Professional Documents
Culture Documents
-1992
-2 Pilot areas are in zamboanga del norte and sarangani
-strategy in reducing mortality and morbidity rate caused by a common childhood illness .
Pneumonia
Diarrhea
Dengue
Malaria
Measles
Malnutrition/Anemia
Ear Problems
Target Age:
1wk old age – 5y/o
5.A combination of individual signs leads to childs classification and not for diagnosis.
***classify illness is classification right!!!
But identify illness is diagnosis its wrong!!
6.IMCI management procedures use limited essential drugs means low cost but high
effective and we need active participation of care takes is needed.
a.Antibiotics (PO,IM,APPLIED)
b.Anti malarial (PO,IM)
c.Anti Helmentics (PO)
7.The guidelines do not describe the management of trauma and other emergency.
Intramascular/IM
1st line:chlorampenicol
2nd line:Benzylpenicillin (Procaine penicillin)
Applied:
Eyes: Tetracycline ointment
Skin, mouth and umbilicus: Gentian violet
Half strength of Gentian Full strength of Gentian
Violet Violet
.25% concentration .5% concentration
1 ml GV + 3 mil distilled 1 ml GV + 1ml distilled
water water
ANTI MALARIALS
PER OREM/PO
1ST line: Sulfadoxine(pyrimethamine), Chloroquine, Primaquine
2nd line: Arthemeter (Lumefantrine)
Intramascular/IM
Quinine- use for severe cases of malaria
ANTI HELMENTICS
PER OREM/PO
Albendazole
Mebendazole
Reminders in giving anti helmentics:
Only 12mos age and above
With 6 months interval after the last deworming
STEP BY STEP PROCESS: INTEGRATED CASE MANAGEMENT PROCESS
1.Assess s/s
2.Classify illness: Severe- pink
Moderate – yellow
Mild – green
3.Identify treatment- color code treatment:
Pink: referral or admission but with pre referral management or treatment in Health
Center.
Yellow: well enough to go home but with specific management/treatments like
antibioticspo, anti malaria po
Green: well enough to go home but with simple home care or home management like safe
remedies,TSB, paracetamol
4.Treat the child –the first dose of any drugs is given in health center
5.Counsel the mother
6.Give follow care commonly 2 days, 5 days, 14 days or 30 days.
3.To determine
shock: vital signs
DIARRHEA
-occurs when stool contains more water than normal
-consistensy of stool: watery loose stool.
-frequency of bowel movement: 3 or more within a day
-Clinical Manifestation: 3 or more of loose/watery stool within a day according to WHO and
DOH.
Program:CDD (Control of diarrheal disease)
Main objective:to reduce mortality rate d/t diarrhea among children 5years of age through
extensive care management.
Extensive care management: Oresol rehydration Therapy
ORS:1.oresol pocket/hydrite
2.home made ORS
3. AM- Rice water
MEASLES
Reminders!!!
1. A child with diarrhea who is due for OPV should receive a dose of OPV but it is not
counted.
Example: baby jane visited health center to receive OPV1 but she is (+) for
diarrhea.
What will the nurse do? You may still give the OPV1 vaccine to jane but her visit is
not counted, after 4 wks baby jane has no diarrhea so the nurse will give OPV1 to
baby jane because her 1st visit is not counted due to her diarrhea.
2. If only one child at the health center needs immunization, you may do so open vial
vaccine and give it to the child because of the principle. ”life before resources”
You may keep open vials of OPV for the next immunization if:
a. The expiry date has not yet passed.
b. Vaccine stores at 0-8 degree Celsius.
c. And must not taken out of the health center for outreach activities
d. No changes in color (VVM) vaccine vial monitor a device to determine color in vial.
CLASSIFICATIONS NEEDING VITAMIN A:
1. Severe Pneumonia
2. Severe persistent diarrhea
3. Persistent diarrhea
4. Severe complicated measles
5. Measles with eye or mouth complications
6. Measles
7. Severe malnutrition
8. Severe anemia
9. Very low wt.
BABY A BABY B
At birth – 6 mos old At birth – 4 mos old
-exclusive BF -exclusive BF
-8-12x BF within 24 hours -8-12x BF within 24 hours
4 mos – 6 mos old
-BF + once a day or 2x a day
complementary foods
if child shows:
a. interest to semi solid food
b.appears hungry after BF
c.not gaining weight appropriately
6 mos – 12 mos old 6 mos – 12 mos old
-BF + complementary foods 3x a day -BF + complementary foods 3x a day
-if no BF complementary foods 5x a day -if no BF complementary foods 5x a day
12 mos – 2 y/o 12 mos – 2 y/o
- BF + complementary foods 5x a day - BF + complementary foods 5x a day
-if no BF complementary foods 5x a day -if no BF complementary foods 5x a day
2y/o and above 2y/o and above
-5x a day family food -5x a day family food
BREASTMILK:
1.it contains the ffng:
Macronutrie Micronutrien Minerals
nts: ts: Antibodies
Lactose Vit. A igA
Proteins Vit.C
fats Iron
2.Milk formula should be given through cups or spoon and never bottle.
3.Complementary foods must be energy rich,nutrient rich,locally affordable. Like mashed
potato,bananansquash,tokwa,egg,bulanglang,lugaw rcipes are: pulverize dilis,mongo or
shrimp for protein,iodized salt for iodine and malungay or horse radish for iron.
4.Signs of hunger:
a. beginninng to fuss
b.sucking of thumb or fist
c. movements of lips
YOUNG INFANT COMMON ILLNESS/PROBLEMS
FEEDING PROBLEMS:
ORGANIZATIONAL PHASE
Social preparation Spotting & Core group Setting up
developing potential formation community org
leaders or committee
-continously learning -person who have -core group consist -when all sectoral
more about the deep concern and of the identified organization have
conditions of the understanding on potential leaders. been put up.
community. the conditions of the -Main role:represents -This organization
-Main Objectives: to community the different sectors will facilitate wider
deepen and CHARACTERISTICS of the community participation and
strengthen ties with OF A POTENTIAL like: collective action on
the community LEADERS: -Elder sector community
1.respected of -Youth sector problems.
community members -Children sector
2.has wide influence -Handicapped sector
to elite & poor -Fisherman/farmer
community sector
members. -Women sector
3.responsible & -Livelihood sector
committed. -Health sector
4.has good
communication
skills.
5.willing to work for
a desired change.
TRAINING/EDUCATIONAL PHASE
-To strengthen the organization and develop its capability to attend the community basic
healthcare needs.
Conducting Health Services and Leadership- Training of
Community mobilization of formation activities community health
diagnosis resources workers
-done to come up -actual exercises of -constant meetings - village or grassroot
with the profile of people power and -different activities workers lik BHW,hilot
the community confidence. (APIE) -Conduct training
needs, issues and -team building needs assessment
problems. exercises to enhance (TNA)
-Social Investigations cohesiveness -to determine the
is collecting level of health skills
collating, analyzing and knowledge the
& understanding trainees possess.
data to draw a clear -result of the
picture of the assessment serves
community. as basis for the
-known as the health skills training
community study. and curriculum.
2 types of
community Dx:
1.comprehensive
community
diagnosis:aims to
obtain general
information about
the community
2.Problem oriented
community diagnosis
-particular need
-particular group
INTERSECTORAL/ COLLABORATION PHASE:
-Facilitate and collaborate with:
-Institution
-Agencies
-Other key people
-Articulate the communities for support and assistance
PHASE OUT
-After 5 years of activities the nurse gradually prepares for:
a. Turnover of work
b. Develops a plan for monitoring or action plan
c. Subsequent follow up of the organizations activities
Phase of strategy
1. Impact assessment
URBAN- rapid urban appraisal
RURAL- rapid rural appraisal
2. Phase out action plan
3. Gradual pull out of intervention
4. Institutionalization of the community organization with other agencies who provided
support of
(SEC) security exchange committee.
5. Provision of consultancy services.
EPIDEMIOLOGY:
- Study on disease occurrence or distribution
- Backbone on disease prevention
Endemic- constant and always present
Sporadic- occasional, irregular
Epidemic – sudden increase or in excess of “expected level”
- outbreak
Pandemic – worldwide distribution
DEMOGRAPHY:
- Study on human population size, distribution & composition
Census-complete enumeration of the population
Roles/responsibility of CHN:
C-ollect data
A-nalyze data
T-abulate data
E-valuate data
R-ecommended programs
Formula: