HEALTH PRACTICES FOR CHILDREN

1. Care of eyes # Teach students * To wash face & eyes every morning with clean water* Not to share towels/handkerchiefs* Not to apply kajal/surma* Not to let flies sit on eyes of children* Not to throw dust, stones or darts at each other or aim slings, toy-

guns, arrows to anyone * To eat in plenty Vitamin A rich foods* Use good light for reading, the source being from left side. Do not read

on lying-down position

2. Care of ears #Teach children*To wash ears well with clean water during bathing*Not to swim in dirty water*Not to poke sticks , pencils etc inside ear*Avoid shouting into other’s ears*Avoid exposure to loud sounds e.g. crackers*If foreign body enters inside ear-to report health workers3.Care of teeth

#Teach students

*To brush teeth every morning , night and after meal*Not to pick with pins or pointed objects*Not to eat to many sugary or sticky sweets*To chew a piece of fibrous vegetable e.g. carrot at the end of the meal*Not to crack hard nuts with teeth*If toothache is present , attend doctors to prevent decays

4.Care of nose & throat# To teach children *Not to blow or spit indiscriminating on wall or ground*To use handkerchief while blowing *Not to pick noses*To practice deep breathing through nose in morning*Not to shout at top of voice* Wash nose & throat with clean water5.Care of skin, nail & hairTake bathe everyday by using soap. Armpit & groin should be washed Hair should be washed at least weekly. More frequently during summer. Should be combed regularly .Long hairs be plaited neatly . If lice infected , take treatmentFinger nails to be cut once a weekWash hands well with soap after toilet and before foodLeave footwear outside house

Hand Washing Technique

6. Care of bowels & bladderTo drink plenty of fluids especially in summer To eat plenty of fruit, raw saladsTo take active part in gamesTo try to keep regular time for emptying bowelsEmpty bladders before going to bed and as soon as you get up in the morningUse latrine and keep it clean

7.Sleep,rest,exercise and posture# To teach children toGo to bed early and rise early Sleep in clean ,quite & well ventilated room Use mosquito nets Do not sleep in closed room in which there is burning charcoal or woodPut bedding in the sun from time to timeTake regular exercise Take active part in physical training & outdoor games at schoolTake regular exerciseTake active part in physical training & outdoor games at schoolAlways keep the back in straight posture

NUTRITION & FOOD SANITATIONNutritious diet Balanced diet consist of foods having Proteins ,Carbohydrates, Fats, Vitamins & Minerals in correct proportionsProtein foods : milk , egg , meat , fish , dals , pulses , nuts Carbohydrate foods : cereals , potato, banana Fatty foods: oil , ghee , butter Vitamin-rich foods: Vit A -green leafy vegetables , mango , papaya , beans , milk, , , egg , meat , fish Vit B –hand pounded rice , atta , millets , pulses , beans , milk , , egg , meat , fish Vit C –lemon , orange , amla , guava, tomato Vit D –exposure to sunlight, butter , ghee , eggs

Mineral rich foods: green leafy vegetables, pudina, radish, karela , bajra , ragi , gur , meat , liver, eggs

Ways to make diets more nutritiousMix dal with cereal as in khichadi Wash & scrub potatoes well and cook them without removing , skin Do not throw away water in which rice &vegetables are boiled Serve sprouted moongor chana either raw or half- cooked Avoid overcooking vegetables

COMMON MALNUTRITION DISEASES AMONG SCHOOL CHILDREN

1.Protein energy malnutritionCaused due to lack of enough food or protein or both Smaller in size and thinner Becomes easily breathless while playing Shows less interest in surroundings May have swelling of feet and peeling of skin Hair is sparse and light in color Can be treated by giving small frequent feeds containing , ,, plenty of protein

2.Vitamin A deficiencyMay lead complete or partial blindness Usually follows measles , pneumonia , whooping cough , diarrhoea Night blindness in early stages Eyes look dull and dry White foamy triangular patches on outer white part of eye If untreated , cornea , may become ulcerated Besides, skin becomes dry and scaly Should be referrred for Vitamin A Solution dosage3.Vitamin B deficiencyCracks at the corners of mouth Smooth , red and raw tongue4. Vitamin C deficiencySpongy and bleeding gumsTeeth become loose Small haemorragic spots under skin

5. Vitamin D deficiency Causes rickets Bow legs and knock-knees Beading on ribs Bulging of bones of head Soreness and tenderness of body Delayed eruption of teeth6. Anaemia- Lack of blood - Easily tired and lethargic - Pale lips and conjunctiva- Flat and pale nails- To be referred from IFA tablets7. Goitre- Enlarged Thyroid gland- Mental and physical defects- Prevention*Iodated salt to be kept properly and consumed daily

Food Sanitation=> Ensure that-> Children have a clean eating place-> Hand-washing after toilet and before meal-> Eating of mid-day meals/snacks-- At regular hours - - Without hurrying

=> If mid-day meal is + -Cooks and food – severs to wash hands before handling.- Proper washing of fruits and salads. Keep foods covered.- Clean – scrubbed utensils are used.- Only freshly cooked foods are served.=> Food hawkers are not allowed near the school – premise.

COMMON MALNUTRITION DISEASES AMONG SCHOOL CHILDREN

Making School Health Education meaningfulMust be closely related to children’s day to – day activities To be based on their interests & physical , mental and ,,,,emotional needs Should not be taught as a separate subject , but as an ,,,,integral part of existing curricular subjects Should be imparted in an interesting manner Should be carried out with co-operation with parents , ,,,,community members & health staff

• Different ways of health education activities• “ Formation of School Health Clubs Consisting of Teachers , students , parents & health staffs To discuss health problems at school , plan to solve them

and ,,,,implement• Demonstration & practical work health drills comprising of hygienic activities e.g.

washing ,,,hands Field trips to show insect breeding grounds ,

water ,,,,chlorination , construction of soakage pits Asking children to bring one good food item and talk about

it ,for 2 minutes

Action songs/poems , stories , games & puzzlesSnakes & ladders Good health Solving problems Dramas , puppet shows & role play .• Health parades , competitions , class charts & diaries.• Exhibitions & Display boards.•Talks ,debates & discussions.• Visual aids.• Involvement of parents >of parents in School Health Committee >Planning menus for school canteen & mid-day meal >Meetings between teachers and parents. Child to child activities

>School going children spreading health messages to non-school goers

OBSERVING CHILDREN FOR DEFECTS & DEVIATIONS FROM NORMAL

*Points to be rememberedDo not discuss abnormalities when found out, in front of the child or other children Distressing/embarassing to the child*May invite teasing from other children*Talk to parents advise to see doctor

S/S INDICATING ILL HEALTH

Hair Child constantly scratches head EyeRubbing eyesWatering or purulent discharge Red & Swollen eyelid Squinting Holds book too closely or very far while reading Frowns while reading Complains of frequent headache Cannot see what is written on board

EarsConstantly pokes ears or pulls ear Complains of earache Discharge or crusting in ear Inattentive in class Does not respond to when called Turns head listeningTeeth Looks black &rotten Complaints of toothache Bad odour

Lips & TonguePale in color Cracks at corners of mouthNoseBreathing through nose Speaks with nasal twang Running nose with sneezingNeckSwellingsNailsFlat and pale nails Bluish in color SkinLight-colored or reddish patches patches Round, itchy, scaly patches Rash on fingers and body Boils & Dry & scaly & Swelling of face and feet

Bones, joints & musclesBulging of front of head Bony bead-like swellings on breast bone Bow leg or knock-knees Feet twisted inwards or outwards Curved back (hump) Pain & swelling of joints ChestGets out of breath easily Gets attacks of breathlessness

AbdomenToo large for body and age Complains of passing worms BMI = Weight(in kg) / Ht.(in cm2) Frequent urination Dirrhoea & vomitingSpeech Stammering Can not speak clearly General condition & behaviourLook small for age Listlessness and apathy Declination to playing Sleepiness Gets easily tired Finds difficulty in understanding

TREATMENT OF MINOR AILMENTS

POINTS TO BE REMEMBERED Teachers may give simple treatment for certain ailments

But ensure that the child is being seen by a health personnel laterInform parents about what can be done before referral to doctor

CONDITION DO THE FOLLOWING Refer immediatelyAnaemia 1. Give IFA

2. Advice mother to give plenty of Green Leafy Vegetables

1. If child is very pale2. If there is breathlessness or swelling of

face or feet

Cough & cold

1. Give Paracetamol2. Let child gargle with

hot water & salt

1. If accompanied with pain on swallowing or whoop or blood-stained Sputum or difficulty in breathing

2. If more than 2 weeks

Diarrhoea 1. Give plenty of fluids2. Give bland soft diet 3. Start ORS4. Advice mother ORS

1. If accompanied by fever &vomiting2. If stools are watery or very frequent or contain blood & mucus3. If child is ill and mouth is dry

CONDITION DO THE FOLLOWING REFER IMMEDIATELY

Earache Keep ears dry If febrile or there is dizziness or hearing- impairment

Headache Give Paracetamol If accompanied by stiff neck, dizziness, vomiting or fever

Headlice Advice mother to cut hair short, wash hair with soap, apply Benzyl Benzoate emulsion & keep head covered with cloth overnight & comb next morning, wash with soap and hot water; To repeat until no lice remain

Joint pain Give Paracetamol If several joints are involved or joint is swollen & tender

CONDITION DO THE FOLLOWING REFER IMMEDIATELY

Scabies Advice mother to:1. Scrub bath child with soap & water2. Apply Anti-scabies emulsion allover body

except head & face3. Apply 2nd & 3rd layers on the next 2 days

without any batching in between 4. Scrub bath on 3rd day5. Wash clothes well6. Treat other family members

Sore eyes 1. Frequent washing of eyes with clean water & cotton swabs

2. Apply antibiotic drops

If pain in the eye

Tootache 1. Give Paracetamol / Nimesulite 2. Mouth-wash with lukewarm water3. Ask child to chew clove

If child has fever or if there is painful & swelling gum

CONDITION DO THE FOLLOWING REFER IMMEDIATELY

Ulcer 1. Clean with wool & boiled water

2. Apply antiseptic cream

3. Apply bandage

1. If fever+2. If more than 1 week3. If several ulcers+

Vomiting 1. Give plenty of fluids 2. Let child chew sugar

cane3. Start ORS4. Advice mother to give

bland diet &continue ORS

1. If accompanied by watery diarrhoea

2. If eyes are yellow3. If child looks very ill &

mouth is dry

FIRST AID IN ACCIDENTSPoints to be remembered Act quickly, quietly & methodically Give priority to A. Airways B. Breathing & C. Circulation If breathing stops go for mouth-to-mouth respirationControl bleeding Treat for shock Do not allow crowding around injured child Do not give anything orally if child is unconscious has suspected internal bleeding If fracture +, immobilize before referral Arrange for conveyence to PHC After giving any first aid - Always inform parents & Always send child to PHC

FIRST AID MEASURESCondition DO THE FOLLOWING REFER IMMEDIATELY

1. Burns 1. Immerse burnt part in cold water until pain is relieved

2. Apply antiseptic cream3. Do not bandage as far as possible4. Give a pain killer & plenty of fluids

1. If burns are extensive & deep

2. If shock+

2. Bruises 1. Place injured part at rest2. Apply cold compression

1.If fracture/dislocation is+

3. Animal bites

1. Clear with soap & water2. Apply antiseptic 3. Do not bandage

1.For ARV

4.Drowning

1.Keep face down with head turned to side2.Place your arms around child’s body &raise body of child3.Clear airways 4.Give artificial breathing

1.After breathing starts

Condition DO THE FOLLOWING REFER IMMEDIATELY

5.Fainting 1.Loosen clothing around neck & chest2.Keep child in lying –down position & raise foot-end 3.See that child gets fresh air 4.On recovery, give lots of fluid to drink

. If recovery is not rapid or complete

6.FB in ear 1. Apply antibiotic drops 2. 2.Do not attempt to remove FB

For removal

7.FB in eye 1.Prevent child from rubbing eye2.Wash eye with clean water 3.Apply antibiotic drops

If eyes are red & painful

8.FB in nose 1.Block normal nostril & ask child to blow2. Do not poke anything to remove FB

If first-aid fails

CONDITION DO THE FOLLOWINGREFER IMMEDIATELY

9.FB in throat

1.Lay child over your knees with head downwards & slap 3-4 times sharply between shoulders 2. Or, hold child around waist bending forward & press suddenly on abdomen

1. If first-aid fails

10.#/sprain 1.Place child in most comfortable position 2.Immobilize injured part by using splints &bandage

1. Transfer immediately to PHC/Hospital

11.Heat Stroke

1.Place child in shade 2. Undress child 3. Apply cold wet cloths on body especially armpits

1. If child is unconscious. On the way, continue cold compresses

12. Insect stings

1. Remove sting if visible2. Apply cold compressed3. Give pain killer

Always refer to PHC/Hospital

CONDITION DO THE FOLLOWING REFER IMMEDIATELY

13.Poisoning 1. Try to find out type of poison 2. If conscious, induce vomiting (except

for SK oil ) by tickling back of throat or by giving salt solution

3. Treat for shock

To PHC/Hospital. Continue artificial respiration, if needed

14. Snake bite

1. Tie a piece of cloth above bitten area 2. Wash with soapy water 3. immobilize & keep the part lower

than body

To PHC/Hospital

15. Wounds 1. Control bleeding by applying pressure 2. wash with clean soapy water3. Apply antiseptic cream & bandage

If wound is dirty or bleeding profusely or child is in shock

16. Nose-bleed

1. Make child sit with head slightly bent forward

2. Ask child to pinch nose for 1-2 minutes

3. Apply cold compress on nose 4. Do not let child blow nose

If bleeding continues refer to PHC/Hospital

FIRST-AID FOR CHOKING

FIRST AID FOR FRACTURE & ANIMAL BITE

PROCEDURES

Splinting Support properly fracture part while placing on splint Pad splint with cloth Make splint long enough to immobilize the joint above joint below fracture Knot of securing bandage should be on splint and not on flesh BandagingRoll bandage tightly before using it Make 2-3 turns on top of each other when starting bandage for fixationAlways start from below & work upwards Do not bandage too tightly