Oganksion _ Integrated Management of Childhood Iliness unicef SICK CHILD AGE 2 MONTHS UP TO 5 YEARS. ASSESS AND CLASSIFY THE SICK CHILD Senses 2 SRERreeeeat anon a : ee. s PLAN. TREAT SOME CONYDRATION WITH ORS ® FOLLOWUP (reven: woMALAouA ry MOORRATE ACUTE MAL MUTATION » Se ee 38 RITRARLUNOS AO MOTE HEALTH » incon te ages * eit rncieeamiosctie ° Recording Form: HIV on ART follow-up eps © oSICK YOUNG INFANT AGE UP TO 2 MONTHS [ASSESS AND CLASSIFY THE SICK YOUNG INFANT. ‘TREAT AND COUNSEL FOLLOW-UP Recording Form: Yeung infant recording form Annex: ‘Skin Problems 8 os 8 oene sesecsSICK CHILD AGE 2 MONTHS UP TO 5 YEARS ASSESS AND CLASSIFY THE SICK CHILD ASSESS CLASSIFY IDENTIFY TREATMENT ASK THE MOTHER WHAT THE CHILD'S PROBLEMS ARE ‘+ Determine ifthis isan intial or folow-up visi for this _ USE ALL BOXES THAT MATCH THE problem, CHILD'S SYMPTOMS AND PROBLEMS: © follow-up vist use the followup instuctions -—»« TO CLASSIFY THE ILLNESS, ‘on TREAT THE CHILD chart. © inital vist, assess the child as follows: ‘GHEGK FOR GENERAL DANGER SIGNS stead aera = Se ech hae sana vom ‘A chil ithany genera denger sign needs UNGENTatenon: compe the assesment and any preter! estmen melaely 3 ers ot delayed"THEN ASK ABOUT WAN SVAPTONS: ‘Does the child have eough or dificult breathing? ronan cated Sa oe, Lou + Cheng + Gere Anos sca mime Nae 1 Festa 1 tonearm aap toes stowotsauy presence a obtener Seni + Snore senescent 9 W wneecing with eithe oon {st breating or est ” Newer fore pssbi 8 othr Greate sais vers ely sarees ae ‘ar oninn lo Jimena mating toralere pasate menage‘ aac asrben prow soto he na tara gue er 86 HMO Postel Bok or oxalate On aroncn ces eit usd mars hn at ea est eg ow HY stings nt wre waldorf eke UNG 8 Me ON MCT eae ere 36 We,‘Does the child have davehea? sorrow ns Cooke gener roe «+ Contrary ingot? 2 Dig enety Sa vey sot ona oa deecaa + Sou oan iowa sare 1 hotes ma| Prery tres ey iy ‘Sinsheraoee took Sou (Gre td sos apse ns rao ‘erate en) 1 foto URGENTLY to Rota h mote nant uF Peete ete eset Fetow pin dye ao Ao we nw on hed ach no Pas THMREHEA | « Greiner anit efor ‘Give cipatinocin for de Faeroe [cede ieieernrerete‘Does the child have an ear problem? fe itemespan? «Longe ig tam > inweerdacnage? —* tear (soy Ean PROBLEN ya torowlong? Raster ting"THEN GHEGK FOR ACUTE MALNUTRITION > tamu — mites mertre Check for any mae comptstin preven: ohny general danger sgn 5 Any soer clarfeaton © Posumoni wit cheat inarng + nema cnptetons en ota oh RUT prion? ‘Avi toisn RUT poten + chiaia tees hen S month, sates ‘rvatwsings (ove poe 3 01 7). Jobim? te Wont Heme Nome Leng corned yg Re HO gow anc ae, 7RUTE ie Rayo Un Tap Food cri ope nae on ih av aa alien Gis ores fr S ape ‘Goins resending SSterenpounetnerprsts fen ¢ aie (eracnisaqe mone mare ‘asi ma hots xe nes ‘rarer nin eng camara Festa weer ow ubins dea a a nnn awn RTF 00 NOT hen cn ey ase fh RITE"THEN CHECK FOR FIV INFECTION [ase |r ves: Oe ta PORTE a NEOATIVE {© Segete PORTVE NEGATE mea i HY poatin and cht i nape or lmsown. > vor ccmdnsntnso ime eset > testeotng AS Re mabor a eon ART ree? Jen. men rest: > tomer pose sent ast TEST ov ne aeosnce pa oY eda Hans de afin rein nse rp We repos pe 6 MoD afer he aber oe SoH enIngs Wels ecco rp tele one ect.THEN CHECK THE CHILD'S IMMUNIZATION, VITAMIN A, DEWORMING STATUS, and ORAL HEALTH THuORATION SCHEDULE” Foor ontora guerre ve xeon aco! Vann Ary 3 ae sn matron shin nde scoson wo se pain rani ate ir eyntons cans th A stesntoo acct Wih BCG Mba te 9 eas $e 9H BCE ke remorse’ Pewsey fom 9 ote TST Caan oar 3 mae ooo BC. OPT neg te sparen actine Secon ese mats ae gn oa mom ig pee sierra mute ACHE 25 a a5 08 arn DUNG es ose Prcuectrn Coa Vcane (FOV bagi cir nected eres ce ete mes ASSESS OTHER PROBLEMS:TV TESTING AND INTERPRETING RESULTS Hi wong RECOMMENDED or {+ Al euren wet ino i Spec Bote bam HVE Rte edb tO oer ese Pe se) [ Tipe ov Tove ] Fiore iaepeis 1 aT Sa ga [cg ri era ot gen wan a ha 16 ti Malai wy cc or lc fess) TROCOGIEAE | saa Saly Slat ha pretence S| Pata Vaasa POA ara Sea WY aan ay Hee os Baa Ema fests |inetvsiee os peau crne cin ine [ncetngona fo [or expored chien To monthe or ote spare WY ana eens wane eS eo = Peter ie it aa ton a oar ee a kieeummniece ee cea erie mmanmaniamnnmanan [ Tan Ane an ea | area ea REGAIN em FRSTEREASTEEDN carr iv EXPOSED aw le Navara Fay TS OE ery aa are ieee coe creliee roosco nae vnea rap [cana bo riawd by Scafosng Repeat cnn boanonara hs ban ree‘WHO PEDIATRIC STAGING FOR FIV INFECTION ‘Tis so er mentor etn anal wt dara col zea eA vata Cee fe hl ane by aed cs sea emt Lek athe dase er ach ‘he Gee shots ighn ape pte non er nal tec spams epee ‘relusameonaponmarvats knpasl neon [+ Uneqared nd umsscrael ‘verso seein growin 2 inn ovr dye Recareorcwmnicupereipraiy tactinectors | Frere mh Sage Sige? Sige ‘Sige ymstomatie tuts ace Moaerata neene over tear (A08) = [Groroma anes [Snow mespantoariaptartngeons ome fsiereminininsesonrg |nonsrionettonara ose ery [Srwonssgs fe gnome oom [> eragedbe wcloaeen [> Besta nn [> ere ar cm man thane pie tans. hater Pt). Stinson ie, mnt ema ees [2 Sian mapa near ont ncaa 2 Seal pm (EY + Ror racring aa J+ Snore aotong nsen ne ers msg emer) reat wna Poor |. Kaper sro nreadnanay wero |. reese sone > ypecera menite tore Js este “ons iin drab nea ofr ho elo cine dope nd Hen eetTREAT THE CHILD CARRY OUT THE TREATMENT STEPS IDENTIFIED ON THE ASSESS AND CLASSIFY CHART ‘TEACH THE MOTHER TO GIVE ORAL DRUGS AT HOME Follow the instructions below for every oral drug to be given at home. ‘Also follow the instructions listed with each drug's dosage table. ‘Give an Appropriate Ort Antoiotie dosage forthe ci he ug tech 1 Waten the mother practise mensurng a does by here. {asthe mothe o give the fest ose ona {Bop carey wrt give the og, then package the drug. are than one dr willbe given, callac, count and package each deg + Expnin atl the oral dru ables or syrops must be used to nish the course of {contrat even he cil gets beter. + Cheek he mate's undestending before she faves the cine ee‘TEACH THE MOTHER TO GIVE ORAL DRUGS AT HOME Follow the instructions below for every oral drug to be given at home. {iso follow the instructions listed with each drug's dosage tabi Give Inhaled Salbutamol for Wheezing Pam tact mre os vor (199 ge a 1 Repetaplod eon oe to rv bc des parr ‘Spuers cane aden me lowng wa Sisiat basen ane dpe me ruts ei + Gute ete neath qtr tte an dg apm aero + Cat wrot Vin hetererathe ne cpm patel oe fhe ce nora wd endo 2 Por boone ho tthe carr eh in {nna ny msc be maby margin pA Ct posyen) 1 hentia conmwa sae san 6 nde sas at ce ce le rag Paseo sci netsh eben sbe aeshetd bua eae ere roman “A enc eth tho be ioe en pn Give Oral Antimalarial for P. falciparum MALARIA "Cou u tress once eric and eave nr cs ra dy res chon Bontaccousercam otescee seancmance nn «+ Sectartenms chy gop ater mata opcode ct Een nen novus etreonr ea main fst wornass it Treatment Schedule for confirmed P. vivax or P. OVALE Cases ve arcuonoounerant| Gong Caamgsowcny | ethan sores ee re uaeuctntsanae Soy emmeg i | femme armorametieian ime Si eagicngeW wasps = ees 8) ome | ov | test |S o cs a roars mmen e 3 Pino srl rh men nessa tt ar on soe Sens Caras CoO at nave ¥ourBteas ns scose, Stanes han ‘Sep Para est inte dt Qc) recta‘TEACH THE MOTHER TO GIVE ORAL DRUGS AT HOME Follow the instructions below for every oral drug to be given at home. ‘Also follow the instructions listed with each drug's dosage table. Treatment Schedule for Plasmodium malarise Malaria ices Ree omen ie oT eee «ly teeegeaimne rope oman mr ow? | oma ars ee pdt cong tesa OayS onan oy hte Sid Retort Treatment Schedule for mixed P. falciparum and P. vivax infection smn ter Wn ‘She FRANCINE o> ty 8 12 ening ne) auen | 2190 ea sige de “resent ign Sar mee Fro tvaninen nd te rc astern Roel wer Give Paracetamol for High Fever (> 38.5°C) or Ear Pain + ie practi 6 awh ner craps ‘svmupiaome/) s¥RuP eso a | msn Bom i anor rom 8S Give ron +m era cerca 41, Fone mae cao St 0 | “Sia! ieranigy rome) 125mm wo) awit 2oomiee m0) Give Micronutrient Powder + aera ow Supra UNE on 6-23 mc eit‘TEACH THE MOTHER TO TREAT LOCAL INFECTIONS AT HOME + Explain to he moter what tne eaten sand why lt shou be sven. {Deri the estmen! steps stein the appropat box. 1 Mitch the mother she does heat wenkmert ne ini except or emedy for ough or sore tron). needed for trontment tome, give mother the ube of etacyline ointment or 3 ‘mal bot ofgentan lt + Check he mathersundertending beloe she leaves the cli ‘Soothe the Throat, Relieve the Cough with a Safe Remedy Dart novo mz. ost gin nan sero om Treat Eye infection with Tetracycline Eye Ointment ‘sean on an cag uy + Then py baryon anathema aly ‘eat nt hres no ps eschoge ‘etn inte oe (Clear the Ear by Dry Wicking and Give Eardrops* + ry ra i Treat for Mouth Ulcers with Gentian Violet (GV) Tet rash late iy “ian ns noth on of dt wrap agent iat 1 hance roum rr tare goon 3% chen 1 Cormega our terme cr hve een cd Treat Thrush with Nystatin Oral Suspension Tra fur ine 8817 ye 1 Scenes ens Ht ge gon aeGIVE VITAMIN A AND MEBENDAZOLE or ALBENDAZOLE IN THE HEALTH CENTER + Explain to the mother why the drug is given + Determine the dose appropriate for the child's weight (or age) ‘+ Measure the dose accurately Give Vitamin A Supplementation and Treatment Give Mebendazole or Albendazole 4 mg Abed sarge dente ce + 121023 nna 200 ger os oy one rete“+ Expeinto te mother wny the drug is ve. 1 Heasre tn dose accurately. 1 Give he drug a en intramuscular injection Give Intramuscular Antibiotics ‘Gee Arps sb ma} ns Ganeran( mah) ‘Di Son vane? ate wae como REFERRALS KOT POSS OR DELAYED pe! te am cto nh rare era sony spon ot meringta, esos or ampen cane rane + Determine the dose appropiate forthe c's weight or 994). 1 Use stone nee an serie ayrnge when ging an injection hl eanat be rtered, ol the insrctons provided. ‘ort sano ee Say Pah i. end GIVE THESE TREATMENTS IN THE HEALTH CENTER ONLY 1 7Simoh roby eee er ‘omen | atmgatva Stow pwedmra aa tet Osim ase lee tzmonta @- a0 ASSESS & CLASSIFY ena, ‘DONGT REPEAT Rap Dag Tota poste on he tl vi ee ant ear ick ERY SER EERE DEAS cd hoe " Portes wre ss 9 oeGIVE FOLLOW-UP CARE FOR ACUTE CONDITIONS. FEVER: NO MALARIA Dean a = sw Assess & Lassi ezet te ratrataet techie ony gee ages or lt nc. VERY SEVERE FEBRLE OS EASE chan» pote marae re ex raat Nosh moro AS tneroroame MEASLES WITH EYE OR MOUTH COMPLICATIONS, GUM OR MOUTH ULCERS, OR THRUSH Cee es ant cig fore {eteirasGoeaerain beer nom a ii hg ty nn stern no i niin tn inthis wos, art ey eae vom a moh ep 1 mutn lest sare bang steeper vor ore anh wore sk ot ims ory gon corey 1 iiechtches rosie itn metoning eo np EAR INFECTION ist erp > Se ASSESS CLASSY at erpamer chagrin Sr of tsane is Coen ang 1c ane mre eng ee core angig gurus ey Eine toe FEEDING PROBLEM + Sa ta cr sen ny oy rig dr pias ym he marae ANEMIA ee oe Gefen Aton meter ru 1 er ce, {ita heptmn pr sae' ment te rename raeGIVE FOLLOW-UP CARE FOR ACUTE CONDITIONS. UNCOMPLICATED SEVERE ACUTE MALNUTRITION Aes vos ing rete ‘eon cd ih serena (PL, MAN aon ee ‘Chan ches pes by thang eg uw pte eo Susi mon ree "Toshi cose tome eb Seer orececceneetenae Seen ae, » scammer ee sees ose caeaeaimnie carina Ee See eee cone cerrnemeunn Secu anaied MODERATE ACUTE MALNUTRITION Ar cae Nowe i gsm seo (UF HA AIC sed a eases eng Soe qr COUNSEL THE MOTHER ca ‘ceang tem os atoms morn sgn oma Cot soe aca ‘cca gn mt anyhoo i wean he orton Fee i esr tingo itn clo ng esther MMC an reema7GIVE FOLLOW-UP CARE FOR HIV EXPOSED AND INFECTED CHILD HIV ExPos! Foow apron on per ai tines, ‘Nese flow a9 von ewe nas 1 Soantoneemant wang ouch ernacm org pba, a cad antow vps) + Ft ace Wn, cin rr ot aes a + Sante inna era 5 cme trippin osm matte comic he ce ow + Aone Pe crit rary + Somme or peat HV on Moh steer an snk mo CONFIRMED HIV INFECTION NOT ON ART soonanony pi ten SEE ateeranratyeeeuinirimt Te anne See te ae SSE rees SAS ceerme nts 1 Sacer nd ee cy apne _iseaci = reatGIVE FOLLOW-UP CARE FOR HIV EXPOSED AND INFECTED CHILD ‘CONFIRMED HIV INFECTION ON ART: THE FOUR STEPS OF FOLLOW-UP CARE Ft npn at cons mn expanses arte ante Soars tay te tte reena7COUNSEL THE MOTHER FEEDING COUNSELLING Assess Child's Appetite A tren aged months of mote lth SEVERE ACUTE MALNUTRITION dems ofboth ft ot WAL es than-9acares of MUAC lees than 15 mn) nd no rae! compaction shad ou eesanee tor spate. ep cnn a a dt a yw Va Re RU, ran GUAGE vi RoE TSN GTS HEAT Fe cna tchi one ba RT pn 1 hatred toca apie ed UTP, 1 sowtogne ute ae amovel of RUTF 1 the chido ak eh intone mo axe oT son or CusNOT ABLE aoa ow oo pode oT UTE pun 02 ht Sexes Noobs nbn 3FEEDING COUNSELLING ‘Assess Child's Feeding ses ie Ye Ot MODERATE ET MALNLTEON AMEN COPAME HY RFECTN rn EBPOSED, ous nt nasi cag mates Care Pema nose Pn oe 1 bojauate mentee rg room? + During ities, hs teen's aig hanged?FEEDING COUNSELLING Feoding Recommendations During Sickness and Health ed ay et ae GRY 8 GS RTP TU aT Er ase I ea TR SOR BDU an at PN.reerFEEDING COUNSELLING Feeding Recommendations fr HV EXPOSED Chon Intent Formula Oniy & thFEEDING COUNSELLING ‘Stopping Breastfeeding Storr BREASTEEONG nes rag tom axes mikono Dens ris shou haem at overran Pan nora ee an, 1 omer en dae nd once wa ay, poe 1 Gcpeee mierda {Redon iiyrfomaor dtr nike. mam cove mit 1 Liteon ppanasere ay ae ‘oven mater ep oan cht oe Cura part Ans cost onstuathe So yang bt apes? ners) 1 Sonny ony rear nt oes tay tas fot yo fs Seen anaes eng bone net ton cnr a etn 8 Feeding Recommendations For a Child Who Has PERSISTENT DIARRHEA 1 ut easier, short facuo biger asta ca anno 1 ang erm 1 root ao ath nova emi eed reerEXTRA FLUIDS AND MOTHER'S HEALTH | Advise the Mother to Increase Fluid During lnoss esc Tiered moe foun wl eng wench en i aki mith wn nen arco 1 Inemme chars Foren ge sep eel yet ir cme ange dae hang. Ove i mcr tan A Pan cn TREAT TE HUD cat Counsel the Mother about her Own Health + fanerte 1 Grctasus sg onan waren nesies rue?WHEN TO RETURN ‘Advise the Mother When to Return to Health Worker FOLLOWUP IITA eto reflow tat cia *semeceiee ecru eaves mae 2 ees aT 1 Sludvaccntn tateSICK YOUNG INFANT AGE UP TO 2 MONTHS ASSESS AND CLASSIFY THE SICK YOUNG INFANT ASSESS CLASSIFY IDENTIFY TREATMENT‘CHECK FOR VERY SEVERE DISEASE AND LOCAL BACTERIAL INFECTION [as “LOOK, isTeN FEEL: eterna + countne ‘as AL YOU ‘sy teng? Sevmeinere ‘nears = Nein ‘ule Rae ‘envene el? ‘Seen ae este 4 Coaklraen pera 1 Lookin yur its PEER ene. Imo got stnie “treo pratt on anita tai. Tob: a tea age Spronmst OC he “cer last manapamet th keg ex end rational trace etie r WHO Pekka cht, rae‘CHECK FOR JAUNDICE vnunet present ASK: LOOK AND FEEL fs itenaieder + takin + ii rcs smnoce Same gseon my Foe barat praca Pw ‘ovoe a eer erty tp ad Sos peer yon ean tro tion "THEN ASK: Does the young infant have darhea"? i-¥es coox ano Feu ‘ee hr avo ser un Sion * > Pic estnctta sen owt ‘Gro fg ra Bab mreone Syn 2 Verso fonger an cay? eae ama Touts oOo ey evenme ass maar ano ren ey Falonap n? sgn tnctimges ‘Avoua nrc ee fh dees av cbrges om ul anlar ans many nay at an Gena ata cs ov cy nd ben reco‘THEN CHECK FOR FIV INFECTION |r ves: ogi PORTE rNEORTIE > natn ong ots HY sa? Vgc es POSTIVE a ECAC 5 Sg ou PORIIVE NEGATE Wnts oi md HO poste viol > ithe yuny an renntendeg nu? Sita ee ati in rei m0 et Morr a young itn state aroun > Perc mv wa be mabe eit prom Shp ealerteyarg can + Pevanton o watrah-T-ChlecTrannission(PHTET ART prostate: eestor‘Seeman stron wary | ruesso7t"THEN CHECK FOR FEEDING PROBLEW OF LOW WEIGHT FOR AGEIN NON-GREASTFED INFANTS ‘Use cart or HY EXPOSED nants ot eastleting AND he fant es onan eee arnt to hosp: = ik youging? Oram ght age > Hoc manyimeadgine Leak scr a whe covenant ar mie es + Hwmuennovenstoacy Shh + Rone sora ‘into st ‘argu? rectTHEN CHECK THE YOUNG INFANT'S IMMUNIZATION AND VITAMIN A STATUS: | ASSESS OTHER PROBLEMS: ASSESS THE MOTHER'S HEALTH NEEDS Nevtona satus and penn, conacepon Check hygiene pacices. Smoking ceeeaton Inthe amyTREAT AND COUNSEL TREAT THE YOUNG INFANT GIVE FIRST DOSE OF INTRAMUSCULAR ANTIBIOTICS “+ Chota don ftom anpeth and genie aruce te Sag ccomaucon woe STA TAG ERE TOT WET STS 113 ater 250g So aE Tae aera er youn aii ih VERY SEVERE OSEASE fra no pont, cringe amen nd pertain ye. ie pn ote ny tras an oe anlage maa ely Pai an west al ne pero ne ay TREAT THE YOUNG INFANT TO PREVENT LOW BLOOD SUGAR (cho soma noes bet mete cnctve Tatas gh ease en mk ove 2960 m0 rth) spent (Te mak agar war soe ere ina 2edmieup ocean mae) un 2:0 (Shh ot ned rat kr ne try anger rues77TREAT THE YOUNG INFANT TEACH THE MOTHER HOW TO KEEP THE YOUNG INFANT WARM ON THE WAY TO THE HOSPITAL “+ opin auger cobra mck spot lth Sr Dsthe jog an wh aur mig dg ak gots ces ap ol nasty an coh GIVE AN APPROPRIATE ORAL ANTIBIOTIC FOR LOCAL BACTERIAL INFECTION “tne set Anodtn dope repro TEACH THE MOTHEA TO TREAT LOCAL INFECTIONS AT HOME 1 lannow nestor Te Ta hin Faris or Unbiel nocton [Fo Test Tush lars whit pathos im mouth) trent ha doth etret nce ely fr 5 oe Ph ret sel oar ur is ay 7 ae 5 Conny wa op an rt neo an wt 1 on et wn sen gontan vee 25%) ag ee ee ans a age 2 by meaee 1 Atanas vemantogetan set Min beta 00uD) um 2 es + Ponte ner antanear we ta rang cent 08H) OR fmf toe ties ovarana doy ua) 3 Bye) + oo ara ‘To Treat Diarrhea, See TREAT THE CHILD Chart. roaTREAT THE YOUNG INFANT immunize Every Siek Young Infant, as Needed GIVE ARV FOR PMTCT PROPHYLAXIS nate tote ART oral pregnet ad cng women ath a nlecton a ul hina on ART propha' Nevaorocr are ue pees oyu it ci os EXPOSED tonne >i MV aroma ATT 1 ear eeing Geer Gein gin ahr nn Hexen mcg not rea taange NO 20 er nets pening ne hes HV gan ecgraed fa ame BORE GT “PREVENTION OF RATERHAL-TO-CHLDTHANSURSSION PNTCT ART PROP ARS: ‘Orne Bs: MOTHER ON UFELONG TRPLE ART REGIE, YOUNG HESNT ON WP PROPHLANS FRU IRTHFOR EBKSIFEREASTFEEENNGORNVPOR AZT FOR 4 WEEKSIF ON RenuaceuenrFeEane. rm ye on Tat i Ea To 8 ONTUEDON WERK FER CESEATON RASTEENEG YOUNG AKT RPTL FM KTH OEE ORR pee