2. Child Health and Development Why to learn Paediatrics? To reduce significantly mortality and morbidity associated with major causes of diseases in children. To contribute to healthy growth and development of children.

3. Medical Education Goal Departmental objectives Specific objectives Teaching Learning objectives Evaluation Population Disease pattern Morbidity Mortality Care delivery place Level of entry students Resources Evidences Socio-economic Status Education Tradition and Beliefs

4. Usefulness of Medical Information Relevance X Validity Work Adapted from : Slawson et al; J.Fam. Pract. 1994;38:505-513

5. Population Pyramid of Nepal

7. Pattern of Diseases in Children Age group dependent Neonatal age group Prematurity Birth asphyxia Sepsis Hypothermia Congenital conditions

8. Pattern of Diseases in Children Age group dependent Under 5 age group Respiratory infections Diarrhoeal diseases Malnutrition Measles Skin infections Ear infections

9. Pattern of disease in children Age group dependent School age group –Tonsillitis –Rheumatic fever –Glomerulonephritis –Worm infestations –Accidents

10. Pattern of disease in children Age group dependent Adolescent age group –Behavioral problems –Substance abuse –Inappropriate sexual behavior –Acne –Anorexia nervosa

11. Child Survival Indicators Vaccination Coverage Infant Mortality Rate741999 BUC Neonatal Mortality491996FHS Under 5 Mortality Rate1061999 BUC Vaccination Coverage (%) –BCG96%1997WHO –DPT3/Polio78%1997WHO –Measles85%1997WHO –DPT drop out 31%1996WHO

12. Child Survival Indicators ORT, ARI & Nutrition ORT use rate49%1996DHS Children with ARI taken to health facility18%1996DHS Under weight59%1996DHS Stunted64%1996DHS Wasted21%1996DHS

13. Pattern of Disease in a Paediatric Inpatient Pneumonia 41.5% Acute Gastroenteritis8.9% Asthma5.0% Protein-Energy Malnutrition4.2% Tuberculosis3.4% Source Patan Hospital, 2056-2057

14. Pattern of Admission in a Neonatal Unit Most of the admission are after one week of age. 13.3 % death in the unit. Most of these deaths are due to late arrival 2057 KCH

15. Global Burden of Diseases in Children

16. Interventions Available for Improving the Child Health

17. Interventions Included in the Integrated Management of Childhood Illnesses