Lecture 5 Child Health Interventional programs
A- Antenatal and intranatal fetal monitoring
Frequent serial assessment of fetal wellbeing from the second trimester
of pregnancy till delivery of fetus in the process of labor
Aim
- Decrease of perinatal mortality
- Decrease of neonatal morbidity
- Decrease of childhood morbidity, disability and mortality
Service millstones
- Chronological uterine level assessment compared to LMP
- Maternal weight follows up - Fetal quick count study
- Fetal heart sound auscultation -Serial fetal ultrasonography
- Doppler placental fetal circulation assessment
- Fetal amniocentesis and chromosomal study
-Fetal blood investigation
B- Neonatal resuscitation
It is immediate postnatal medical assessment, management and
follows up of the health state of the newborn and providing him the
appropriate health care
Aim
- Decrease of perinatal mortality
- Decrease of neonatal morbidity and mortality
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
Service millstones
-Apgar scoring -Insurance of respiratory functions
-Immediate encouragement of breast feeding
-Early detection of congenital anomalies -Umbilical stump care
-Cleaning and warming -BCG Vaccination
-Prophylactic treatment of neonatal conjunctivitis
-Nursery admission for premature and ill newborns
GOBI child health services
It is a package of child health services evidently based to markedly
reduce child mortality
G: Growth monitoring
It is periodic child weight and height monitoring using growth charts and
case health management accordingly
NB. The growth is interpreted as normal when the growth curve of the
concerned child lies between 3rd and 97th percentiles as illustrated in
charts below.
Aim
- General Child health assessment via monitoring of growth as essential
child health parameter
- Early detection of nutritional disorders and chronic child illnesses
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
O: Oral rehydration therapy for diarrhea
It means wide distribution and immediate use of oral rehydration salts for
all children suffering from diarrhea to prevent dehydration, electrolyte
imbalance and death through enhancing awareness of peoples regarding
this issue.
ORS is the basic and main therapy for all cases of diarrhea and it is
proved to be the chief component in prevention of child mortality due to
diarrhea
Service millstones
-Emphasis on permanent availability of ORS
-Education of mothers how to make home ORS
-Establishment of ORS units in health facilities
B: Breast feeding enhancement
Encouragement and providing help for mothers to enhance successful
exclusive breast feeding of their children for 6 months and to
continue breast feeding while weaning for the next 6-18 months
Service millstones
-Immediate breastfeeding within the 1st 30 minutes after labor
-Avoiding all prelacteal feedings
-Encouraging health facility mother child rooming in
-Encouraging breastfeeding on demand
-Emphasis on practicing night breastfeeding
-Avoiding breast milk substitute
-Avoiding feeding bottle and pacifiers
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
Some benefits of breastfeeding for the child
-Ideal nutrition - building defense and immunity
-Best growth and development
-Better intelligence and psycho social development
-Reducing allergic diseases (as bronchial asthma. allergic dermatitis)
-Reducing many childhood illnesses (as otitis media, leukemia,
hyperkinetic syndrome)
-Reducing many adulthood chronic illnesses (as IHD, Hypertension, DM)
I: Immunisation
Giving all children whole childhood vaccines against serious infectious
diseases (tuberculosis, measles, diphtheria, pertussis, tetanus,
poliomyelitis)
Aims
- Reducing prevalence of serious child hood infectious diseases
- Reducing childhood mortality, morbidity and disability
Integrated management of childhood illnesses (IMCI):
The IMCI strategy: is a broad strategy developed by WHO and UNICEF
to reduce childhood deaths, illness, and disability below five years, which
occur mostly in developing countries and to improve children growth and
development.
It combines comprehensive management of childhood illnesses which
cause more than 70% of childhood mortality and morbidity including
acute respiratory infections (ARI), malaria, diarrhea, measles and
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
malnutrition with care of immunization in children below the age of five
years.
The strategy focuses on three main components:
1- Improvements in the case management skills of first level health staff
2- Improvements in the health system required for effective management
of childhood illness
3- Improvements in family and community practices
Benefits of the IMCI strategy
1- Accurate identification of childhood illnesses in outpatient settings
2- Ensuring appropriate combined treatment of all major illnesses
3- Strengthening the counseling of caretakers and provision of preventive
services, and speeding up the referral of severely ill children
4- Improving the quality of care of sick children at the referral level
5- Promoting appropriate care seeking behaviors in the home setting,
6- Improving nutrition and preventive care
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Lecture notes in Maternal and Child health April 2025 Dr. Nabil Gonaid
