CLINIC SUPERVISOR'S MANUAL - Management Sciences for Health

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SECTION 5: INFORMATION SYSTEM GUIDELINES Hydrocortisone 100mg Injection Insulin (any) 100 units (10ml) Measles with diluent (10 doses) Methyldopa 250mg Metronidazole 200mg Paracetamol 120mg/5ml Suspension (50ml) Rifampicin/Isoniazid/Pyrazinamide 120/80/250mg Salbutamol Inhaler 100mcg/dose (200 doses) Theophylline 300mg SR DTP-Hib 2 nd dose DTP-Hib (Diphtheria.Tetanus/Pertussis-Haemophilus influenzae B) vaccine 2 nd dose given to a child under one year – preferably at around 10 weeks after birth. OPV 2 nd dose OPV (Poliomyelitis) vaccine 2 nd dose given to a child under one year, preferably around 10 weeks after birth. HepB 2 nd dose Hepatitis B vaccine 2 nd dose given to a child under one year – preferably at around 10 weeks after birth. 18 Clinic Supervisor’s Manual
SECTION 5: INFORMATION SYSTEM GUIDELINES ROUTINE MONTHLY INDICATORS FOR PROGRAMME MANAGEMENT-Detailled INDICATOR DEFINITIONS A selected list of indicators are included to support the clinic supervisor and staff in discussing data and determining actions following from the data. CHILD HEALTH INDICATORS Name Failure to gain weight Rate Target No child should fail to gain weight over the period of one month – continuous growth is a more important sign of good health than attained weight. Definition Percentage of children below the age of 5 years who had an episode of growth faltering/failure (failing to gain weight) during the month, or since the last visit if over one month. While each weight may be recorded on the Road to Health Card, a child should NOT be entered more than once in a month for either weighing or failure to gain weight, even if it is weighed more often. Calculation Numerator: Number of children < 5 years failing to gain weight Denominator: Number of children < 5 years weighed Rationale Failure to gain weight, even for one month, indicates early nutritional problem or an acute illness and is the most sensitive indicator of the nutritional well being of individual children or whole communities. This indicator encourages the use of the Road to Health (RTH) card and raises awareness of the problem of malnutrition. Data source Each weight is recorded on the Road to Health card, and the register if weight gain is absent. If there is no RTH card available, be very careful. The nutrition register, Tick register, Child health register are less reliable because of potential double counting. Common mistakes Actions to consider Children coming back for rehabilitation are often entered more than once in a month. Not all children coming are weighed – if only those who “look malnourished” are weighed, the results will be biased. Any individual child not gaining weight needs to be put on an “at risk” register and followed closely, with support to the mother both at home and in the clinic. Communities with more than 5 - 7% of children not gaining weight need special nutrition remedial action and nutrition promoting activities in the community. Graphs Simple line or bar graph of % children not gaining weight. The village location of those not gaining can be placed on a spot map – if clustered, do outreach to that village or community. Other possible indicators Nutrition is classically a field for sample surveys and sentinel site investigation, as routine growth monitoring is seldom accurately done. Yet this is the most sensitive and accurate indicator of child health. % Children under the third centile is a less sensitive indicator of current nutritional situation. This only picks up malnutrition once it is established. If all the weights of the children coming to the clinic are recorded on a large RTH card on the wall, one can easily see how many are MALNOURISHED – that is under the 60% line. Height for age measures stunting (shortness) but this is not a measure of current nutrition – i.e. the child may have been sick long ago and not grown at that time – thus, this measure is used in surveys to measure long term trends Micro-nutrient deficiency (Vitamin A, Iodine, anaemia) require special surveys to measure. However, mothers of children who are not gaining weight should be reminded to use iodised salt in the home, provide vegetables eggs and meat to assure adequate micronutrients. Clinic Supervisor’s Manual 19
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CLINIC SUPERVISOR’S MANUAL
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PREFACE The Clinic Supervisor’s M
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PREFACE Many of the manual’s sect
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INTRODUCTION GUIDELINES FOR THE PRE
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INTRODUCTION ELEMENTS OF THE SUPERV
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TABLE OF CONTENTS SECTION 1 HOW TO
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ABBREVIATIONS - ACRONYMS AA Alcohol
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SECTION 1: HOW TO USE THE CLINIC SU
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SECTION 1: HOW TO USE THE CLINIC SU
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SECTION 11 CLINICAL TIPS • Introd
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COUNSELLING SKILLS Why do nurses ne
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Checklist for Interactive Counselli
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TUBERCULOSIS A thin and ill-looking
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ASTHMA What do I need to know about
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ASTHMA (cont.) Do I have the skills
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DIARRHOEA Why discuss managing acut
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DIARRHOEA (cont.) Counselling mothe
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HIV/AIDS: Prevention ACRONYMS FOR H
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HIV/AIDS: Prevention (cont.) � Du
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CONTRACEPTIVE SERVICES (cont.) �
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Checklist Counselling Contraceptive
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DRUG MANAGEMENT What is meant by "R
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SECTION 12 PROBLEM SOLVING AND PRAC
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