1981= Diarrheal disease control program

1985= UIP
1990= Acute respiratory infection
control program
1997=
1) RCH launched= CSSM(1992) +
Family planning.
2005=
1) RCH under NRHM with main focus
on primary health care.
2) Adolescents included in phase 2 of
RCH.
3) & obviously NRHM launched for the
first time.
2013=
1) RMNCH+A = XII Plan
a) Es.ONC, Em.ONC, PP care
b) HBNC, FBNC, IMNCI,
IMMUNISATION, RBSK.

2014=
1) INAP – to achieve single digit NMR
& SBR by 2030.
2) Mission indradhanush.
3) IDCF.
2018=
HBYC- 3 monthly visit by ASHA.
Ayushman Bharat= 1.5 lac H&W centre.

EIGHT imp causes of childhood

mortality.
NEONATAL=
1) Neonatal infections
2) Preterm birth complications
3) Birth asphyxia
4) Cong. Malform.
5) Others
CHILD=
 1) DIARRHEA (10%)
2) PNEUMONIA (11%)
3) MENINGITIS
4) MALARIA
5) MEASLES
6) INJURIES & OTHERS

Latest figures of U5MR, IMR, NMR=

36, 32, 23
UNDER 15 = 30% of population

CHAPTER 2 GROWTH
1) 3 main hormones for fetus growth =
thyroxine , insulin, glucocorticoids.
2) Fast growth rate is during early
fetal, 1-2 years post natal, puberty.
3) Adolescents= 10-20 yrs
4) A sign of accelerated growth of
lymphoid tissue is frequent finding
of large tonsils & palpable lymph
node in normal children b/w 4 to 8
years.
5) Lean body mass aka Fat free tissue
includes muscle, skeleton, internal
organs. And it closely correlates
with stature.
6) Skeletal maturity closely correlates
with sexual maturity
7) Chest circumference done bw
inspiration & expiration @ nipple
level.
8) Normal growth is bw 3rd & 97
centiles.(+/-2SD)
9) Prematurity correction not done
after 2 years.
10) WHO based MGRS charts are uptill
5yrs of age and includes – skinfold t,
growth velocity.
11) HC @ birth = 34(G – 2,1,0.5)
12) HC @12 yrs = 52cm
13) Patho short stature is either <-3sd
or lesser growth velocity.
14) Increase in US:LS (rickets,
achondroplasia, untreated cong
hypothyroidsm
15) Turner syndrome is a common
cause of short stature in girls
therefore shouldn’t be ruled out
even if typical features are absent.
16) Other short stature syndromes-
Down, Prader-willi, Russell Silver,
Seckel
17) Though psychosocial dwarfism is a
functional hypopituitarism but
therapy with GH is not beneficial.
18) Turner, SGA with inadeq. Catchup
growth, renal failure all respond to
GH.
19) Macrocephaly with >2 SD.
20) Micrencephaly is abnormally small
brain based on neuroimaging and is
usually coexistent with
microcephaly.
21) Apert(FGF) and crouzon(FGFR2,3)
both assoc with craniosyntosis due
bicoronal synostosis.
22) The degree of facial deformity in
crouzon is milder than in Apert and
patient don’t show cleft palat
syndactyly and mental retardation.
23) Carpenter and Pfeiffer also assoc
with craniosyntostosis.
24) Metopic- trigonocephaly, B/L
Coronal – Brachycephaly, U/L
 Coronal – plagiocephaly, Sagittal-
Scaphocephaly.
25) Cloverleaf and tower shape
(Acrocephaly) assoc with multiple
suture fusion.
26)