E.

CHILD HEALTH
(12 – 59 MONTHS)
 CHILD HEALTH
Children 12 months to 59 months old are
included under this age group.

This section covers the different roles and responsibilities

of BHWs in promoting:
 Garantisadong Pambata Program
 Integrated Management of Childhood Illnesses
(IMCI)
 Oral Health Program of the DOH.
GARANTISADONG
PAMBATA
PROGRAM
( GP )
 GARANTISADONG PAMBATA
PROGRAM ( GP )
MALNUTRITION is still considered a nationwide
problem among Filipino children.

 causes decreased resistance against infections and

often result to higher risk for complications.

 preventable through micronutrient supplementation

and proper nutrition (i.e. Eating nutrient – rich foods
like vegetables and fruits).
 GARANTISADONG
PAMBATA PROGRAM ( GP )
INTESTINAL PARASITISM OR SOIL-TRANSMITTED
HELMINTHIASIS (STH)
is one of the multifactorial causes of
malnutrition.
It mostly affects children aged 1 to 12 yrs old
causing nutritional deficiencies on iron and
Vitamin A.
 ROLE OF THE BHW
School children are included in the GP program.
Adequately trained BHWs are expected to
identify and record the eligible population of their
household catchment areas and assist RHMs in
providing different services under this program on
micronutrient supplementation.

They are not expected to comprehensively discuss

malnutrition or specific nutritional needs of
children
 Importance of GP program
GP is an integrated package of services
concerning health, nutrition, and environmental
sanitation but mainly covers micronutrient
supplementation of vitamin A and iron among
children.

Also includes deworming among preschoolers

ages 1- 5 years.
 Importance of Deworming, Vitamin A and
Iron supplementation
 DEWORMING significantly improves language and memory
development

VITAMIN A SUPPLEMENTATION provides protection to

children against measles and prevents malnutrition which
causes decreased resistance against infections

IRON SUPPLEMENTATION provides protection to children

against iron- deficiency anemia which is one of the most
common forms of nutritional deficiency among children,
causing paleness and easy fatigability
 BHWs SHOULD DO
1. Using the latest immunization booklet (e.g.
Mother and Baby book), gather the following
data during your household visit:
a. name and age of the child ≤5 yrs old
b. immunization and micronutrient
supplementation given, if any
c. weight
d. height
BHWs SHOULD DO
2. In areas where the BHWs also functions as a Barangay
Nutrition Scholar (BNS), BHW should do the following
during their scheduled household visit:
a. weigh the child ≤6 yrs old and plot his/ her weight in
relation to his /her age in months
b. Explain and discuss to the mother the meaning of the
plotted growth curve:
i. growth of the child is within normal limits if the plotted
weight over age is between the line curves
ii. Growth of the child is not improving if the plotted weight
over age is in a straight or same line from the previous plot
iii. Child is at risk of malnutrition and decreased resistance to
infection if his/her weight goes beyond the curve lines
BHWs SHOULD DO
3. If there is a possible risk of malnutrition based on the
plotted growth curve, refer the child to the RHM for
adequate management.

4. Constantly remind the mother to bring her child on the

next scheduled r micronutrient supplementation date.
This will provide increased resistance against infections.

5. Encourage the mother to maintain proper nutrition,

good personal hygiene, and proper sanitation with her
child to help prevent risk of exposure to common
childhood diseases. (e.g. pneumonia or diarrhea)
BHWs SHOULD DO
6. Assist the mother in going to their designated
health facility for micronutrient supplementation of
her child.

7. Constantly remind mothers :

 deworming activities for preschoolers 1-5 yrs old
is simultaneously done during the GP campaign
 deworming activities for schoolchildren is
scheduled every january and July of the year.
BHWs SHOULD DO
8. Using the latest referral form for integrated
Helminth Control Program, refer a child who present
with any of the following signs and symptoms within
the first 10 hours after intake of the deworming
drugs, to the RHMs or to nearest health facility for
appropriate management:
 Local sensitivity or allergy
 Mild abdominal pain
 Diarrhea
 Erratic worm migration
BHWs SHOULD DO
9. Using the latest IEC materials for nutritional
guidelines for Filipinos, discuss to the mother
nutrient-rich foods which can readily be found
within the community.

10.Encourage mothers to plant vegetable gardens

within their household for additional sources of fresh
and nutritious foods for the family.
 INTEGRATED
MANAGEMENT
OF CHILDHOOD
ILLNESSES
(IMCI)
 INTEGRATED MANAGEMENT OF
CHILDHOOD DISEASES (IMCI)

Early detection and adequate management

of common childhood symptoms such as
cough, diarrhea, and fever are provided
under the IMCI program. It aims to reduce
morbidity and mortality of cases due to
common childhood illnesses such as
pneumonia, diarrhea and measles.
 ROLE OF THE BHW
Adequately trained BHWs are expected to
identify common childhood illnesses within
their household catchment areas and assist
RHMs in providing adequate first aid
management .

They are not expected to comprehensively

discuss the different types of childhood
illnesses and its treatment modalities.
 IMCI program
Included in IMCI program are the following
common childhood symptoms:
1. Cough
2. Diarrhea
3. Fever
4. Ear infection
NEVER self-medicate with
antibiotics to prevent
occurrence of antibiotic-
resistant bacteria
 cough
Cough with the following should be consulted to
BHWs, the RHM or nearest health facility for
adequate treatment :
With or without phlegm
difficulty of breathing
despite increased fluid intake
lasting for more than 2 days
 What mothers can do at home when
their children have cough
 For ordinary cough and colds, encourage mothers of sick
children to increase fluid intake of their child and provide
nutrient-rich foods to improve resistance against infection and
prevent dehydration

 Adequately trained BHWs may teach mothers of sick children

on how to prepare lagundi decoction (refer to annex on herbal
medicine) a DOH recommended medicinal plant

 Refer the sick child if cough persists for more than 3 days with
or without signs of pneumonia for adequate management
 diarrhea
 Is a symptom of gastrointestinal infection that is
highly preventable and curable.
 Caused by a virus, bacteria or parasitic organism.
 Not all forms of diarrhea will require antibiotics

 NEVER self-medicate with antibiotics to prevent

complications

 Diarrhea often results from ingestion of

contaminated food and water because of poor
personal hygiene and poor sanitation
 diarrhea
Neonates and infants are at a higher risk for
dehydration. A few hours of diarrhea can cause
dehydration; thus should be immediately
consulted when there are any of the ff:
 Profuse, watery stools at least 3 times a day
 Foul smelling, yellowish to greenish stools with or
without blood
 Excessive thirst
 Sunken eyeballs
 Sunken fontanels in infants
 What can mothers do at home when their
children have diarrhea
 Continue breastfeeding her child with diarrhea and/ or
give “am” or oresol to replace lost body fluids.

 Oresol sachets may be request from BHWs or nearest

health facility

 homemade oresol may be prepared by mixing the ff:

1 liter of clean water (5 glasses of 200 ml each)
6 tsp of sugar
½ tsp. of salt
 What can mothers do at home when their
children have diarrhea
The best and practical way to prevent diarrhea
include the following:
 regularly practice good hand washing techniques
before eating and after using the toilet
 Wash fruits and vegetables before eating or
cooking
 Drinking water only from safe sources and
avoiding street foods that are not properly
covered against insects or bacteria.
Ear infection
Usual signs and symptoms :
 Foul- smelling ear discharge
 Ear pain
 Fever
 Impaired hearing capacity on the affected ear
 BHWs SHOULD DO
1. Using the latest immunization booklet (e.g. Mother
and Baby book and forms for IMCI), gather the
following data during your household visit:
a. name and age of the child ≤5 yrs old
b. immunization and micronutrient supplementation
given, if any
c. weight
d. height
e. Danger signs of pneumonia, dehydration or
measles, if any
 BHWs SHOULD DO
2. For patients with cough, refer the child immediately when there
is cough with any of the following:
 Short rapid breathing
 Fever (37.8 ̊C and above)
 Difficulty of breathing
 Loss of appetite or poor suck among neonates
AGE OF PATIENT NORMAL RESPIRATORY RATE

2 TO 12 MONTHS 60 breaths per minute

1 TO 5 YRS OLD 50 breaths per minute

more than 5 YRS OLD 40 breaths per minute

Normal respiratory rate per age group
 BHWs SHOULD DO
3. For patients with diarrhea, refer the child
IMMEDIATELY when there any of the ff:
Profuse, watery stools at least 3 times a day
Foul smelling, yellowish to greenish stools with or without blood
Excessive thirst
Sunken eyeballs
Sunken fontanels in infants

4. Encourage the community to avoid indoor air pollution

and cigarette smoke within the hopusehold
 BHWs SHOULD DO
5. Encourage members of the household to cover mouth
when sneezing or coughing within or outside their
household to prevent spread of infection

6. Encourage members of the household to regularly eat

nutrient- rich foods (e.g. vegetables and fruits) for
increased resistance against infections.

7. Encourage members of the household to maintain

cleanliness and proper hand washing techniques most
specially when handling neonates and infants.
 ORAL
HEALTH
PROGRAM
 ORAL HEALTH PROGRAM
ROLE OF BHW

Under the oral health program, school children,

adolescents and adults are also included.
Adequately trained BHWs are expected to identify and
record the eligible population of their household
catchment areas and assist RHMs in providing the
different services under this program.

They are not expected to comprehensively discuss oral

health diseases
 ORAL HEALTH PROGRAM
DENTAL CARRIES OR TOOTH DECAY and GUM
DISEASES are the two most common oral health
problem

Risk factors causing oral health diseases

 Unhealthy diet
 Poor oral hygiene
 Tobacco use and alcohol, among adults
 How to prevent oral health diseases
 Healthy diet should start from birth up to 6
months through exclusive breastfeeding and
continued with complimentary feeding up to 2
yrs old

 Oral hygiene should start as soon as the first

tooth erupts at 5-6 months old. Important to visit
the dentist as they are more knowledgeable and
have follow up visits every 6 months thereafter
.
How to prevent oral health diseases
Low grade fever (T=37.8C to 38.C) may still
be due to tooth eruption among infants;
diarrhea and moderate to high-grade fever
are no longer due to tooth eruption. Advise to
seek adequate management

Adequate tooth brushing techniques may

also be already taught to children as early as
1 to 2 yrs old
 BHWs SHOULD DO
1. Assist the mother to locate the nearest health
facility with dental services
2. Encourage members of the household to practice
and train their children for good oral hygiene (e.g
tooth brushing every after meals)
3. Encourage members of the household to bring their
children on the scheduled dental visit to ensure
adequate oral examination.
4. Constantly remind members of the household that
low-grade fever may still be due to tooth eruption
among infants but diarrhea and moderate to high
fever is no longer.