WELCOME TO PRESENTATION ON U5 CARE.

MAHESWARI JAIKUMAR

CARE OF UNDER FIVE.

NATIONAL POLICY FOR CHILDREN.

•The Govt of India has adopted a Children’s policy ( United Nations Declaration of the Rights of a child & The Constitutional provision ).----Aug 1974.•“ It shall be the policy of the state to provide adequate services to children, both before & after birth & through the period of growth, to ensure their full physical, mental & social development. The state shall progressively increase the scope of such services so that with in a reasonable time, all children in the country enjoy optimum conditions for their balanced growth.”.•As per the declaration, -------The development of children is considered an integral part of national development.•The policy considers children as the “NATION’S SUPREMELY IMPORTANT ASSET”.•The nation is responsible for their NURTURE & SOLITUDE.

•It spells measures to be adopted & priorities to be assigned to children’s prog.•The focus areas are, Child Health, Child Nutrition & Welfare, Welfare of the Handicapped & Destitute children.•In line with the policy A NATIONAL LEVEL CHILDREN’S BOARD was established.•The board is headed by PRIME MINISTER as chairman.•The board provides a forum to issues relating to child welfare, purposeful development of children as useful members of the society.

•TO REALIZE THE INITIATIVES OF THE POLICY THE FOLLOWING PROGRAMMES WERE INITIATED & EDIFIED.•ICDS.•SUPPLEMANTARY FEEDING PROGS.•NUTRITION & EDUCATION.•NATIONAL’S CHILDREN’S FUND.•Inst of national awards for child welfare, Welfare of the handicapped, CSSM prog.

NEED FOR U5 CARE.•Large numbers.---- 12 % of the general population.•Large number of children live in rural sreas where health services are marginalized.•Children are the future resources.•In the interest of the national development children require special attention.•The mortality rate among U5 is high – 11.2% of all the deaths.•Malnutrition, Infection are the major cause of a high mortality rate.

•A high morbidity rate also necessitates designing appropriate services.•The common morbidity conditions are, --- Diarrhoeal diseases, PEM, retarded growth & development, anemia, VPD, Vit A deficiency.•Accessibility of the children---/ services.•Vulnerability. •Specific health problems.

LOW BIRTH WEIGHT.•The incidence of LBW babies in India – 26%.•LBW is the single most cause in deciding the survival chances.•10% of LBW can be reduced.•The following are the interventions to reduce LBW.-----------•Identification of at risk mothers & appropriate care.•Prevention of infection among pregnant mother.•Increasing food intake.•Optimal ante natal care.

MALNUTRITION.•Protein Energy Malnutrition.•Micro nutrient Malnutrition.

•INFECTITIOUS & PARASITIC DISEASES.•ACCIDENTS & POISONING.•BEHAVIOURAL PROBLEMS.•OTHERS.

UNDER FIVES CLINIC.AIMS & OBJECTIVES.

Care in illness.

Growth monitoring Preventive care

SYMBOL OF U5 CILICS

CARE IN ILLNESS•The apex of the triangle represent “Care & Treatment of Sick Children”.•Care of sick children can be done by trained nurses.•Therefore the health care training should focus in preparing nurses.•The illness care comprise of --------•Diagnosis & treatment of acute illness, chronic illness- physical, mental, congenital & acquired abnormalities, disorders of growth & development.•X- ray & lab services.•Referral services.

PREVENTIVE CARE.IMMUNIZATION.

•Immunize the children against VPDs.•Immunize as per the vaccination schedule stipulated under the National Immunization Prog.

NUTRITIONAL SURVEILLANCE.

•Nutritional surveillance helps in identification of sub clinical cases.•Helps in appropriate management.

HEALTH CHECK UPS.•Periodic health check ups include physical examination & appropriate lab investigations.(3-6 months).•The Child Health Card facilitates these components.•Health check ups help in the identification of “AT RISK” children.•Special care is designed & implemented accordingly.

ORAL RE HYDRATION.•On an average, children in developing countries tend to have 2-6 episodes of diarrhea per year.•Every episode carries risk of death & dehydration, & lowers child’s nutritional level.•HAF have reduced the number of diarrhoeal deaths.FAMILY PLANNING.•The triangle in the center of the larger triangle represent family planning.•Family planning is the central concern for the welfare of the mother & the child.•The couples are counseled through U5 clinics.

HEALTH EDUCATION.•The border of the triangle represents health education.•Health education regarding child care , family planning, & other aspects of general hygiene is given.

GROWTH MONITORING.•Growth monitoring constitutes the basic activity.•The following weight monitoring schedule is recommended.•1 yr – every month.•2 yr – every 2 months.•Till 5-6 yrs – every 3 months.•The weight monitoring is done by means of GROWTH CURVE.•THE GROWTH CURVE HELPS IN DETECTING ONSET OF GROWTH FAILURE.

THE GROWTH CHART.•The growth chart or THE ROAD TO HEALTH CHART was first designed by DAVID MORLEY. (LATER MODIFIED BY WHO.).•The chart visibly displays the physical growth & development of a child.

GROWTH CHART USED IN INDIA.•The growth chart has 4 reference curve.•The top most curve corresponds to 80 per cent of the median. of the WHO standard).•The lower lines represent 70%, 60%, & 50%, of that standard.•80% of the median weight is approximately equivalent to 2 SD below the median which is the lower limit of “normal range”.•The purpose of these lines is to indicate the degree of malnutrition.

•The growth chart recommended by India shows three degrees of malnutrition.•FIRST DEGREE – Gr I – the child’s weight is between 80% & 70%.(mild malnutrition)•SECOND DEGREE – Gr II – weight is between 70% & 60%.(moderate malnutrition)•THIRD DEGREE – Gr III – weight is below 60% line (severe malnutrition).

•Grade IV – weight below 50%.

USES OF GROWTH CHART.•Growth monitoring.•Diagnostic tool.•Planning & policy making.•Education tool.•Tool for action.•Tool for evaluation.•Tool for teaching.

RIGHTS OF A CHILD.THE CONSTITUTIONAL PROVISION.•Art 24 – prohibits employment of children below 14 yrs.•Art 39 – prevents abuse of children of tender age.•Art 45 – provision of free & compulsory education for all children until they complete the age of 14 yrs.•FYP have specially focused on child’s welfare.

UN DECLARATION OF THR RIGHTS OF A CHILD.

•The GENERAL ASSEMBLY OF THE UNITED NATIONS – 20 Nov 1959, declared the rights of the child.•The following are the rights.•Right to develop in an atmosphere of affection & security & wherever possible in the care & under the responsibility of his /her parent.•Right to enjoy benefits of social security, including nutrition, housing & medical care.•Right to free education.

UNIVERSAL CHILDREN’S DAY.•Nov 14 is observed as Universal Children’s Day•It was started by the International Union for Child Welfare & UNICEF.•A NGO –was set up in 1979 (International Year of Child)., to ensure ongoing, systematic international action specially directed towards promoting & protecting the rights of the child.•1990 – the World Summit for children agreed on a series of focused goals for improving the lives of the children.•Goals were chalked out to meet the same.

SOCIAL GOALS FOR THE YEAR 2000.•A one third reduction in 1990 U5 death rates.•Reduction of MMR.•A halving of malnutrition among U5.•Achievement of 90% of immunization.•A halving of death caused by diarrhoea.•One third reduction of child death due to ARI.•Basic education for all the children.•Clean water & safe sanitation for all communities.•Acceptance in all countries the rights of the child.

•Right to full opportunity for play & recreation.

•Right to name & nationality.•Right to special care if handicapped.•Right to be first among the first to receive protection & relief in times of disaster. •Right to learn to be useful member of society & to develop in a healthy & normal manner & in conditions of freedom & dignity.•Right to be brought up in a spirit of understanding, tolerance, friendship among people, peace & universal brotherhood &•Right to enjoy these rights regardless of race, colour, sex, religion, national or social origin.