Presentation 2.pptxgggfddghgfddhutdchgddghg

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1. Growth and development includes all physical intellectual, social and emotional aspects Growth and development - Growth → increase in physical size of the body Development → increase in skill and function

2. Normal growth and development takes place Only if - 1. Optimal nutrition is provided 2.freedom from recurrent episodes of infections 3.freedom from adverse genetic & environmental influences MCH care is concerned with the process of growth and development which is the foundation of human life

3. - Determinants of growth & development 1 . Genetic inheritance - height, weight, mental and social development and personality. 2 . Nutrition - it influences growth & development before and after birth -retardation of growth is an indicater of malnutrition 3.age - growth rate is maximum fetal life during first year of life and then again at puberty. 4. Sex -growth spurt in males occurs little later than females that is in 12 to 13 years

4. 5. physical surroundings - sunshine, lighting, etc 6. Psychological factors - child-parent relationship 7. infections and parasitosis - →during pregnancy- rubella, syphilis affect intrauterine growth of fetus →infection after birth -slows down growth and development 8. Economic factors - connected with nutrition and living of the family g. 9 . Other factors - birth weight of child, birth spacing, etc

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6. Normal growth- concept of normality A normal child may be defined as one whose characteristics falls within the range of measurements accepted as normal for the majority of children in the same age group. →the limits of normal variation are in between 3rd & 97th centiles

7. Methods of assessment I. weight 2. Height length of infants 3. Head & chest circumference → this are measured and compared with reference standards → for making comparison_ a. Median > mean → a variation of 2 standard deviations from either side of the mean is considered within normal limits. b.by mean of percentiles - - - it refers to the number of individuals falling below a particular level. c.by weight for length, weight for height.

8. Longitudinal assessment -assessment of growth by measuring The same child at regular intervals. . Cross-sectional assessment - comparison between large number of children's of same age group → usually by percentile charts

9. Reference values Harvard (as Boston) standards - longitudinal assessment on a large series of children mostly from north European country. WHO reference values - based on cross-sactional data assembled by United States national centre for health statistics (NCHS) →.WHO reference values are used for children upto 5 years of age Indian standards- ICMRin a nationwide cross-sectional study establish a much needed reference standards for growth and development.

10. Reference versus standard values → if the values are derived from a population racially different from population under study it is considered as reference values → reference values cannot be used as standard value’s applicable to a population racially different.