CHILD HEALTH PROGRAMS

ESSENTIAL PACKAGES OF CHILD SURVIVAL

Nutritional Screening Management of Common Childhood Illnesses

Developmental Milestone Complementary Feeding by 6 Months

Screening

Prevention and management of hypothermia on newborn

Disability Detection
Full Immunization

NB Eye Prophylaxis
Newborn screening

NB resuscitation First Aid

Counseling on Accident Prevention and Use of Safe Toys Dental Care

Immediate and Exclusive Breastfeeding

Micronutrient Supplementation
Birth Weight and Growth monitoring
Advise on Psychosocial Stimulation
Growth monitoring and Promotion
CHILD HEALTH
PROGRAMS
• Infant and Young Child
Feeding
• Newborn Screening
• Expanded Program on
Immunization
• Management of
Childhood Illnesses
• Micronutrient
Supplementation
• Dental Health
• Early Child Development
• Child Health Injuries

CHILD HEALTH PROGRAMS

 GOAL

UNDER-9
MORTALITY RATE AND MORBIDITY RATE
 INFANT AND YOUNG CHILD
FEEDING
• Goal
– Reduce child mortality rate by 2/3 by 2015

• Objective
– Improve the survival of infants and young children
by improving their nutritional status, growth and
development by optimum feeding.
BREASTFEEDING PROGRAM
 BREASTFEEDING
BREASTFEEDING PROGRAM
PROGRAM
• Marilen F. Pacis RN,RM,MAN
• Exclusive breastfeeding in the first four (4) to six (6)
months after birth is encouraged as well as
enforcement of legal mandates.
 LEGAL MANDATE
• RA 7600
– (The Rooming-In and Breastfeeding Act of 1992)

• Executive Order 51 of 1986

– (The Milk Code).
 RA 7600

– Known as "The Rooming-In and

Breastfeeding Act of 1992.“

A. Rooming in
B. Human milk bank
WHEN SHOULD ROOOMING IN BE DONE?
A. NSD
- 30 minutes after birth
*Well infants regardless of age gestation;
and
*Infants with low birth weights but who can
suck.
B. CS
- within three (3) to four (4) hours after birth

C. Deliveries Outside Health Institutions

- immediately after admission to OB ward
 RA 7600
(The Rooming-In and Breastfeeding Act of 1992)

• Human Milk Bank

–Provision of facilities for Breastfeeding
Collection and Storage
 EXECUTIVE ORDER NO. 51
(Philippine Code of Marketing of Breastmilk Substitutes)
“Provision of safe and adequate nutrition for
infants by:
A. protection and promotion of breast
feeding
B. proper use of breastmilk substitutes
and breastmilk supplements

THROUGH

Adequate information
Appropriate marketing and distribution
 EXECUTIVE ORDER NO. 51
(Philippine Code of Marketing of Breastmilk Substitutes)

 ADVANTAGES OF BREASTFEEDING
A. Health Benefits
- Mother
- Child
B. Social and Economic Benefits
ADVANTAGES OF BREASTFEEDING

Benefits to the Child in the First Years of

Life

– strengthens the immune system

– decreased incidences of respiratory infections
– diarrheal disease is three to four times more likely
to occur in infants fed formula than those fed
breast milk
– to reduce the likelihood of ear infections
– decrease in the probability of Sudden Infant
Death Syndrome (SIDS) in breast-fed infants
– be protection from allergies
Benefits to the Child Later in Life

– fewer dental cavities

– less likely to become obese later in childhood
– Children who are exclusively breast-fed during
the first three months of their lives are 34 percent
less likely to develop juvenile, insulin-dependent
diabetes
– Decrease the risk of childhood cancer in children
under 15 years of age
– Fewer psychological, behavioral and learning
problems as they grow older.
– More mature, assertive persons
Benefits to the Mother

– Physical and emotional growth

– Helps lose weight after birth
– Promotes contraction of uterus
– Reduces risk of developing osteoporosis in later
years
– Less likely to develop uterine, endometrial or
ovarian cancer.
– Increase sense of confidence
Social and Economic Benefits of
Breastfeeding

– Avoids the financial burden of buying infant

formula

– Breast-fed babies are less likely to need

excessive medical attention as they grow
DIFFERENT POSITIONS FOR
BREASTFEEDING
Breast-feeding: Cradle hold
Breast-feeding: Cross-cradle hold
Breast-feeding: Football hold
Side-lying hold

• Marilen F. Pacis
RN,RM,MAN
NUTRITION FOR CHILDREN
VADD

IDD

IDA
 Improving diet / dietary diversification

VADD
VADD
IDD
IDD
IDA
IDA

Micronutrient
Micronutrientsupplementation
supplementation Food fortification
 UNIVERSAL SUPPLEMENTATION OF
VITAMIN A
TARGET PREPARATION DOSE/
DURATION
Infants 100,000 IU I dose only
6-11 months
Children 21-71 200,00 IU I capsule
months every 6
months
 UNIVERSAL SUPPLEMENTATION OF IRON
SUPPLEMENTATION

TARGET PREPARATION DOSE/

DURATION

Low Birth Weight Drops: 15mg elemental 0.3 ml OD at 2-6

iron/0.6ml months

Infants 6-11 months Drops 15 mg/0.6 ml 0.6 ml OD x 2

months

1-5 years old Syrup 30 mg/5 ml I tbsp OD x 6

months

6-11 years old anemic and Syrup 30 mg/5l 2 tbsp OD x 6

underweight months
 SUPPLEMENTATION OF IODINE

TARGET PREPARATION DOSE/

DURATION

Women 15-45 years old Iodized oil 200 mg 1 cap for 1 year
capsule

School-age children Iodized oil 200 mg 1 cap for 1 year

capsule

Adult male Iodized oil 200 mg 1 cap for 1 year

capsule
NEWBORN SCREENING
What is newborn
screening? Why is it important to
have a newborn
screening?

When is newborn screening don

How is newborn screening done

What are the disorders

included in the
newborn screening
package?
 Congenital Adrenal Hyperplasia
CONGENITAL HYPOTHYROIDISM

Glucose-6-Phosphate
Dehydrogenase Deficiency
Phenylketonuria (PKU) (G6PD Def)

Phenylketonuria Galactosemia
Disorder ScreenedEffects SCREENED and not Effect if SCREENED and
Treated treated

CH (Congenital Severe Mental Retardation Normal

Hypothyroidism)

CAH (Congenital Death Alive and Normal

Adrenal
Hyperplasia)

GAL Death of Cataracts Alive and Normal

(Galactosemia)

PKU (Phenyl Severe Mental Retardation Normal

Ketonuria)

G6PD Severe Anemia, Kernicterus Normal

EXPANDED PROGRAM ON
IMMUNIZATION
 MEASLES
EPI
POLIOMYELITIS

DIPHTERIA
EPI EPI

TETANUS

HEPATITIS

PERTUSSIS EPI
(Whooping cough)
TUBERCULOSIS
 FULLY

VS

COMPLETELY
IMMUNIZED
CHILD
 PRINCIPLES OF VACCINATION
AMONG CHILDREN

Is there a limitation in
the number of
vaccines to be given
per day?
 PRINCIPLES OF VACCINATION
AMONG CHILDREN

None.
It is safe and
immunologically
effective to administer
all EPI vaccines on the
same day at different
sites of the body.

Use one syringe per

child during vaccination.
 ROUTINE IMMUNIZATION
SCHEDULE
Minimum age
Number of Minimum Interval
Vaccine at first DOSE
doses Between Doses
dose

BCG At birth 0.05 ml 1 (ID)

Hepatitis B At birth 0.5 ml 3 (IM)

DPT 6 weeks 0.5 ml 3 (IM) 4 weeks

OPV 6 weeks 2 drops 3 (ORAL) 4 weeks

6 weeks then
Measles 9 months 0.5 ml 1 (SC)
8 weeks
What are the vaccines
that contains live
attenuated vaccine?
 THE LIVE
VACCINE
-POLIO, MEASLES and
BCG
 POLIO
VACCINE
• Caused by a virus
• Vaccine used in LIVE
ATTENUATED VIRUS
• Polio vaccine is a clear
pink or pale orange liquid,
comes in a small bottle
with dropper cap
• Vaccine is given ORALLY
• OPV is damaged very
quickly by heat.
• OPV may not be
damaged by
freezing
 MEASLES
VACCINE
• Caused by a virus
• Vaccine used in LIVE
ATTENUATED VIRUS
• Freeze dried
• Dry vaccine mixed with
diluent water
• Easily damaged by heat.
• Reconstituted vaccine loses
its potency very quickly,
even if it is cold.
• Discard left-overs.
 BCG
VACCINE
• Protects against TB
• Made from a weak but living
microbacterium (Bacillus Calmette Guerin)
• Freeze-dried and is reconstituted
before administration
• BCG is damaged most easily by sunlight.
Containers dark colored.
• Not damaged by freezing. Stays potent
when kept cold.
 THE COLD Manufacturer
CHAIN
AIRPORT

CENTRAL VACCINE STORES

REGIONAL STORES

HEALTH CENTER DISTRICT HOSPITAL

DISPENSARY OUTREACH SERVICE

IMMUNIZING STAFF/
Mother and Child
DEVELOPMENTAL
DEVELOPMENTAL
ASSESSMENT
ASSESSMENT
 METRO
METRO MANILA
MANILA
DEVELOPMENTAL
DEVELOPMENTAL
SCREENING
SCREENING TEST
TEST
(MMDST)
(MMDST)
 MMDST
• Clinical tool used in the early detection of
children with serious developmental delays.
• It was developed for health professionals
so that slow development may be
recognized, referrals made and
appropriate therapy prescribed as soon as
possible.
MMDST
 MMDST KIT
• A bright red yarn pom-pom
• A rattle with a narrow handle
• Eight 1-inch colored wooden blocks (red, blue,
yellow, green)
• A small clear glass/bottle with 5/8 opening
• A small bell with 2 ½ inches in circumference
• A rubber ball 12 ½ inches in circumference
• Cheese curls
• A pencil
• Bond paper
The
The MMDST
MMDST is is designed
designed to to detect
detect
developmental
developmental delays
delays in
in children
children 22 weeks
weeks
to
to 66 ½½ years
years old,
old, evaluates
evaluates aa FILIPINO
FILIPINO
child’s
child’s four
four aspects
aspects of of development:
development:
personal
personal social,
social, fine
fine motor
motor adaptive,
adaptive,
language,
language, and
and gross
gross motor.
motor.
 4 AREAS ASSESSED
• PERSONAL-SOCIAL
• FINE MOTOR ADAPTIVE
• LANGUAGE
• GROSS MOTOR BEHAVIOR
 PERSONAL SOCIAL

• INDICATES THE CHILDS

ABILITY TO GET ALONG
WITH PEOPLE AND TAKE
CARE OF HIMSELF.
 FINE MOTOR
ADAPTIVE
• TASKS WHICH INDICATE
THE CHILDS ABILITY TO
SEE AND USE HIS HANDS
TO PICK UP OBJECTS AND
TO DRAW.
 LANGUAGE
• TASKS WHICH INDICATE
THE CHILD’S ABILITY TO
HEAR, FOLLOW
DIRECTIONS AND TO
SPEAK
 GROSS MOTOR
• TASKS WHICH INDICATES
THE CHILD’S ABILITY TO
SIT, WALK OR JUMP.
 STEPS
STEPS IN
IN THE
THE
ADMINISTRATION
ADMINISTRATION OF
OF
THE
THE MMDST
MMDST
1. Calculate for the
child’s age.
• Formula: Date of test minus birth date
Year Month Day
1. 2008 3 28
- 2005 2 4
___________________________________
3 1 24
2. Draw the age line
• Mark the calculated age of the child
on the scale and draw a line through
the 4 sectors of development.
• Write the date of the test at the
top of the age line.
3. The Test procedure
• Establish rapport
• Make the child as comfortable as possible
• Administer the test starting from
personal-social sector, fine motor adaptive,
language sector and gross motor test.
• Avoid asking questions which suggests
the answer
 Scoring and Interpreting the Test
Result
A. Score
A.1. Passed (“P”)
A.2. Failed (“F”)
♣ Delay- a failure that falls
COMPLETELY TO THE LEFT
OF THE AGE LINE
A.3. Refusal (“R”)
A.4. No opportunity (“NO”)

B. Interpretation
 Interpreting Test Result
• Step 1- Mark each delay shading the right
end of the bar.
• Step 2- Count the number of sectors that
have 2 or more delays.
• Step 3- Count the number of sectors that
have 1 delay with no passes intersecting
the age line in the
same sector.
• Step 4- Interpret the result
DISCUSSING TEST RESULT
 Discussing the test result

• Overall test result should be given to the parent

or caregiver in GENERAL TERMS
• Praise the child if able to perform well during the
test
• If the child has a number of delays, REMIND
them that THIS IS A SCREENING test and
retesting should
be done
RETESTING
 Retesting

• Usually done if the overall interpretation

is ABNORMAL, QUESTIONABLE, OR
UNTESTABLE
• Should be done within approximately
TWO WEEKS
DIFFICULT TEST SITUATION
 Difficult Test Situation

1. The SHY child

2. The UNCOOPERATIVE child
3. The OVERACTIVE child
4. The child with MANY SIBLINGS
5. The INTERFERING PARENT
THANK YOU!