National programmes related to child health and welfare

National programmes related to child health and welfare 9/30/2020 Mrs. Sharin Neetal D'souza 1

National programmes related to child health and welfare Prepared by: Mrs. Sharin Neetal D’souza Lecturer Dept. Child health nursing Yenepoya nursing college 9/30/2020 Reviewed by: Prof. Umarani J Dr. Priya Reshma Aranha Mrs. Sharin Neetal D'souza 2

Learning objectives At the end of the class students will be able to • list out all the national programmes and its objectives 9/30/2020 Mrs. Sharin Neetal D'souza 3

MOTHER & CHILD • Maternal & child health programme • Integrated child development service scheme • Reproductive & child health progamme • Child survival & safe motherhood programme

COMMUNICABLE DISEASES • National malaria eradication programme • Revised national tuberculosis control programme. • National AIDS control programme

CONTROL OF NUTRITIONAL DEFICIENCIES & DISORDERS • National iodine deficiency disorder control programme • Applied nutrition programme • Supplementary nutrition programme • Balawadi nutrition programme • School midday meal programme

CONTROL OF NON COMMUNICABLE DISEASE • National school health programme • National programme for control of blindness

MATERNAL & CHILD HEALTH PROGRAMME Objectives i. To reduce maternal, infant & childhood mortality & morbidity ii. To promote physical & psychological development of children & adolescence iii. To promote reproductive health

Services for the children • • Essential newborn care Immunizatoin Appropriate management of diarrhoea Appropriate management of acute respiratory tract infection • Vitamin A prophylaxis • Treatment of anemia

Newborn care • • Birth weight for all newborn Resuscitation of asphyxiated babies Care for law birth weight babies Prevention of hypothermia Exclusive breast feeding within 1 hr of delivery Referral of newborn who show signs of illness Immunisation

Prevention of anemia • IFA- small tablets • If facilities are available stool examination for hookworm infestation should be done • Distribution of mebendazole in areas where prevalence rate of hookworm infestation is high

PREVENTION FROM DIARRHOEAL DISEASES Advice the mother to give § Increased volume of fluid § Oral rehydration therapy § Home available fluids § Continue feeding

Prevention of deaths due to pneumonia • Correct case management for all cases of acute respiratory infection • Early initiation of treatment • Referral for children with severe pneumonia

Vitamin A prophylaxis • 1 st dose 1, 000 IU with measles vaccination • 2 nd dose 2, 000 IU at 16 -18 months along with DPT/OPV booster • 3 rd dose 2, 000 IU each at 6 months interval

INTEGRATED CHILD DEVELOPMENT SERVICES

OBJECTIVES • It started in 1975 • To improve the nutritional & health status of children of age group 0 -6 yrs • To lay the foundation for proper psychological, physical & social development • TO reduce mortality, morbidity, malnutrition & school drop out • TO achieve an effective co-ordination of policy & implementation among the various departments working for the promotion of child development • To enhance the capability of the mother & nutritional needs of the child through proper nutrition & health education

DELIVERY OF SERVICES v Supplementary nutrition o Is given to children below 6 yrs of age o The type of food depends location, local available , type of beneficiary AIM-TO PROVIDE o Below 1 yr-200 cal & 8 -10 g of protein o 1 -6 yr- 300 cal & 15 g of protein o It is given 300 days a year

v. Nutrition & health education o 15 -45 yrs age group o Organized by anganwadi workers during home visit v. Immunization

v Health checkup Include o Care of newborn, infant o Care of children under 6 yrs of age • Periodically recording of height & weight of children • Watch the mile stone • Immunization • General health checkup every 3 -6 month • Treatment of diseases like diarrhoea, dysentry, respiratory tract infection, deworming • Prophylaxis against vitamin A deficiency & anaemia • Referral services

v. Non- formal preschool education o Given 3 -6 yrs age group o To provide opportunities to develop desirable attitude, values & behavior pattern among children

REPRODUCTIVE & CHILD HEALTH PROGRAMME

This approach has been defined as “people have the ability to produce & regulate their fertility, women are able to go through pregnancy & child birth safety, the outcome of pregnancy is successful in terms of maternal & infant survival & wellbeing & couple are able to have sexual education free of pregnancy & contracting disease.

HIGHLIGHTS • The programme integrate all intervention of fertility regulation, maternal & child health with reproductive health of both men & women • The services to be provided are client oriented • The programme will provide various intervention & quality of care • The programme aims at providing the out reach of services primarily for all vulnerable group of population • Facilities of obstetrics care, MTP, IUD insertion

RCH PHASE 1 • Family planning • Child survival & safe motherhood component • Client approach to health care • Prevention & management of AIDS, STD’s etc

CHILD SURVIVAL & SAFE MOTHERHOOD PROGRAMME

• This approach means that every couple should be able to have children when they want • That the pregnancy is uneventful, that safe delivery services available • That the end of pregnancy mother & child are safe & contraception by choice are available to prevent pregnant & contracting disease

SERVICES FOR THE CHILDREN ü Essential new born care ü Exclusive breast feeding & weaning ü Immunization ü Appropriate management of diarrhoea ü Appropriate management of acute respiratory tract infection ü Vitamin A prophylaxis ü Treatment of anaemia

v. New born care • If birth weight is less than 2000 g refer to a medical officer for further examination v. Resuscitation of asphyxiated babies • The mucus trapped in the mouth should be gently sucked with the help of mucus sucker & give mouth to mouth respiration if necessary

v. Prevention of hypothermia • After birth the newborn should be wiped dry & covered well with soft, clean, cotton cloth which has been washed with soap & dried in sun • Exclusive breast feeding within 1 hr of delivery • Refferal of newborn who show signs of illness • Immunization

RCH PHASE-11 Began from 1 st April 2005 The focus of the programme is to reduce maternal & child morbidity & mortality with the emphasis on on rural health STRATERGIES q Essential obstetric care a) Institutional delivery b) Skilled attendance at delivery q Emergency obstetric care a) Operationalising 1 st referral services b) Operationalising PHC & CHCs for round the clock Delivery services q Strengthening referral system

NATIONAL MALARIA ERADICATION PROGRAMME

OBJECTIVES • Launched in 1953 OBJECTIVES Ø To prevent deaths due to malaria Ø To reduce the morbidity Ø To maintain agricultural & industrial production by undertaking intensive antimalarial measures in such areas

Reclassification of endemic areas It can be done according to annual parasite incidence Areas with API more than 2 § All the areas with API 2 & above are brought under regular insecticidal spray with 2 rounds of DDT § Where the vector is refractory to DDT 3 rounds of malathion are recommended § Areas refractory for both to be treated 2 rounds of synthetic pyrethroids spray at interval of 6 wks

Areas with API less than 2 This areas will not be under regular insecticidal spraying. How ever Focal spraying is to be undertaken only around p. falciparam cases detected during survillances

SURVELLANCE AIM Case detection through laboratory services & providing facilities for proper treatment. ACTIVE SURVILLANCE § Multipurpose worker will find out whethere is a fever cases in the house § Whethere is fever case in the house between his previous visit & present visit § If the answer yes he will collect the blood sample administer a single dose of chloroquine according to age of a patient § After confirming if it is positive then rest of the treatment will continue

Passive survillance It is the search for malaria cases by local health agencies such as PHC, hospital, subcenter. Present strategies • Early case detection& prompt treatment • Integrated vector management v It include indoor residual spraying in selected pockets at high risk areas for malaria. v. The bed nets are supplied by the government free of cost. v. Use of larvivorous fish

REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME

features • Achievement of at least 85% cure rate of infectious case through supervised short course chemotherapy. • Involvement of NGO’s information, education, communication & improved operational research.

PAEDIATRIC TUBERCULOSIS v. The drugs will be supplied by patient wise boxes same as a adult v. For intensive phase- 1 day medication package v. For the continuation phase- 1 week supply of medication v. The combipack drugs for extension of intensive phase are supplied seperately v. Treatment will be based on the child’s body wieght

• There will be 2 generic PWB’s 1) For the 6 -10 kg weight band 2) For the 11 -17 kg weight band Children weighing less than 6 kg will be treated with loose anti-TB drugs ie ISONIAZID 5 mg

NATIONAL AIDS CONTROL PROGRAMME

OBJECTIVES A. To reduce the spread of HIV infection in India B. To strengthen India’s capacity to respond to HIV/AIDS on a long term basis

NATIONAL AIDS PREVENTION & CONTROL POLICY OBJECTIVES Reduction of the impact of epidemic & to bring about a zero transmission rate of AIDS IT CAN BE ACHIEVED BY Ø Blood safety programme o Blood transfusion services o Professional blood donation has been prohibited o Licensed blood bank were permitted o Voluntary blood donation was encouraged

o The strategy to ensure safe collection, processing, storage & distribution of blood. o Zonal blood testing centers have been established (Function-To test the blood samples from the blood bank attached to them & to report the result of HIV test same day)

Ø Councelling & voluntary testing Ø School AIDS education programme Ø Information , education, communication & social mobilization i. To raise awareness, improve knowledge & understanding among the general public health about AIDS infection ii. To create a supportive environment for the care & rehabilitation of person with AIDS infection

Ø Prevention of HIV transmission from mother to child Ø Anti retroviral treatment Ø Family health campaign

NATIONAL IODINE DEFICIENCY CONTROL PROGRAMME GOAL To reduce the prevalence of iodine deficiency disorder below 10% in the entire country OBJECTIVES § Survey to assess the magnitude of the iodine deficiency disorder § Supply of iodised salt in the place of common salt § Resurvey to asess the extent of IDD & impact of iodized salt

ACTIVITIES • Use of iodised salt in place of common salt • Monitoring & surveillance • Man power training & mass communication

APPLIED NUTRITION PROGRAMME

. LAUNCHED AT 1963 OBJECTIVES 1. To make people conscious of their nutritional needs 2. To increase production of nutritious & their consumption 3. To provide supplementary nutrition to vulnerable groups through locally produced food

components ü Production of protection food ü Training of functionaries involved in the production of these foods ü Nutrition education & demonstration

ACTIVITIES q Kitchen gardens, school, community gardens are set up to promote the concept of balanced diet, as well as to increase production q Fishery units & poultry units are setup. This gives employment, added income & more production of food q Providing better seeds as well-bred-cattle were provided q Supplementary feeding, through local food production, was given to vulnerable pregnant, lactating mother & children q Panchayath, yuvak & mahila mandals were to be involved q Formal pre-school education

SUPPLEMENTARY NUTRITION

OBJECTIVES • To improve the nutritional status of pregnant & lactating mothers & children below 6 yrs of age in the weakest & most vulnerable areas • Reduction in mortality & morbidity in children below 6 yrs • Enhance the capacity of mothers to look after the daily health & nutritional needs of children

ACTIVITIES ü TO PROVIDE SUPPLIMENTORY NUTRITION ü To provide health services including supply of vitamin A solution & iron & folic acid tablets BENIFICIARY § Children below 6 yrs of age-30 kcal & 10 -12 g protein/day § This will provide 300 days in a year

BALAWADI NUTRITION PROGRAMME

OBJECTIVES Launched in 1970 -71 OBJECTIVES v To supply 1/4 th of calories requirements & ½ of the protein requirement of the preschool child v It is to be supplement to what the child receive at home v As far as possible locally available food stuffs is to be utilised v Children belolngig to the lower socio economic group would be selected v Community involvement would be encouraged

Services • Providing 300 cal & 10 g of protein/child/day for 270 days a year • Non formal education of preschool child is given

MID-DAY MEAL PROGRAMME

• It started in 1925 • It provides food 6 -11 yr of children for 200 days a year OBJECTIVES o Providing food to meet the gap in nutritional requirements particularly in poor children o This would help the children not only improving the nutritional status, but also improves their performance at school o It would indirectly act as an incentive for sending children to school o The proper & major objectives of the programme is to attract more children for admission to school

PRINCIPLES ü The meal should be a supplement & not a substitute to the home visit ü The meal should supply at least 1/3 rd of the total energy requirement & ½ of the protein need ü The cost of the meal should be reasonably low ü The meal should be such that it can be prepared easily in school, no complicated cooking process should be involved ü As far as possible, locally available foods sounds be used, this will reduce the cost of the meal ü The meal should be frequently changed

FOOD STUFFS § Cereals & millets § Pulses § Oils & fat § Leafy vegetables § Non Leafy vegetables Grams/day/child 75 30 8 30 30

NATIONAL SCHOOL HEALTH PROGRAMME

OBJECTIVES ü To promotion of positive health ü To prevention of diseases ü Early diagnosis, treatment & follow up of defects ü Awakening health conscious in the children ü To provide the healthful environment

ASPECTS • Health appraisal of school children & school personnel • Remedial measures & follow up • Prevention of communicable diseases • Nutritional services • First & emergency care • Health education • School health recods

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS

Started in the year 1976 STARTEGIES q. To rule out the causes of blindness q. To shift the eye camp approach to a fixed facility surgical approach q. Construction of dedicated eye operation theater, eye wards & training of eye surgeon q. To strengthen participation of voluntary organization in the programme.

TARGETS o Motivation of eye donation o Specially for children -development of 50 ophthalmology units -early diagnosis & treatment -primary eye care -school eye screening programme -referral services VISSION 2020 – RIGHT TO SIGHT

Evaluation 1. What is vision 2020 2. How many days in a year mid-day meal program is implemented? 3. Goitre is seen due to -----------deficiency 4. Isoniazid is given for children whose weight is below than ------kg 9/30/2020 Mrs. Sharin Neetal D'souza 70

Reference • K. Park. Text book of preventive medicine. • Wong’s essentials of pediatric nursing; 17 th edition • Marlow. Text book of paediatric nursing, 6 th edition • Rimple sharma. Text book of paediatric nursing • Parul Datta. Text book of child health nursing 9/30/2020 Mrs. Sharin Neetal D'souza 71

THANK YOU 9/30/2020 Mrs. Sharin Neetal D'souza 72