Table 1

Comparison of the content of PACK Child and 2014 South African version of IMCI,39 arranged according to page sections in PACK Child

PACK ChildCovered in IMCIPACK ChildCovered in IMCI
Symptom pages Routine care pages
Assess and manage child’s fluid needsYesHelp baby breathe at birthYes
Manage glucoseYesAssess and interpret growthYes
FeverYesFirst assessment of the newbornLimited
Pallor or anaemiaYesBaby <2 months old: routine careLimited
WheezeYesChild ≥2 months old: routine careLimited
DiarrhoeaYesScreen the child in the prep roomNo
Seizures/fitsLimited*Routine visit (schedule)No
Eye/vision symptomsLimited Long - term health condition pages
Ear symptom/difficulty hearingLimitedBreast feedingYes
Mouth and throat symptomsLimitedFormula feedingYes
Cough and/or breathing problemsLimitedEatingYes
JaundiceLimitedPoor growth in the child <2 months oldYes
Skin symptomsLimitedThe underweight childYes
Painful skinLimitedNot growing well/growth falteringYes
Generalised itchy rashLimitedAcute malnutritionYes
Localised itchy rash/itch with no rashLimitedThe child with a close TB contactYes
Generalised red rashLimitedCheck for TBYes
Lumps and bumps on skinLimitedTB: routine careYes
Crusts, flaky skin and ulcersLimitedTB medicationYes
The emergency childNoHIV: diagnosisYes
Cardiopulmonary resuscitationNoHIV: routine careYes
ChokingNoMonitor the child with HIVYes
Decreased level of consciousnessNoStart ARTYes
The injured childNoMedication dosing chartYes
Fracture/sNoPrevention of mother-to-child transmission of HIVYes
Bites and stingsNoEczemaLimited
BurnsNoChronic malnutritionNo
The blue childNoOverweightNo
PoisoningNoThe child with a drug-resistant TB contactNo
The inconsolable crying/irritable childNoPost-exposure prophylaxisNo
HeadacheNoThe child with allergyNo
The tired or lethargic childNoAsthmaNo
Lumps/swellings in neck, axilla or groinNoEpilepsyNo
Nose symptomsNoBronchiectasisNo
Face symptomsNoKnown heart problemNo
Gum/teeth symptomsNoChronic arthritisNo
Recurrent respiratory symptomsNoCerebral palsyNo
Abdominal symptomsNoDown syndromeNo
Vomiting/refluxingNoLife-limiting illness: routine palliative careNo
ConstipationNo Charts
Anal symptoms/wormsNoWeight-for-age chart: girlsYes
Genital symptomsNoWeight-for-age chart: boysYes
Urinary symptomsNoHeight-for-age chart: girlsYes
Back painNoHeight-for-age chart: boysYes
Arm or hand symptomsNoWeight-for-height charts: girls and boysNo
Leg symptoms/limp/walking problemsNoBMI chart: girlsNo
Foot symptomsNoBMI chart: boysNo
Joint symptomsNoWeight-for-age chart: cerebral palsy (GMFCS IV)No
Altered skin colourNoWeight-for-age chart: cerebral palsy (GMFCS V)No
Nappy rashNo Useful tools for clinicians
Hair and scalp symptomsNoProtect yourself from occupational infectionNo
Nail symptomsNoProtect yourself from occupational stressNo
Suspected child abuse/neglectNoCommunicate effectivelyNo
The stressed, miserable or angry childNoPrescribe rationallyNo
Behaviour problemsNoMedication dosing tablesNo
Communication problemNoHelpline numbersNo
Not moving or sitting properlyNoQuick reference chartNo
School problems/bullyingNo
Sleep problemsNo
Parenting difficultyNo
  • ART, antiretroviral therapy; BMI, Body Mass Index; IMCI, Integrated Management of Childhood Illness; PACK, Practical Approach to Care Kit; TB, tuberculosis; GMFCS, Gross Motor Function Classification System.

  • *Limited—these topics are covered to a limited extent in the 2014 South African version of IMCI.