paediatrics with associated disorders.pptx

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1. CHILD CENTERED CARE OVERVIEW OF GLOBAL CHILD HEALTH HOW TO INTERACT WITH A CHILD PRESENTED BY NSUBUGA UMARU 2022/U/MMU/BNSD/015

2. CHILD CENTERED CARE The child Rights of a child Roles of paediatric nurse and qualities of a good paediatric nurse. Care giver centered care. Child health in Uganda, Africa and the entire world.

3. Who is a child??

4. Rights of a child Children do not participate in any decision for the environment in which they are raised from. They later inherit the world which the adults have created for them, better or worse. Pediatric care has its implication on the ultimate progress of the nation. They need all the care and protection as they are every nation’s wealth. They don’t live independently except in isolated scenarios

5. Rights of a child Do you know human rights? Patient rights? Then what are the rights of a child?

6. Roles of a pediatric nurse OLD ROLES NEW ROLES Disease centered care Child centered care Discouraging the families on neglect of the female child. Taking special care of the female child as she is the future mother. Immunization of all girls for tetanus and rubella before marriage. Starting care for the woman after she becomes pregnant. Health education on planned parenthood and guarding the maternal health before conception. Special care during last trimester and the post natal period to the child born with congenital anomalies and hereditary disorders. Early identification and family counseling based on biochemical screening and chromosomal studies to prevent congenital anomalies and hereditary disorders in children. Only caring for child after birth of child. Guarding the health of child from day of conception.

7. OLD ROLES NEW ROLES Only care to the sick children in hospital. The participation in prevention of illness, health promotion activities. Caring of the physical condition of child in isolation. Comprehensive care of child in relation to his home and the community in which he lives and providing emotional support to the family. Not allowing the parents to be with the child in the hospital and rigid visiting hours. Ensuring the children must have one parent stay with them in the hospital and participate in care. Flexible visiting hours in children wards. One of illness oriented. One that is health oriented. Only cleanliness and treatment oriented. Warmth and love oriented. Touch Only curative and rehabilitative to the children in hospitals. Health promotion activities. The concept of pediatrics as infant feeding and care of a few diseases of children. The comprehensive care of child in its totality from conception to maturity within the framework of his family and community. Adapting indifferent attitude to child neglect and abuse by family and society. Safeguarding and protection of children’s rights by health providing cultural practices

8. Caregiver centered care Involve care givers in the care of the child. Visiting: Previously, visiting hours were very strict. Today, there is flexibility for visiting. Parents, siblings or relatives are not permitted to visit if they have been exposed to an infectious disease or have cold or other infections. Rooming in Parents should not be prohibited to stay at the child’s bedside, if they desire so. Play room should be available for child.

9. Care by parent units These units allow whole family to be involved in the care of the sick children. A child gets attention when its needed each day from a familiar person, under supervision of the nurse. Children can continue to learn and grow during hospital stay. A nurse can observe the parents, their skills, attitudes and techniques and any problems

10. Parent support groups These groups can meet parents in and out of the hospital. Led by nurses or other therapists. A non threatening environment is provided, where parents may feel comfortable enough to move away from the hospital routine and ventilate their feelings and concerns to relieve their anxiety and stress.

11. Self care Nurses have responsibility of assessing the abilities of the hospitalized child and then helping the child to learn self care skills. The time and methods used in teaching these skills depend on child’s cognitive abilities, emotional state and readiness to learn.

12. Child health in Uganda, Africa and the entire world.

13. Global Child Health- Epidemiology 1 Millennium Development Goal (MDG) 4—to reduce child mortality rate by two-thirds between 1990 and 2015—was the most off track of any of the eight MDGs. Worldwide, the top five causes of child mortality include pneumonia (16 %), preterm birth complications (14 %), diarrheal illness (11 %), intrapartum-related complications (9 %), and malaria (7 %). Of the 6.9 million childhood deaths each year, the large majority occur in sub-Saharan Africa and Southern Asia. 5.4 million children under five years of age died in 2017 with half of these deaths in Sub-Saharan Africa.

14. Epidemiology-2 The global under-five mortality rate declined from 77 per 1000 live births in 2000 to 39 per 1000 live births in 2017. An estimated 0.9 million children aged 5 to 14 years died in 2018, about 2,500 deaths in this age group a day. From 1990 to 2018, the mortality rate in children aged 5 to 14 years declined by 53 per cent, and the number of deaths dropped by 46 per cent from 1.7 (to 0.9 million per year. Injuries (including road traffic injuries, drowning, burns, and falls) are leading causes of death and lifelong disability among older children and young adolescents.  WHO, 2019

15. Epidemiology- 3 72 % of under 5 deaths occur in the first year of life The global NMR is 30 per 1000 live births 3.8 million newborn deaths- preterm birth( 28%),severe infections( 36%), complications of birth asphyxia( 23%).

16. Causes of death in children 64 % (4.9 million) of under-five deaths worldwide can be attributed to infections In Africa, 73 % of under-five deaths are due to infections. Others are complications of prematurity, birth asphyxia(1/4 of all childhood deaths) malaria, under nutrition(1/3 of all deaths) Poor sanitation & poor water quality(1/5 of all deaths) ABOUT IDEATHS: Safe childbirth and effective neonatal care are essential to prevent these deaths. 45% of child deaths under the age of 5 years take place during the neonatal period. Handbook of Paediatric Global health- Nupur

17. CHILD HEALTH IN UGANDA

18. NURTURING CARE.ORG

19. Epidemiology- Uganda 55% of Uganda’s population are <18 years- ( 2014 Census;UBOS 2023) The NMR is 19 per 1000 live births-UNICEF, 2023 34% of <5 deaths are due to newborn deaths- Liu et al 2014

20. HOW TO INTERACT WITH CHILDREN Create a kid- friendly space: luxury colorful walls, fish tanks and soft kid friendly chairs Communicate on a child's level : communicating to children about their health means putting yourself in their shoes , learn the child's name in advance . A friendly “hi grace great to meet you !” can help put a suffering child at ease Recognize their bravery: Explain before you touch : Involve the child and the parent : Educate yourself

21. references 1. Nelson Textbook of Pediatrics by Robert M. Kliegman , Joseph St. Geme , et 2. Pediatric Physical Examination: An Illustrated Handbook" by Karen Dudek Brugnolini 3. Pediatric Decision-Making by Steven P. Shelov and Jessica B. Shelov