CONTROL OF ACUTE RESPIRATORY INECTIONS 1.

Very severe disease

2. Severe pneumonia
CARI LAUNCHED IN 1989 3. Pneumonia
4. No pneumonia: cough or cold
OBJECTIVES OF CARI PROGRAM
VERY SEVERE DISEASE DANGER SIGN (2 mos. -5 years old)
o Reduce the mortality due to pneumonia among the under-fives
by 25% from baseline levels by year 2000 o Not able to drink
o It hopes to accomplish this through the ff. strategies: o Convulsions
o Abnormally sleepy or difficult to wake
1. Training govt. and private health workers in the
o Stridor in calm child
standard management of ARI
o Severe under nutrition
2. Enabling barangay Health Workers (BHWs) to
identify VERY SEVERE DISEASE DANGER SIGN (<2 mos. old)
3. pneumonia cases refer cases for treatment, teach
mothers how to care for their sick children at home,  Stopped feeding well
follow up compliance of treatment  Convulsions
4. Assuring the adequate supply of antibiotics and  Abnormally sleepy or difficult to wake
other essential drugs in all health facilities  Stridor or wheezing
5. Teaching parents and communities how to recognize  Fever of low body temperature
*Refer urgent to the nearest hospital
the Symptoms of pneumonia and other acute
respiratory infections, how and when to give proper SEVERE PNEUMONIA
home care
6. Mobilizing NGO's and filed workers to  Infant = breaths > 60 bpm
communicate with parents and communities  Severe chest indrawing
7. Advocacy and social mobilization to gain support to *Refer urgent to the nearest hospital
local govt. officials, NGOs, private and educational PNEUMONIA (NOT SEVERE)
institution.
 Fast breathing (cut oft)
Goal:  60x per minute or more if the infant is < 2 mos.
 50 x per minute or more if the child is age 2 mos. Up
 Morbidity & mortality from pneumonia & other acute to 12 months.
respiratory infections are reduced.  40x per minute or more if the child is age 12 mos. Up
 NATIONAL Objectives for Health are: to 5 years
o reduce the incidence of pneumonia to 350 per *no chest indrawing
100,000 children under five years old from 506 NO PNEUMONIA
cases per 100,000 under five years old.
o Reduce the mortality from pneumonia to 120 deaths  BREATHING < 60 breaths per minute
per 100,000 children under five years old from 140  No severe chest drawing
per 100,000 children under five years old.  Cough and cold

Strategies/Objectives CHILDREN AGED 2 MONTHS – 5 YEARS OLD CLASSIFIED TO

HAVE PNEUMONIA SHOULD BE:
 Early detection & appropriate case management
 Ensuring adequate supply of appropriate antibiotics  Give antibiotics
 Health education & information  Mother was told to bring back the child after 2 days for
 Promotion of breastfeeding reassessment
 Mother advised on home care

STEPS IN GIVING AN ANTIBIOTIC IN TABLET FORM

MANAGEMENT OF THE CHILD WITH COUGH OR DIFFICULT
BREATHING  Check the milligrams per tablet written on the package
 Weigh the child. If none, use the age of the child in giving
ASSESSMENT antibiotic dose.
ASK
 How old is the child?
 Is the child coughing? For how long?
 Age 2 mos.-5 yrs.- Is the child able to drink? Age <2 mos. Has
the infant stopped feeding well? CONTROL OF DIARRHEAL DISEASES
 Has the child had fever? For how long? CDD LAUNCHED IN 1980
 Has the child had convulsions?
GENERAL OBJECTIVE

LOOK, LISTEN  To reduce mortality from diarrhea particularly

among children under five through intensive case
 THE CHILD MUST BE CALM)
management utilizing Oral Rehydration Therapy
 Count the breaths in 1 minute.
 Look for chest indrawing
(ORT), environmental sanitation, MCH, nutrition
 Look and listen for stridor and health education activities.
 Look and listen for wheeze, is it recurrent?
 See if the child is abnormally sleepy or difficult to wake STRATEGIES
 Feel for fever, or low body temperature
 Look for severe undernutrition o Analysis of water supply
o Logistic support to existing provincial laboratories
FOUR Classification
 o Construction of sanitary toilets and improvement of the population, through adoption of desirable
unsanitary toilets dietary practices and healthy lifestyle
o Enforcement of sanitation code
OBJECTIVES
o Improvement of personal hygiene, food sanitation,
insect /rodent control measures  To increase the food and dietary energy intake of
o Strengthening of related nutrition activities and the average Filipino
MCH practices for the prevention and control on  To prevent nutritional deficiency diseases and
o diarrheal diseases nutrition-related chronic degenerative ds.
o Implementation of effective IEC materials in  To promote a healthy well-balanced diet and
support of CDD program  To promote food safety
PREVENTIVE INTERVENTIONS ON DIARRHEA NUTRITIONAL GUIDELINES
 Breastfeeding  Eat a variety of food everyday
 Improved weaning practices  Breastfeed infants exclusively from birth to
 Use plenty of clean water Months. And then give appropriate foods while
 Handwashing continuing breastfeeding
 Use latrines  Maintain children's normal growth through Proper
 Proper disposal of babies’ stools diet and monitor their growth regularly
 Measles immunization  Consume fish, lean meat, poultry or dried beans
 handwashing  Eat more vegetables, fruits and root crops
 Eat foods cooked in edible/cooking oil daily
SIGNS AND SYMPTOMS OF DEHYDRATION  Consume milk, milk products or other calcium rich
foods such as small fish and dark leafy vegetable
 poor skin turgor everyday
 sunken fontanels  Use iodized salt but avoid excess intake of salty
 dry mouth foods
 sunken eyeballs  Eat clean and safe food
PREVENTION % CONTROL:  For healthy lifestyle and good nutrition, exercise
regularly, o not smoke and void drinking alcoholic
 Give the child more fluids than usual beverages
 Continue feeding the child
 Watch for signs of dehydration NUTRIENTS IN FOOD

Interventions o PROTEIN
o CARBOHYDRATES
 Providing clean water for drinking & food o FATS
preparation o VITAMINS
 Teaching children & adults to wash their hands o MINERALS
properly o WATER
 Breastfeeding infants are some of the most
important things governments & families can do to
protect health.

NUTRITIONAL GUIDELINES FOR FILIPINOS

GOAL

 The goal of the 2000 Nutritional Guidelines of the

nutritional status, productivity and quality of life of

VITAMIN A Maintain normal vision, skin health and etc.

THIAMINE Help release energy from nutrients, prevent beriberi

RIBOFLAVIN Prevent deficiency such as inflammation of tongue

NIACIN Support skin, nervous and digestive system prevents pellagra

BIOTIN Help in energy and amino acid metabolism; synthesis of fat glycogen

PANTOTHENIC Helps in energy metabolism

FOLIC ACID Prevents anemia; formation of DNA and RBC

 VITAMIN B 12 Formation of new cells

VITAMIN C Helps in formation of CHON, collagen, bones and prevent scurvy

VITAMIN D Help in mineralization of bones by enhancing absorption of Ca

VITAMIN E Strong ant-oxidant

VITAMIN K Involves in the synthesis of blood clotting

CALCIUM mineralization of bones and teeth, muscle contraction and relaxation, blood clothing, BP, and immune
defenses
CHLORIDE Maintain normal fluid and electrolyte balance
CHROMIUM Work with insulin and is required for release of energy from glucose
COPPER Necessary in absorption and use of iron in formation of hemoglobin
FLUORIDE Involves in the formation of bones and teeth, prevents tooth decay
IODINE Regulates growth, physical and mental development, and metabolic rate
IRON Essential in the formation of blood
MAGNESIUM Mineralization of bones and teeth, building CHON
MANGANESE Facilitate many cell processes
MOLYBDENUM Facilitate many cell processes
PHOSPHORUS Mineralization of bones and teeth, USED IN THE ENERGY TRANSFERE AND MAINTAINANCE
OF ACID-BASE BALANCE
SELENUM Work with Vitamin E to protect blood compound from oxidation
SODIUM Maintain normal fluid and electrolyte balance
SULFUR Integral part of vitamins, biotin and thiamine as well as the hormone
ZINC Essential for growth, development, reproduction and immunity

DESIRABLE CONTRIBUTION TO TOTAL ENERGY INTAKE

 CHO – 70%
 CHON – 10-15%
 FAT – 20-30%
MAINTAIN a well-balanced diet

SCHEDULE OF REVEIVING VITAMIN A SUPPLEMENT TO INFANTS, PRESCHOOLERS % MOTHERS

Schedule Infants (6-11 months) Preschoolers (12-83 POST PARTUM

months) MOTHERS
Give 1 dose 100,000 IU 200,000 IU 200,000 IU within 1 month
Give after 6 months 100,000 IU 200,000 IU After delivery of each child
only

SCHEDULE FOR TREATMENT OF VITAMIN A DEFICIENCY

Schedule Infants (6-11 months) Preschoolers (12-83 months)

GIVE TODAY 100,000 IU 200,000 IU
GIVE TOMORROW 100,000 IU 200,000 IU
 GIVE AFTER 2 WEEKS 100,000 IU 200,000 IU

Recommended IRON requirements

Dosage
Infants (6-12 months) 0.7 mg daily
Children (12-59 months) 1mg daily

Treatment for IRON deficiency

Dosage
children 0-59 months 3-6 mg/kg body weight per day

IODINE supplements

Dosage
Children 0-59 months in endemic areas Iodine capsule (200 mg) potassium iodine in oil once a year

FLUORIDE

 Supplementation to the teeth through water supply