Under 5 health 2.pdf

Health of under Five children Dr. T. Ashokkumar MD I IS I 6,6 2631 569 w 281m 0 I wt s Learning objectives Explain common problems of under five children. • Identify heath services provided to under five children • List the objectives and the components of child health care implemented in...

Health of under Five children Dr. T. Ashokkumar MD I IS I 6,6 2631 569 w 281m 0 I wt s Learning objectives Explain common problems of under five children. • Identify heath services provided to under five children • List the objectives and the components of child health care implemented in KSA • Identify indicators of quality of Under-five Health Services. • 0 Preschool Health In most countries, there is a relative neglect of children of preschool age. 0 Characteristics of preschool period 0 1. High morbidity of infectious and parasitic diseases. 2. High prevalence of malnutrition. 3. High incidence of injuries. 4. Growth and development. • 1. High morbidity of infectious and parasitic diseases Infectious Diseases: • Respiratory: e.g., ARI, Chicken Pox, Whooping Cough, German Measles, etc. • GIT: e.g., Diarrheal Diseases, Hepatitis A. • Skin Diseases: e.g., Impetigo, Scabies Diseases. • and Fungal Parasitic infections: e.g., Oxyuris and Ascaris. 0 2. High prevalence of malnutrition Malnutrition is prevalent among preschool children due to: ● ● ● 0 Hyperactivity and lack of interest in food. Faulty feeding habits. High prevalence of infectious and parasitic diseases The most common malnutrition diseases among preschool children are: 0 ● Protein energy malnutrition (mild, moderate and severe). ● Micronutrient deficiencies: iron deficiency anemia, vitamin A deficiency and iodine deficiency. ● Rickets. 3. High incidence of injuries Preschool children are more prone to injuries as they are curious, energetic and eager to explore the environment. Most injuries occur where children spend the most active portion of their day (home, nursery or playgrounds). ➢ ➢ ➢ ➢ ➢ 0 Falling downstairs causing head injuries or fractures. Household liquids Ingestion (kerosene, potash , insecticides). Ingestion of drugs. Burns or scalds. Electric shock. 0 3. Growth and development Growth By the end of the second year, the birth weight gets quadrupled. After the second year, the increase is steady at an annual rate of about 2.25 - 2.75 kg in weight and 7.5 cm in height until the adolescent spurt occurs. Development Motor skills are usually more coordinated in the second year relative to the first year. The behavioral development of the child must be assured through emotional and moral stability, that is, a home where he will find bonds of affection and 0 discipline. Heath services provided to under–five: • • • 1. Preventive care: Immunization Nutritional surveillance Health education • • • 2. Growth monitoring: Weigh the child periodically. Plot the growth chart. Detect early signs of growth failure. • • 3. Care in illness: Diagnosis and treatment x-ray and lab services 0 Recent schedule for Vaccination in Saudi Arabia: Age at visit At birth 2 - Months 4 - Months 6 - Months 0 Vaccines Hepatitis B (IM) IPV(IM) DPT(IM) Hepatitis B (IM) Hib (IM) Pneumococcal conjugated vaccine (PCV)(IM) Rota vaccine (oral) IPV(IM) DPT(IM) Hepatitis B (IM) Hib (IM) Pneumococcal conjugated vaccine (PCV)(IM) Rota vaccine (oral) OPV (oral) BCG(ID) IPV(IM) DPT(IM) Hepatitis B (IM) Hib (IM) Recent schedule for Vaccination in Saudi Arabia: Age at visit 9 months Measles (SC) Meningococcal Conjugated quadrivalent (MCV4) (IM) 12 months OPV (oral) MMR (SC) Pneumococcal conjugated vaccine (PCV)(IM) Meningococcal Conjugated quadrivalent (MCV4) (IM) 18 months 24 months First class primary school age 0 Vaccines OPV (oral) DPT (IM) Hib (IM) MMR (SC) Varicella (SC) Hepatitis A (IM) Hepatitis A (IM) OPV (oral) DPT (DT) (IM) MMR (SC) Varicella (SC) • • 0 Weight of the child is taken periodically at monthly intervals during the 1st year, every 2 months during the 2nd year and every 3 months thereafter up to the age of 5. growth curve or chart is made to monitor the progress. The frequency of child visits to the PHC is as follows: • Around 7 visits in the first year coinciding with immunization visits. • 2 visits every year during age 2-5 years. 0 Procedure done in every visit: 1. Measure of weight, height and head circumference. 2. Prepare the growth chart. 3. Explain characteristics of growth chart to mother. 4. Assist mother regarding breast feeding. 5. Advise mother regarding artificial feeding if indicated. 6. Explain proper nutrition of the child. 7. Inform mother about schedule of immunization. 8. Identify children who are at risk. 9. Encourage mother to attend visits regularly. 0 The objectives and the components of child health care implemented in KSA 1. Health education of mother. 2. Growth and development monitoring. 3. Immunization. 4. Treatment of diseases. 0 Indicators of quality of Under-five Health Services 1. Infant Mortality Rate. 2. Neonatal Mortality Rate. 3. Post neonatal Mortality Rate. 4. Child Death Rate. 5. Under-five Mortality Rate. 0 1. Infant Mortality Rate (IMR) Total number of infant deaths (0 - < 1 year) in a given year and locality X 1000 Total number of live births in the same year and locality 0 The main causes of infant mortality are: ARI (acute respiratory infections) Gastroenteritis and dehydration. Low birth weight . Prematurity. Birth asphyxia. Neonatal infections (Tetanus neonatorum) • • • • • • 0 In KSA, Infant mortality rate is 5.9/1000 LB (2019). 0 • Infant deaths are related directly to poverty, diseases, bad sanitary conditions, overcrowding and ignorance. • Infant mortality rate is a good index for community development in general, and of infant welfare services in particular, as it is a measure of the effect of the different environmental factors surrounding the infant during the first year of life. 2. Neonatal Mortality Rate (NMR) Total number of neonatal deaths (0 - < 28 days of life) in a certain year and locality X 1000 Total number of live births during the same year and locality 0 The main causes of neonatal mortality are: • Low birth weight. • Prematurity. • Birth asphyxia. • Neonatal infections (Tetanus neonatorum) 0 . . 3. Post neonatal Mortality Rate (PNMR) Total number of post neonatal deaths (28 days - < 1 year) in a certain year and locality X 1000 Total number of live births during the same year and locality The main causes of post neonatal mortality are: ARI. Gastroenteritis and dehydration. 0 4. Under-five Mortality Rate Total number of deaths of underfive children ( 0− < 5 years) in a given years and locality X 1000 Total number of live birthsin the same year and locality In KSA, Under-five mortality rate is 19.1/1000 LB (2011). 0 The main causes of under- five mortality rate are: 0 1. ARI 2. neonatal causes 3. Gastroenteritis and dehydration 4. Injuries 0