1. Lecture 4

2. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
1] Sectoral coordination:
(National Health Services Council )
2] Health manpower
1] Sectoral coordination:1- Coordinating and integrating all health system elements in the kingdom including the private sector. 2- Ensuring optimal utilization of health facilities and available resources in the Kingdom. 3- Selecting adequate alternatives for the operation of hospitals and financing health care services Developing specific criteria for the establishment of new health facilities. 5- Ensuring regional balance regarding health care services .6- Selecting adequate health insurance alternatives. 7- Conducting health services studies and research at the national level.
2] Health manpower: 1- Encourage private medical and health colleges. 2- Encourage hospitals to establish their own training centers. 3- Enlarge the base of medical postgraduate studies. 4- Strengthen the role of the Saudi Commission for Health Specialties
3] Financing health care: 1- The application of The cooperative health insurance system. 2- Encouragement of the private sector to undertake a greater role in financing, construction and management of health facilities. 3- Better coordination and integration between government health agencies
(Labor Force Council )
3] Financing health care

3. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
4] The function of the Ministry of Health
5] Relevant Data and Statistics
6] Improve the Pharmaceutical Sector
4] The function of the Ministry of Health: 1- Develop and supervise enforcement of regulations and control rules. 2- Continue to provide public health services and primary health care services. 3- Ensure that the disadvantaged categories have continued access to adequate health care Establish and supervise the implementation of strategies and general plans.
5] Relevant Data and Statistics: All Sectors should: 1- Promote evidence based policy-making. 2- Promote efficient resource allocation by combining/coordinating the multiple public delivery systems and the private sector. 3- Assure quality by developing accreditation and other quality standards for facilities and manpower.
6] Improve the Pharmaceutical Sector: 1- The development of a comprehensive list of essential medicines. 2- Encourage the use of substitute or generic medicine. 3- Offer more training to physicians on logical use of medicines. 4- Develop medicine-pricing system. 5- Effective systems for storage and distribution.

4. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
1] Sectoral coordination:
(National Health Services Council )
1- Coordinating and integrating all health system elements
2- Optimal utilization of facilities and resources
3- Alternatives for the operation and financing services.
4- Specific criteria for new health facilities.
5- Ensuring regional balance
6- Selecting adequate health insurance alternatives.
7- Health services studies and research.
4] The function of the Ministry of Health: 1- Develop and supervise enforcement of regulations and control rules. 2- Continue to provide public health services and primary health care services. 3- Ensure that the disadvantaged categories have continued access to adequate health care Establish and supervise the implementation of strategies and general plans.
5] Relevant Data and Statistics: All Sectors should: 1- Promote evidence based policy-making. 2- Promote efficient resource allocation by combining/coordinating the multiple public delivery systems and the private sector. 3- Assure quality by developing accreditation and other quality standards for facilities and manpower.
6] Improve the Pharmaceutical Sector: 1- The development of a comprehensive list of essential medicines. 2- Encourage the use of substitute or generic medicine. 3- Offer more training to physicians on logical use of medicines. 4- Develop medicine-pricing system. 5- Effective systems for storage and distribution.

5. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
2] Health manpower
(Labor Force Council )
1- Private colleges.
2- Hospitals own training centers.
3- Expand on the postgraduate
4- Strengthen the role of the SCFHS
3] Financing health care
4] The function of the Ministry of Health: 1- Develop and supervise enforcement of regulations and control rules. 2- Continue to provide public health services and primary health care services. 3- Ensure that the disadvantaged categories have continued access to adequate health care Establish and supervise the implementation of strategies and general plans.
5] Relevant Data and Statistics: All Sectors should: 1- Promote evidence based policy-making. 2- Promote efficient resource allocation by combining/coordinating the multiple public delivery systems and the private sector. 3- Assure quality by developing accreditation and other quality standards for facilities and manpower.
6] Improve the Pharmaceutical Sector: 1- The development of a comprehensive list of essential medicines. 2- Encourage the use of substitute or generic medicine. 3- Offer more training to physicians on logical use of medicines. 4- Develop medicine-pricing system. 5- Effective systems for storage and distribution.
1- Cooperative HIS.
2- Private sector :financing, construction and management
3- Better coordination and integration between government health agencies

6. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
4] The function of the Ministry of Health
1- Regulations and control rules.
2- Public health services and PHC
3- Disadvantaged access to health care.
4- Strategies and general plans..
5] Relevant Data and Statistics
4] The function of the Ministry of Health: 1- Develop and supervise enforcement of regulations and control rules. 2- Continue to provide public health services and primary health care services. 3- Ensure that the disadvantaged categories have continued access to adequate health care Establish and supervise the implementation of strategies and general plans.
5] Relevant Data and Statistics: All Sectors should: 1- Promote evidence based policy-making. 2- Promote efficient resource allocation by combining/coordinating the multiple public delivery systems and the private sector. 3- Assure quality by developing accreditation and other quality standards for facilities and manpower.
6] Improve the Pharmaceutical Sector: 1- The development of a comprehensive list of essential medicines. 2- Encourage the use of substitute or generic medicine. 3- Offer more training to physicians on logical use of medicines. 4- Develop medicine-pricing system. 5- Effective systems for storage and distribution.
All Sectors should:
1- Promote evidence based policy-making.
2- Combining/coordinating the multiple systems and the private.
3- Quality : facilities and manpower.

7. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
Proposed Health Reforms
6] Improve the Pharmaceutical Sector
1- List of essential medicines.
2- Substitute or generic medicine.
3- Training physicians on logical use of medicines
4- Develop medicine-pricing system
5- Storage and distribution.
4] The function of the Ministry of Health: 1- Develop and supervise enforcement of regulations and control rules. 2- Continue to provide public health services and primary health care services. 3- Ensure that the disadvantaged categories have continued access to adequate health care Establish and supervise the implementation of strategies and general plans.
5] Relevant Data and Statistics: All Sectors should: 1- Promote evidence based policy-making. 2- Promote efficient resource allocation by combining/coordinating the multiple public delivery systems and the private sector. 3- Assure quality by developing accreditation and other quality standards for facilities and manpower.
6] Improve the Pharmaceutical Sector: 1- The development of a comprehensive list of essential medicines. 2- Encourage the use of substitute or generic medicine. 3- Offer more training to physicians on logical use of medicines. 4- Develop medicine-pricing system. 5- Effective systems for storage and distribution.

8. Future changes in the Saudi Health System Strategy
Health System in Saudi Arabia
Future changes in the Saudi Health System Strategy
The function of the Ministry of Health
Develop and supervise enforcement of regulations and control rules
Continue to provide public health services and primary health care services
The 10 Essential Public Health Services:1. Monitor health status to identify and solve community health problems. 2. Diagnose and investigate health problems and health hazards in the community. 3. Inform, educate, and empower people about health issues. 4. Mobilize community partnerships and action to identify and solve health problems. 5. Develop policies and plans that support individual and community health efforts. 6. Enforce laws and regulations that protect health and ensure safety. 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. 8. Ensure competent public and personal health care workforces. 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. 10. Research for new insights and innovative solutions to health problems.
Ensure that the disadvantaged categories have continued access to adequate health care
Establish and supervise the implementation of strategies and general plans.

9. Health System in Saudi Arabia
The 10 Essential Public Health Services:
1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health hazards in the community.
3. Inform, educate, and empower people about health issues.
4. Mobilize community partnerships and action to identify and solve health problems.
5. Develop policies and plans that support individual and community health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8. Ensure competent public and personal health care workforces.
9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.
10. Research for new insights and innovative solutions to health problems.
The 10 Essential Public Health Services:1. Monitor health status to identify and solve community health problems. 2. Diagnose and investigate health problems and health hazards in the community. 3. Inform, educate, and empower people about health issues. 4. Mobilize community partnerships and action to identify and solve health problems. 5. Develop policies and plans that support individual and community health efforts. 6. Enforce laws and regulations that protect health and ensure safety. 7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable. 8. Ensure competent public and personal health care workforces. 9. Evaluate effectiveness, accessibility, and quality of personal and population-based health services. 10. Research for new insights and innovative solutions to health problems.

10. Lecture 5

11. Health Promotion or health education
Health Promotion is broader
than Health Education
“Health Promotion is any combination of educational, organizational, economic and environmental support for behaviors and conditions of living conducive to health .”

12. Health Promotion or health education
Health Promotion is used to encompass various activities eg. :
Behavior & lifestyle,
Preventive health services,
Health protection directed at environment,
Health related public policy,
Economic & regulatory measures.
(Health Education is the
primary and dominant
measure in Health Promotion ).

13. Principles of health education
Interest.
Participation.
Proceed from known to unknown.
Comprehension.
Reinforcement by repetition.
Motivation
Motivation: i.e. awakening the desire to know and learn:- Primary motives, e.g. inborn desires , hunger, sex.- Secondary motives, e.g. desires created by incentives such as praise, love, recognition, competition.

14. Principles of health education
7. Learning by doing
“ If I hear, I forget
If I see, I remember
If I do, I know”.
8. Good human relations
9. Leaders

15. Communication Health Education
Communicator: the person or the team who give the message (Educator).
Message: the contents (materials) of health education
Channel: method of carrying the message
Audience: the receivers (users or targets) of the message

16. Good communication technique
Health Education
Good communication technique
Source credibility.
Clear message.
Good channel: individual, group & mass education.
Receiver: ready, interested, not occupied.
Feed back.
Observe non-verbal cues.
Active listing.
Establishing good relationship.

17. Personnel of health services. Medical students, nursing & social work.
Health Education
Educator
Personnel of health services.
Medical students, nursing & social work.
School personnel.
Community leaders & the influential.
Requirements:
Personality: popular, influential and interested in work.
Efficiently trained and prepared .
Must show good example.

18. Message Health Education What information to be communicated.
Simple, at the level of understanding.
Culturally accepted.
Interesting.
Meet a felt need.
Free of technical jargon.
Use audiovisual aids.

19. Where Does Health Education Happen?
Everywhere!
Schools
Communities
Worksites
Health Care Sites
Homes
Consumer Marketplace

20. Practice Health Education 1-Individual Face to face
Education through spoken word.
A- Occasions of health appraisal.
B- Home visits
Nurses Health visitor Social workers

21. Practice Health Education 2-Group a. Lessons and lectures in schools.
Lectures in work places e.g. factories.
Demonstration and training
3- Mass media.
a. Broadcasting: radio & TV.
b. Written word: newspapers, posters, booklets.
c. Others e.g. theaters.

22. Major Variables in Behavior Change
Health Education
Major Variables in Behavior Change
Thoughts and ideas inside a person’s mind have significant influence on an individual’s health behaviors. These variables interact with social and environmental factors and it is the synergy among all these influences that operate on behavior.
Knowledge: An intellectual acquaintance with facts, truth, or principles gained by sight, experience, or report.

23. Major Variables in Behavior Change
Health Education
Major Variables in Behavior Change
Skills : The ability to do something well, arising from talent, training, or practice.
Belief : Acceptance of or confidence in an alleged fact or body of facts as true or right without positive knowledge or proof; a perceived truth.
Attitude: Manner, disposition, feeling, or position towards a person or thing.
Values: Ideas, ideals, customs that arouse an emotional response for or against them.

24. Lecture 6

25. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Schizophrenia
Criteria for Schizophrenia
Delusions
Hallucinations
Disorganized Speech
Disorganized Behavior
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Negative Symptoms
Flat Affect
Lack of Motivation
Social/Occupational Dysfunction

26. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Major Depression
Criteria for Major Depression
Depressed Mood
Diminished Interest
Weight Loss or Gain
Sleep Disturbance
Restlessness or
Being Slowed Down
Fatigue & Loss of
Energy
Thoughts of Death
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27. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Major Depression
Criteria for Major Depression
Feelings of Worthlessness
or Excessive Guilt
Difficulty Thinking &
Concentrating
Symptoms Occur
Almost Every Day
Significant Distress &
Impairment
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28. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Bipolar Disorder
Criteria for Bipolar Disorder
Manic Episodes
Elevated mood
Grandiosity
Decreased need
for sleep
Talkativeness
Racing thoughts
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29. Serious Mental Illness
MENTAL HEALTH
Classification
and types of Mental Illness
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Serious Mental Illness
Bipolar Disorder
Criteria for Bipolar Disorder
Marked Impairment
Occupation
Social relationships
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May Alternate with
Depressive Episodes

30. Lecture 7

31. Components of school Environment:
SCHOOL HEALTH
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Components of school Environment:
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1. Site and area:
- easily reached.
- Located in quiet area.
- 10 – 15 square m. / pupil
2. School building:
- Damp, fire and rat proof.
- 2 – 3 floors
- > 1 stair case.
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- Governmental design
( E, T, L types ).
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32. Components of school Environment:
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SCHOOL HEALTH
Components of school Environment:
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3. Class rooms:
- Rectangular 6x8 = 48 m2
m2 of floor area for primary
school pupils,
m2 for intermediate & high school students.
- Windows on left side
- Allow best illumination.
- White ceiling.
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33. Components of school Environment:
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SCHOOL HEALTH
Components of school Environment:
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4. School furniture:
- Suitably suspended
writing board,
- Height & slope
of desks ( 150 angle ),
- Size of seats in
relation to students
age & built,
- Distance between
columns of desks
( 60 cm.).
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34. Components of school Environment:
SCHOOL HEALTH
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Components of school Environment:
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5. Kitchen and Dining:
- Proper illumination &
ventilation,
- Rat & insect proof,
- Washable walls & floors,
- Cold & hot water taps,
- Refrigerators ,
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- Sanitary refuse
baskets ,
- > one door
- Proper control of food handlers.
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35. Components of school Environment:
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SCHOOL HEALTH
Components of school Environment:
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6. Water, Sewage and
refuse disposal:
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- Drinking fountains,
- one tap / 40 students,
- one toilet / 30
students,
- Soap & ? Paper
towels
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36. Health Appraisal Objectives Case-finding, specially of unapparent
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SCHOOL HEALTH
Health Appraisal
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Objectives
Case-finding, specially of unapparent
disease ,
Assessment of health status of school
children,
Baseline for follow-up of health status.
Health education and guidance of students,
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37. Health Appraisal Components 1- comprehensive medical examination
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SCHOOL HEALTH
Health Appraisal
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Components
1- comprehensive medical examination
2- Screening tests,
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3- Clinical (curative) service
4- Survey studies.
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38. Health Appraisal Components 1- comprehensive medical examination
SCHOOL HEALTH
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Health Appraisal
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Components
1- comprehensive
medical
examination
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Beginning of each level
Entry
Intermediate
Secondary
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39. Health Appraisal Components 2. Screening Tests:
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SCHOOL HEALTH
Health Appraisal
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Components
2. Screening Tests:
They are simple tests which can be carried out frequently :
- obesity (BMI)
- visual acuity,
- acuity of hearing,
- IQ testing, and
- dental examination.
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40. Health Appraisal Components 3. Clinical Service: School health units,
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SCHOOL HEALTH
Health Appraisal
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Components
3. Clinical Service:
School health units,
referrals to specialized clinics,
referrals to hospitals for diagnosis and treatment .
some cases may need specialized diagnosis or/and management.
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41. Health Appraisal Components 4. Survey Studies:
SCHOOL HEALTH
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Health Appraisal
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Components
4. Survey Studies:
Occasionally required, specially when
precise data are not available
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nutritional deficiency
parasitic diseases
handicapping conditions
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42. May be congenital or acquired.
SCHOOL HEALTH
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Health Appraisal
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Components
Handicapping conditions:
May be congenital or acquired.
Children with minor or mild cases of disability can attend regular schools,
Severe forms (e.g. the deaf, blind, or mentally retarded) would attend special institutes.
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43. Some forms in regular school:
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SCHOOL HEALTH
Health Appraisal
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Components
Handicapping conditions:
Some forms in regular school:
Heart disease
Musculoskeletal deformities
Impaired vision
Impaired hearing
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1-Heart disease: Rheumatic valvular disease is the most important. 2-Musculoskeletal deformities: mild paralytic poliomyelitis, and healed rickets Impaired vision: mainly due to errors of refraction, or may be corneal opacity. 4-Impaired hearing: neglected chronic otitis media, ear injury by foreign body, and occasionally ototoxic drugs and complicated meningitis.
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44. Health Appraisal Components School Health Record
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Health Appraisal
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Components
School Health Record
Each child should have his own health record
Contents of Record:
- Personal and social data.
- Results of health appraisal.
- Immunizations/date/age.
- Any morbidity, and management data.
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45. Health Appraisal Components School Health Record
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SCHOOL HEALTH
Health Appraisal
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Components
School Health Record
Value of Health Record:
For reference whenever health data are needed;
(e.g. past medical history to assist diagnosis of
existing disease.)
Allows follow-up of chronic disease.
Collecting statistical data and indices of school
children, ( for future planning and evaluation
of health services).
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46. Health Appraisal Role of Teacher: - Spotting suspected cases
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SCHOOL HEALTH
Health Appraisal
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Role of Teacher:
- Spotting suspected cases
through supervision of the
students in the classrooms.
Participation in health
education program.
Supporting mental health
promotion.
- First aid
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47. Health Appraisal Role of School Health Physician : Health appraisal.
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SCHOOL HEALTH
Health Appraisal
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Role of School Health Physician :
Health appraisal.
First aid and emergency service.
Participation in prevention and control of communicable diseases.
Inspection of the school environment.
Participation in health education.
Supervising preparation of statistical
indices and health reports.
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48. Lecture 7

49. MCH PERIODS OF MATERNAL CARE: I. Before pregnancy:gy
I. Before pregnancy:
(> 15 yrs.) for physical and psychological preparation to bear responsibility.
A) Nutrition:
The nutritional status
strongly influences gy
Foetal growth
Birth weight (newborn)
Nutrition during infancy

50. MCH PERIODS OF MATERNAL CARE: Maternal Abs passive immunizationgy
I. Before pregnancy:
B) Infections:
Maternal Abs passive immunization gy
Maternal immunization against rubella
protects the outcome of pregnancy.
Tuberculosis severely affects nutritional
status of mothers

51. MCH PERIODS OF MATERNAL CARE: (Antenatal Care) II. During pregnancy:gy
Aims:- gy
Promote, protect and maintain health.
Detect high risk.
Relieve fear and anxiety.
Health Education: ( elements of
child care, nutrition, hygiene …… etc)

52. - Affects newborn infant
MCH
PERIODS OF MATERNAL CARE: gy
II. During pregnancy:
A) Nutrition:
- Well nourished preg good birth wt.
- Anaemia during pregnancy gy
- Common
- Affects newborn infant
- Preventable

53. MCH PERIODS OF MATERNAL CARE: B) Infection: II. During pregnancy:gy
II. During pregnancy:
B) Infection:
- Rubella
Congenital deformities
Abortion gy
- Syphilis
IUFD
Stillbirth
- Malaria
IUFD
Low birth wt
- UTI
Amnionitis
IUFD
Placentitis
Low birth wt

54. MCH PERIODS OF MATERNAL CARE: II. During pregnancy:gy
II. During pregnancy:
C) Chronic Diseases
Stillbirth
Abortion
Low birth weight
High perinatal
mortality gy
D) Smoking
E) Heavy work and stress in late pregnancy
leads to low birth wt
F) Psychological stress

55. MCH PERIODS OF MATERNAL CARE:gy
II. During pregnancy:
Good ANTENATAL care can provide for all of this and more. gy
(key family practices)
First visit………
Beyond 16 weeks
Second visit…..
Between 24 and 28 weeks
key family practices: Pregnants should receive the recommended four antenatal visits, recommended doses of tetanus toxoid vaccination, and is supported by family and community in seeking appropriate care, especially at the time of delivery and during the postpartum/breastfeeding period.
Third visit……...
Between 30 and 32 weeks
Fourth visit……
Between 36 and 40 weeks

56. MCH PERIODS OF MATERNAL CARE: (Intra-natal Care) III. During labour :gy
AIMS:
Asepsis
Minimum injury to mother and newborn. gy
Preparedness to deal with complications.
(prolonged labor – ante partum hemorrhage – convulsions )
Care of baby at delivery.

57. MCH PERIODS OF MATERNAL CARE: b) Care during labourgy
III. During labour :
a) Antenatal Care (Risk assessment)
b) Care during labour
- Infection
ophthalmia neonatorum gy
tetanus neonatorum
- Bleeding
Perinatal asphyxia or neonatal asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It results most commonly from a drop in maternal blood pressure or some other substantial interference with blood flow to the infant's brain during delivery.
- Trauma
Mother
Newborn
- Asphyxia

58. MCH PERIODS OF MATERNAL CARE: IV. Post-Natal Care Aims:gy
Aims:
Restoration of health.
Check adequacy of breast feeding.
Provide basic health education.
(Evaluate effect of antenatal Care)?! gy
V. Post lactation: spacing?

59. MCH THE RIGHTS OF WOMEN ! PRIMARY HEALTH CAREgy
SAFE MOTHERHOOD FP
ANC SD
EOC gy
BASIC MATERNITY CARE
FP: Family planning, ANC: Antenatal care, SD : Safe delivery, EOC: Emergency obstetrics care
PRIMARY HEALTH CARE
E Q U I T Y F O R W O M E N

60. MCH Maternal Mortality Malnutrition Anaemia Pregnancy Infectiongy
Malnutrition
Anaemia
Infection
Pregnancy gy
Bleeding
Infection
Labour
Bleeding
Infection
Postpartum
Lack of awareness
Lack of health services
Lack of utilization of health services

61. MCH Child Welfare Infancy and Early Childhood: Rapid growthgy
Infancy and Early Childhood:
Rapid growth
- Period of
Development
Learning gy
Infection
- Vulnerability
Malnutrition
Environmental hazards
- Infants: 4% of population: 25% of deaths
- “1- 4” years: 13% of pop: 20% of deaths

62. MCH Child Welfare Child Care Program Objectives of child care:gy
Child Care Program
Objectives of child care:
Safe entry to life
Reduction in perinatal and neonatal deaths
Reaching a healthy adulthood
Promotion, protection and maintenance of health
(Overcome genetic factor)? gy

63. MCH Child Welfare Child Care Programgy
Child Care Program
1. Prenatal Care ( Ideally before conception )
Parental guidance and discussion involving:
Genetics
Family history
Feeding plans (Br. F)
Home preparation for baby care
Answering questions gy

64. MCH Child Welfare Child Care Programgy
Child Care Program
1. Prenatal Care ( Ideally before conception )
Parental guidance and discussion involving:
Obstetric gy
- Work of mothers
- Nutrition
- Smoking
- Drugs

65. MCH Child Welfare Child Care Program 2. Infant Care - Early evaluationgy
Child Care Program
2. Infant Care
- Early evaluation
- Encourage breast feeding
- Face parents’ concern
- Developmental problems
- Anxiety
- Sleep
- Overfeeding
- Active immunization
- Monitoring of growth and development gy
key family practices: 1.Exclusive breastfeeding(six months)2. Starting complementary feeding at about six months. 3. Provide micronutrients. 4. Full course of immunizations (EPI). 5. In malaria-endemic areas(Insecticide-Treated BN). 6. Continue to feed and offer more fluids to children when they are sick.
7. Appropriate home treatment for infections. 8. Seek appropriate health care when needed.

66. IMCI is an integrated approach to child health that focuses on the well-being of the whole child. IMCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMCI includes both preventive and curative elements that are implemented by families and communities as well as by health facilities.

67. Mortality in and around infancy
VERY IMPORTANT
MCH
Mortality in and around infancy gy
I N F A N T gy
N E O N A T E
FOETUS
PERINATAL PERIOD
28th week
of gestation
Birth
7 Days
28 Days
1 Year

68. Mortality in and around infancy
MCH
Mortality in and around infancy gy
Infant Mortality
Post-neonatal death
Neonatal death
Early neo-natal death
Late neonatal death gy
Perinatal death
Still birth
28th week
of gestation
Birth
7 Days
28 Days
1 Year

69. MCH Child Welfare Child Care Program 3. Second year of lifegy
Child Care Program
3. Second year of life
- Rapid development
- Increased parental concern
4. Pre-school years (< 5 years)
- Accident prevention
5. School years gy
key family practices: 1. In malaria-endemic areas(Insecticide-Treated BN). 2. Promote appropriate physical and affective interactions. 3. Continue to feed and offer more fluids to children when they are sick. 4. Appropriate home treatment for infections. 5. Seek appropriate health care when needed
6. Prevent and provide treatment for child injuries. 7. Prevent and take action for child abuse. 8.
6. Adolescent Care
- Rapid physical growth
- Marked emotional changes
- Personality development

70. CONCLUSION gy
Antenatal care is the key to modification of outcome to the mother and the newborn
Prevention and management of bleeding and infection during and after labour gy
Child care starts ideally before conception
Integrated Management of Childhood Illness (IMCI)
Addressing mortality in and around infancy