assignment on under five clinic slideshare

UNDER 5 CLINIC

Jul 17, 2012

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UNDER 5 CLINIC. Dr. Rekha Dutt. symbol of under 5 clinic. Care in illness. Family planning. Preventive care. Growth monitoring. Aims and objectives. Care in illness : it is mothers felt need. 70%-80% of illnesses can be treated with trained nurses.

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• health education
• 50th percentile
• acute illness
• median weight

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UNDER 5 CLINIC Dr. Rekha Dutt

symbol of under 5 clinic Care in illness Family planning Preventive care Growth monitoring

Aims and objectives • Care in illness: it is mothers felt need. • 70%-80% of illnesses can be treated with trained nurses. • Diagnosis and treatment of acute illness, chronic illnesses and disorders of growth and development. • X ray and laboratory services • Referral services

Preventive care : • Immunization • Nutritional surveillance • sub clinical nutrition • Food supplementation • Health check ups – every 3-6 months. The child health card is maintained. • Oral rehydration solution for diarrhea . The child gets 2-6 attacks in a year. • Family planning • Health education

Growth monitoring – on growth chart also called as Road to health card. • Every month – up to 1 year • 2 monthly – up to 2 years • 3 monthly – up to 5 years • The weight is plotted according to the age of child.

Growth Chart Used In India It has four reference curves. Top most curve – 80 %of the median (50th percentile) of the WHO reference standard. Lower lines represent 70% ,60% and 50% of the standard. 80% median weight is approximately equal to 2 SD below the median which is the conventional lower limit of “normal range”. Purpose of reference curve – It indicates degree of malnutrition.

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• Under Five Clinic Program
• The first five years of life form the foundations of the child’s physical and mental growth and development. Studies have shown the mortality and morbidity are high among this age group. The Department of Health established the Under Five Clinic Program to address this problem.

Program Objectives and Goals 

• Monitor growth and development of the child until 5 years of age.
• Identify factors that may hinder the growth and development of the child.

Activities and Strategies 

• Regular height and weight determination/ monitoring until 5 years old. 0-1 year old=monthly 1 year old and above =quarterly
• Recording of immunization, vitamins supplementation, deworming and feeding.
• Provision of IEC materials (ex. Posters, charts, and toys) that promote and enhance child’s proper growth and development.
• Provision of a safe and learning – oriented environment for the child.
• Monitoring and Evaluation.

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UNDER FIVES CLINIC

Professor david morley.

Emeritus Professor of Tropical Child Health University of London, UK

It is now over 30 years since the book “Paediatric Priorities in the Developing World” was written. This book was largely responsible for the award of the first prestigious King Faisal Prize for International Health, to the author of this editorial. The request to write a chapter for an African Public Health book offered the opportunity to think through the unusual ideas put forward in this book of which was perhaps the most innovative and significant concept of the Under Fives Clinic. It was initiated to meet a situation where there was high mortality and almost no preventive care in an area of Africa with a large population of children. The most significant features of these clinics are still relevant.

Local Personnel provided Preventive and Curative care

The locally trained nurses and clerks were all mothers or fathers. They knew the nuances of the language and the local beliefs. They were responsible for the immunisation, the nutrition of the children through monitoring of the weight curve, advising the mothers on the means to achieve an adequate birth interval, and the treatment of common conditions. For only 10% of the children did they consider it needful to see the doctor or bring the child to be seen and continue with the care on his advice.

Records were kept by the mother

The records consisted of a growth chart with the weight for age chart, information on the family, immunisation, and any reason for special care set out clearly in an easily recognizable form. These were protected by a polythene envelope and carefully kept by the mothers. A study showed that these fewer records were lost than occurred in hospitals which had proper records and filing systems. These records reduced the waiting time considerably and were taken to whichever other health unit the mother attended.

A building designed to meet the needs of the mothers, the children and the staff

Patients did not like a waiting room that was far from the physician's office, but crowding near the door of the consulting room had to be avoided. A low wall separated the nurses’ station and the waiting area for the mothers. They were called in groups. While waiting, the children were weighed by staff with no medical training. Low benches provide the mothers comfortable seating with their children on their laps. There was drinking water and clean toilets for both mothers and children.

Staff discussions were held every week

Discussions on important issues relating to the health of their children took place while the busy mothers waited in the line of flow. After discussion, medications were made available to the nurses for distribution to the mothers to avoid further waiting and delays at the pharmacy.

Satisfaction

The level of satisfaction among the mothers was high. They were seen quickly, usually by local nurses and clerks whom with their regular visits, they came to know well. For the staff, there was the satisfaction of playing a major role in the care for people from their own communities. For the doctor, it was the satisfaction that a good level of preventive and curative care was offered to an average of 400 children a day. His/her time was largely taken up by the care of the more severe or unusual and often more interesting conditions.

In this editorial, Professor Morley addresses a historic topic with much relevance to today's practice. He is the innovator of the concept of under five clinics and was the founder of these clinics in West Africa more than forty years ago. They are now widespread as a concept and practiced all over the world. The under five clinics are clinics that provide comprehensive care for the well as well as ill children. Why did Professor Morley call them under fives clinics? Children under the age of five are singled out for special care because the first five years of life are crucial for brain growth, and until the age of five, the child is completely dependent on his mother.

In the editorial, Professor Morley emphasizes the concept of home based mobile health record of the child which has proved a success. He also stresses the importance of the under- five clinic design to meet the needs of all parties. In referring to weekly clinic staff discussions, he is pointing to an important managerial component often neglected in everyday practice of children clinics.

Professor Hassan Bella , Editor-in-Chief

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UNDER 5 CLINIC - PowerPoint PPT Presentation

UNDER 5 CLINIC

Under 5 clinic dr. rekha dutt symbol of under 5 clinic aims and objectives care in illness: it is mothers felt need. 70%-80% of illnesses can be treated with trained ... – powerpoint ppt presentation.

• Dr. Rekha Dutt
• Care in illness it is mothers felt need.
• 70-80 of illnesses can be treated with trained nurses.
• Diagnosis and treatment of acute illness, chronic illnesses and disorders of growth and development.
• X ray and laboratory services
• Referral services
• Preventive care
• Immunization
• Nutritional surveillance
• sub clinical nutrition
• Food supplementation
• Health check ups every 3-6 months. The child health card is maintained.
• Oral rehydration solution for diarrhea . The child gets 2-6 attacks in a year.
• Family planning
• Health education
• Growth monitoring on growth chart also called as Road to health card.
• Every month up to 1 year
• 2 monthly up to 2 years
• 3 monthly up to 5 years
• The weight is plotted according to the age of child.
• It has four reference curves.
• Top most curve 80 of the median (50th percentile) of the WHO reference standard.
• Lower lines represent 70 ,60 and 50 of the standard.
• 80 median weight is approximately equal to 2 SD below the median which is the conventional lower limit of normal range.
• Purpose of reference curve It indicates degree of malnutrition.

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CARE OF UNDER FIVE’S – Under Five’s Clinic, Aims of Under Five Clinics, Objectives of Under Five Clinics, Role of a Nurse in Under Five’s Clinic and Physical Facilities for a Children’s Clinic (CHILD HEALTH NURSING)

UPDATED 2024

THE RIGHTS OF THE CHILD

To meet the special need of the child, the general assembly of the United Nations adopted on 20 th November 1959, and the declaration of the Rights of the child. India was a signatory to this declaration

• Right to develop in an atmosphere of affection and security and whenever possible in the care and under the responsibility of his/her parents
• Right to enjoy the benefits of social security including nutrition, housing and medical care
• Right to free education
• Right to full opportunity for play and recreation
• Right to a name and nationality
• Right to special care if handicapped
• Right to be among the first to receive protection and relief in times of disaster
• Right to learn to be a useful member of society and to develop in a healthy and normal manner and in conditions of freedom and dignity
• Right to bring up in a spirit of understanding of brotherhood
• Right to enjoy these rights, regardless of race, color, sex, religion, social and national origin

UNDER FIVE’S CLINIC

The under five’s clinic or well baby clinic’s combines the concepts of prevention, treatment, health supervision, nutritional surveillance, and education into a system of comprehensive health care within the resources available in the country, making use of nonprofessional auxiliaries, thus making the service not only economical but also available to a larger proportion of children in the community. Under five clinics must provide for courteous reception of mother and children, with enthusiasm and zeal on the part of each member of the team

AIMS OF UNDER FIVE CLINICS

Care in illness: the basic philosophy of the under five’s clinic to give nurses effective training and responsibility for handling the child healthcare service. The illness care for children will comprise of diagnosis and treatment, X-ray and laboratory services and referral services

Preventive care: the preventive care given on the basis of immunization, nutritional surveillance, health checkups, oral rehydration, family planning and health education

Growth monitoring: for under five clinic to weigh the child periodically at monthly intervals during the first year, every 2 months during the second year and every 3 months thereafter up to a age of 5 to 6 years. The growth curve will help the health worker to detect early onset of growth failure

OBJECTIVES OF UNDER FIVE CLINICS’

• The prevention of malnutrition, pertussis, tuberculosis, poliomyelitis, diphtheria, tetanus and measles
• The supervision of the health of all children upon the age of five
• The education of parents to promote health and family planning
• The provision of simple treatment for diarrhea, with or without dehydration, pneumonia, skin conditions and other common disorders

ROLE OF A NURSE IN UNDER FIVE’S CLINIC

• Treating minor illness
• Referring the more seriously-ill children
• Instructing about feeding, nutrition and hygiene
• Encouraging child spacing and family planning
• Maintaining the children’s weight cards, e.g. road to good health cards
• Being alert in every conditions so that the effectiveness of the service can be improved

PHYSICAL FACILITIES FOR A CHILDREN’S CLINIC

• Outside compound: playground for children waiting to be served including swings slides and sand box are needed. These facilities may be provided by the community volunteer group or by the health committee
• Waiting room should include a reception table and the record. The area should include child health posters, display exhibits and play are for the children
• Weighing and measuring should be provided in a separate area if possible or it may be part of the waiting room
• Isolation area for children with signs and symptoms of illness is essential for every child health clinic

NURSING PROCEDURES LIST CLICK HERE

Here are some key points regarding the care of children under the age of five:

• Nutrition : Proper nutrition is crucial for the healthy development of children under five. Breastfeeding is recommended as the best source of nutrition for infants up to six months of age, followed by the introduction of complementary foods while continuing breastfeeding up to two years or beyond. Adequate intake of nutrients such as protein, vitamins, and minerals is essential for growth and development.
• Immunization : Following the recommended immunization schedule is essential to protect children under five from vaccine-preventable diseases. Vaccines help build immunity and prevent the spread of infectious diseases, reducing the risk of illness, disability, and death.
• Hygiene and Sanitation : Good hygiene practices, including handwashing with soap and water, safe food handling, and sanitation measures, are critical for preventing the spread of infections and diseases among young children. Access to clean water and sanitation facilities is essential for maintaining health and preventing waterborne illnesses.
• Healthcare : Regular health check-ups and access to healthcare services are vital for monitoring the growth and development of children under five, detecting and managing health issues early, and providing appropriate treatment and preventive care. Maternal and child health services, including antenatal care, postnatal care, and well-child visits, play a crucial role in promoting child health and well-being.
• Safety and Childproofing : Creating a safe environment for young children is essential to prevent accidents and injuries. Childproofing the home, including installing safety gates, securing furniture and electrical outlets, and keeping hazardous substances out of reach, helps minimize the risk of accidents and promote child safety.
• Stimulation and Play : Providing opportunities for play, exploration, and stimulation is vital for the cognitive, emotional, and social development of children under five. Engaging in age-appropriate activities and spending quality time with children supports their learning and overall well-being.
• Parental and Caregiver Support : Supporting parents and caregivers in providing responsive and nurturing care is crucial for the healthy development of children under five. Providing information, education, and support on child-rearing practices, positive discipline, and early childhood development can empower parents and caregivers to create a nurturing environment for their children.

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In the 13th-15th centuries, this land was the eastern outskirts of the Golden Horde. Later, until the end of the 16th century, it was part of the Siberian Khanate. In the 18th century, the territory of the present Novosibirsk region became part of the Russian Empire.

Despite the relatively favorable climate, the Russians began to settle here relatively late. The Barabin Tatars were the indigenous people. Today, their total population is about 10,000 people living mainly in the western parts of the region.

The Barabin Tatars were subjected to constant attacks of the Kalmyks (the Oyrates and Teleuts). Russian villages were also under the threat. That’s why people preferred to settle in the north, near Tomsk. Only at the end of the 17th century, Novosibirsk province became attractive to settlers.

More Historical Facts…

The first settlement was founded by the boyar son Alexey Kruglik in 1695. Later, this settlement became the village of Kruglikovo. Today, it is located in Bolotninsky district. In the early 18th century, Berdsky stockaded town was built. Over time, the threat from the nomads decreased and the number of settlers increased.

In 1722, the Siberian line of fortresses along the Irtysh River was constructed. The locals were mainly engaged in soil tilling, fishing and hunting. In the early 19th century, the famous Ural manufacturer Akinfiy Demidov constructed two copper melting plants here - Kolyvansky and Barnaulsky.

In 1893, due to the construction of the Trans-Siberian Railway and the railway bridge across the Ob River, Alexandrovsky settlement was built (from 1895 - Novonikolayevsky). Thanks to its convenient geographical location (the Trans-Siberian Railway crossing the Ob River, transportation ways connecting Siberia with the European part of the Russian Empire), its trade importance grew rapidly. In 1909, Novonikolayevsk became a town. In 1925, it was renamed in Novosibirsk.

Before 1921, the territory of Novosibirsk oblast was part of Tomsk gubernia, from 1921 to 1925 - of Novonikolayevsk gubernia, from 1925 to 1930 - of Siberian krai, from 1930 to 1937 - of West Siberian krai. September 28, 1937, West Siberian krai was divided into Novosibirsk oblast and Altay krai. This date is considered the official date of the region formation.

Novosibirsk Oblast - Features

Novosibirsk Oblast is located in the south east of the East-Siberian Plain, in the steppe, forest-steppe and taiga zones, between the Ob and the Irtysh rivers. The length of the region from west to east - 642 km, from north to south - 444 km.

The southern part of Vasyugan swamp, the largest swamp in the world, occupies the territory in the north and north-west of the province. In the southwest, it borders with Pavlodar oblast of Kazakhstan.

There are about 3,000 lakes on the territory of the Novosibirsk region. The largest lakes are Chany, Ubinskoye, Sartlan. Novosibirsk Reservoir also known as “the Ob Sea” (1,082 sq. km.) was created for Novosibirsk Hydroelectric Power Plant.

The climate is continental. The average temperature in January ranges from minus 16 degrees Celsius in the south and minus 20 degrees Celsius in the north. The average temperature in July - plus 18-20 degrees Celsius.

The largest cities and towns are Novosibirsk (1,621,000), Berdsk (103,500), Iskitim (54,700), Kuybishev (43,000). Novosibirsk is one the largest industrial, transport, scientific, and cultural center of Russia, the third most populous city in the country after Moscow and St. Petersburg. It is also the capital of the Siberian Federal District.

In the historical part of Novosibirsk you can find a lot of preserved monuments of the Russian Empire times. The Soviet era is presented by numerous scientific and cultural attractions, as well as beautiful parks.

There are more than 500 deposits of various mineral resources in Novosibirsk Oblast (coal, refractory clay, peat, anthracite). Natural gas and oil fields are located in the north-western part of the region. There are significant reserves of underground thermal and mineral waters. Forests cover about 4 million hectares, more than 20% of the territory.

Novosibirsk Oblast is one of the most industrially developed regions in Siberia (metal processing and machine building, food, power engineering, non-ferrous metallurgy industries). Heavy industries are concentrated in Novosibirsk, Iskitim and Berdsk.

The regional agriculture specializes in the cultivation of grain, potatoes and vegetables. Dairy cattle breeding, poultry farming and beekeeping are developed. The production of flax plays an important role too. Agricultural development of the territory is not high (about 48%). In general, it has about 25% of all agricultural land in Western Siberia.

Novosibirsk oblast of Russia photos

Nature of novosibirsk oblast.

Novosibirsk Oblast nature

Author: Klemeshev

Novosibirsk Oblast scenery

Author: Mikhantiev Zhenya

Sunflower field in Novosibirsk Oblast

Author: Sergey Savchak

Pictures of the Novosibirsk region

Steppe landscape in Novosibirsk Oblast

Author: Alex Strekhletov

Orthodox church in the Novosibirsk region

Author: Sergey Bulanov

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