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1. Health problems in cildren

2. child A child is a person below the age of 18 years , unless laws of a particular country set the legal age –UNICEF 2

3. Major health problems In children Low birth weight Malnutrition Infections and parasitosis Accidents and poisoning Behavioral problems Other factors . 3

4. 1.Low birth weight LBW infant is any infant with a birth weight of less than 2.5 kg(2500 g or 5.5 pounds) regardless of gestational age . It includes two kinds of infants : 1. Pre-term babies : Their intrauterine growth is normal but they are born too early i.e before 37 weeks of gestation 2. Small-for- date babies : These may be born at term or pre-term , clearly as a result of retarded intrauterine foetal growth . 4

5. Importance of lbw LBW is the single most important determinant of the chances of survival , healthy growth and development of baby . Infant mortality is 20 percent more for the LBW babies . Therefore these are at-risk babies. It’s a challenge for the mother as they are at high risk for development of infections and malnutrition ; therefore extra care is required. 5

6. prevention 6 DIRECT INTERVENTION Early identification of at-risk mothers e.g .diseases , infection ,malnutrition, heavy workload . 1. increase food intake 2. controlling infections INDIRECT INTERVENTION Family planning Improved health and nutrition of young girls Improved enviromental conditions Improved socio-economic conditions Government support ; leave with full wages

7. 2.Malnutrition It is simply deficiency of nutrition , most widespread condition which affects the health of children . Consequences : more prone to infection and slow recovery , slow growth , do not achieve full physical and mental potential . infection malnutrition 7

8. 8

9. 3.List of common infections Diarrhoea Respiratory infections Measles Polio Tetanus Tuberculosis . 9

10. Accidents and poisoning Important health problem in developed countries . Burns , poisoning Trauma Traffic accidents Falls Drowning 10

11. Behavioral problems Breath holding spell Bruxism Pica Thumb sucking Temper tantrums Tics Nocturnal enuresis 11

12. Other factors Maternal health Family Socio-economic circumstances Enviroment Social support and health care 12

13. IMNCI "The Integrated Management of Childhood Illness (IMCI)" A disease management strategy for children

14. INTRODUCTION 10 million children/ year- die in developing countries due to acute respiratory infections, diarrhea, measles, malaria, malnutrition WHO & UNICEF have developed new strategy for management of common childhood illnesses, in an integrated manner, which are responsible for main causes of morbidity and mortality in the developing countries by improved performance of health workers 14

15. STRUCTURE OF IMNCI IMNCI caters to two groups of children 0-2 months Young infants 2 months to 5 years Children 15

16. objectives 16

17. COMPONENTS OF IMNCI 17

18. A. HEALTH WORKER COMPONENT 18

19. b. HEALTH SERVICE COMPONENT 19

20. Principles All sick children under 5 years of age must be examined for conditions which indicate immediate referral or hospitalization . Children must be routinely assessed for major symptoms , nutritional and immunization status, feeding problems and other potential problems. Only a limited number of carefully selected clinical signs, are used based on evidence of their sensitivity and specificity to detect disease. IMNCI guidelines address most common but not all pediatric problems. A limited number of essential drugs are used. Care takers are actively involved in the treatment of children. Counselling of caretakers about home care including feeding, fluids and when to return to health facility 20

21. Based on the presence of selected clinical signs, the child is placed in a ‘ classifications ’. Classifications are not specific diagnosis but categories that are used to determine the treatment. 21

22. IMNCI package IMNCI guidelines recommend standardized case management procedures That based on two age categories: - Upto 2 months and 2 months to 5 years 22

23. Care of Newborns and Young Infants (infants under 2 months) Keeping the child warm. Initiation of breastfeeding immediately after birth and counseling for exclusive breastfeeding and non-use of pre lacteal feeds. Cord, skin and eye care. Recognition of illness in newborn and management and/or referral). Immunization Home visits in the postnatal period. 23

24. Care of Infants (2 months to 5 years) Management of diarrhea, acute respiratory infections, malaria, measles, acute ear infection, malnutrition and anemia. Recognition of illness and at risk conditions and management/referral) Prevention and management of Iron and Vitamin A deficiency. Counseling on feeding for all children below 2 years Counseling on feeding for malnourished children between 2 to 5 years. Immunization 24

25. IMNCI CASE MANAGEMENT PROCESS Steps of case management process are the following: Asses the young infant/ child. Classify the illness. Identify the treatment. Treat the young infant/child. Counsel the mother. Provide follow up care. 25

26. < 2 Months of Age 26

27. 2 months to 5 yr 27

28. ADVANTAGES OF INTEGRATED APPROACH Speeds up the urgent treatment and treatment seeking practices. Prompt recognition of serious condition , hence prompt referral. Involves parents in effective care of baby at home. Partial Success of Individual disease control programme. Involves prevention of diseases by active immunization, Improved nutrition and Exclusive Breastfeeding practices. Highly cost effective . It avoids wastages of resources by using most appropriate medicines and treatment. It reduces duplication of effort. 28