the childhood illnesses and diseases of under-five children in Bangladesh. The newsletter will give some programmatic direction to the policy-makers, managers, and development partners for further providing IMCI services to the children of Bangladesh.
16
Annexure
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Management Information System (MIS)Directorate General of Health Services (DGHS)Mohakhali, Dhaka-1212 Web:www.dghs.gov.bd; Email: [email protected]
To,DirectorManagement Information System (MIS)Directorate General of Health Services (DGHS) Mohakhali, Dhaka -1212, BangladeshPhone:88-02-8816459; Fax: 88-02-8813875 E-mail: [email protected]: www.dghs.gov.bd