TABLE 3.

Harmonization of Kenya IMNCI-PSBI Guidelines

Previous Content in Kenya IMNCI Guidelines	Harmonized Content in Line With WHO Recommendations
Classification 18 signs to guide classification for PSBI/serious disease on page 32 in Kenya IMNCI Chart Booklet	Signs and symptoms harmonized as follows: Convulsions or convulsing now or Not able to feed at all or not feeding well or Fast breathing (60 breaths/minute or more in infants aged <7 days) or Serious chest indrawing or High body temperature (38°C or above) or Low body temperature (less than 35.5°C) or Movement only when stimulated or No movements at all
Fast breathing All infants aged 0–59 days lumped together (pages 32 and 37) in the Kenya IMNCI Chart Booklet	Revised Kenya IMNCI chart booklet distinguishes between fast breathing in infants aged 0–6 days and aged 7–59 days. Infant aged 0–6 days with fast breathing needs to be referred for inpatient treatment. If referral is declined, treat as outpatient with oral amoxicillin daily for 7 days. Infant aged 7–59 days treat in outpatient settings. Review on day 4 is mandatory for both groups.
Critical Illness 11 signs for critical illness on page 37 of Kenya IMNCI Chart Booklet	Signs for SYIs with critical illness (has any 1 of the following): Convulsions or convulsing now Not able to feed at all No movement on stimulation Weight <1500 g

Previous Content in Kenya IMNCI Guidelines

Harmonized Content in Line With WHO Recommendations

Classification

18 signs to guide classification for PSBI/serious disease on page 32 in Kenya IMNCI Chart Booklet

Signs and symptoms harmonized as follows:

Fast breathing

All infants aged 0–59 days lumped together (pages 32 and 37) in the Kenya IMNCI Chart Booklet

Revised Kenya IMNCI chart booklet distinguishes between fast breathing in infants aged 0–6 days and aged 7–59 days.
Infant aged 0–6 days with fast breathing needs to be referred for inpatient treatment. If referral is declined, treat as outpatient with oral amoxicillin daily for 7 days.
Infant aged 7–59 days treat in outpatient settings.
Review on day 4 is mandatory for both groups.

Critical Illness

11 signs for critical illness on page 37 of Kenya IMNCI Chart Booklet

Signs for SYIs with critical illness (has any 1 of the following):

Abbreviations: IMNCI, integrated management of newborn and childhood illnesses; PSBI, possible serious bacterial infection; SYI, sick young infant; WHO, World Health Organization.