Child Health: short and sweet! - wikispaces.netfamilyplanning.care2share.wikispaces.net/file/view/Child+health.pdf · Child Health: short and sweet! Jesse Rattan ... • Rapid assessment

Child Health: short and sweet!

Jesse Rattan, CARE-US October, 2014, Global Learning Workshop, Atlanta, USA

Presenter

Presentation Notes

For the rest of our technical presentations, we are trying to really summarize and give very topline overviews, so we can have time to share and cross-learn from all the expertise in the room. This little girl is also is ‘in a nutshell” a child that is in perfect health, and thriving child. One of the great things about Child health interventions is that health providers use simple observation and questions to improve the health of children.

Session objectives

• Define child health interventions • Learn or review a few facts about child health

• Understand the major killers of young children

• Become familiar with the most important pubic health interventions

• Know a few programming approaches for staffing/human resources;

medicines/supplies/equipment; community mobilization • Know basic indicators for child health for program design and for program

monitoring

• Know a few resources to go to for help

• Discuss who might be good partners to collaborate with and to get help

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Fast facts about child health

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• Child health interventions focus on the main killers of children under five, rather than all children

• 40/60: Globally, 40% of the children died within their first month from newborn (first month of life) problems. The remaining 60% died mostly from either pneumonia or diarrhea, but also from other diseases like malaria, HIV/AIDS and measles.

• A major underlying cause of child death is malnutrition.

• Children under five have the highest mortality rates of any age group in emergencies.

Presenter

Presentation Notes

-child health programs focus on the common killers of children under five, rather than all children. - Globally, as simple public health interventions saved the lives of older children, death and illness has become concentrated in the newborn period.

1990-2014: Dramatic child health improvements

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Presenter

Presentation Notes

The under-five mortality rate has declined by almost half since 1990. The under-five mortality rate is now falling faster than at any other time during the past 2 decades. Equity: Under-five mortality is falling in the poorest households in all regions AND greater declines have been made among the poorest compared to the richest children. So there still is disparity between rich and poor in terms of child health, but the poorest households are improving at a faster rate.

1990-2013: Actual numbers of deaths decline dramatically

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But basic causes and interventions remain the same

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Child Health: newborn baby birth to 1 month

Essential Immediate Newborn Care: 1. The Clean chain (clean hands, clean surfaces, clean

blade to cut cord, clean cord tie, clean cloth) 2. The Warm Chain (dry baby, warm room, warm mother,

wrap up, use hat) 3. Breastfeeding 4. Cord, Eye and Skin Care 5. Immunization

Recognition of danger signs and management of: 1. Newborn asphyxia (breathing problems) 2. Infection or sepsis 6

Basic Interventions: child health, 2 months-5 years old

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Major killers of children 1-5 years old

Interventions: Health workers Community

Diarrhea

- Treatment with ORS and zinc - Danger sign recognition, treatment with ORS,

Pneumonia/ Acute Respiratory Infection

- Antibiotics - Danger sign recognition

Malaria - Treatment with Artemisin combination therapy - Danger sign recognition, sleep under insecticide treated

bednets

Measles - Vaccination - Danger sign recognition

Nutrition - Counseling on feeding and breastfeeding - Vitamin A, and de-worming - Severe malnutrition referral - Counseling on feeding and breastfeeding, vitamin and

deworming

Presenter

Presentation Notes

The memory trick for remembering the main child health problems is DAMMN

Putting it all together Integrated management of childhood illnesses (IMCI)

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• Simple algorithm: IMCI puts diagnosis and treatment of the most common serious child illnesses.

• Integrated assessment: child

presents with one problem, provider checks for all major problems

• Syndromic approach:

Identifies problems through asking questions and identifying signs and symptoms.

Presenter

Presentation Notes

Child health interventions have become even simpler than those simple intervention by being wrapped into a tool called IMCI. IMCI has 3 great characteristics: it is ONE simple algorithm that even very junior cadres of health worker can do, that helps them diagnose and treat the five most common and serious childhood illnesses. It is integrated so that the health worker can check for ALL of the problems at one time, even if the child comes in for just one. It uses the “syndromic” approach, that is to say, the health worker diagnoses problems by asking questions and looking at signs and symptoms– they don’t need laboratory and complex diagnostic tests.

Child health interventions in emergencies: What you need to remember

Service level 1. IMCI 2. Vaccinations against

measles Community level • Community and family

recognition of danger signs and referral system for sick children

• Community engagement during measles vaccination campaigns

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EASY!

Presenter

Presentation Notes

-- community-based interventions–

Programming approaches

• Ensure/identify skilled providers: • Identify cadres needed: nurse, clinical officers, medical assistants • Find and review national protocols for cadres and clinical guidelines • Rapid assessment or in-depth assessment should include questions

about familiarity with IMCI or the basic interventions for the main child illnesses

• Distance self-learning modules available for IMCI • On-the-job coaching

• Improve quality • Identify and help address gaps in infection prevention (IP) practices

and standard precautions

• Ensure equipment/medicines/supplies • Interagency Emergency Health Kit 2011: • Vaccines: coordinate with the WHO/UNICEF/the health cluster who

procure all vaccines

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Presenter

Presentation Notes

- Simple

Programming approaches continued (2)

• Aware and mobilized communities • Community awareness of

danger signs, referral systems

• Work with CHWs, TBAs, leaders, mothers groups

• Integrate mobilization & awareness activities with other outreach: -vaccination, NFI distribution etc

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Programming approaches continued (3)

• Key indicators assessment, design & monitoring

• For assessment and program design: • Infant mortality rate (IMR) • Under-5 Child mortality rate (CMR) • Neonatal mortality rate (NNMR)

• For monitoring health services

• % of children receiving correct treatment for malaria • % of children receiving correct treatment for diarrhea • % of children receiving correct treatment for pneumonia

• Sources for indicators • IMR, NNMR: National level surveys, DHS • % receiving correct treatment:

• OPD or general registers, • direct observation, • individual consultation forms

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Programming approaches 4

• Resources • Sphere manual • IMCI distance learning modules, booklet • CORE website for many child health tools • Inter-agency emergency health kit

• Potential partners, friends and collaborators • Health cluster • Other major health or multi-sectoral NGOs • CARE USA nutrition team (and SRMH team) • Many experts across CARE!

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Thank You!

Documents

Child Health: short and sweet! - wikispaces.netfamilyplanning.care2share.wikispaces.net/file/view/Child+health.pdf · Child Health: short and sweet! Jesse Rattan ... • Rapid assessment