Introduction to Child Health and Child Health Nursing [Autosaved] - Copy.ppt
1. History of Child Health Nursing
M.Sc. Nursing,1st Year (B-2023)
B. P. Koirala Institute of Health Sciences, Dharan
Pediatric: The term “pediatrics” is derived
from the Greek words. “ Pedia ” means child
,“iatrike” means treatment and “ ics” means
branch of science.
Thus, pediatrics means the science of child
care and scientific treatment of childhood
Pediatric Nursing/child Health Nursing:
Pediatric nursing is specialized branch of
nursing that is concerned with the care of
children not only during illness but also during
It is the art and science of giving nursing care
to children from birth through adolescent with
emphasis on the physical growth, mental,
emotionaland psycho-social development.
• It is the art and science of giving nursing
care to children from birth through
adolescent with emphasis on the physical
growth, mental, emotional and psycho-
• Pediatric Nurse: A pediatric nurse is a nursing
professional who is specialized in pediatric
nursing and primarily works in the field of
• The pediatric nurse’s responsibility is not only to
provide care to pediatric population, but also to
incorporate parents and other family members
into the child’s care.
6. Concept of Child Health and Child
Concept of child health
Pediatrics can be defined as the branch of medical
science that deals with the care of children from
conception to adolescence in health and illness.
It is concerned with preventive, promotive ,
curative and rehabilitative care of children.
A child is unique individual, he or she is not a
miniature adult, not a little man or woman.
The childhood period is vital because of
socialization process by the transmission of
attitude, customs and behavior. Family’s cultural
and religious belief, educational level and ways of
living influence the promotion and maintenance
of child health.
Children are vulnerable to disease, death
and disability owing to their age, sex, place
of living, socio-economic status and other
They need appropriate care for survival
and healthy development.
9. Concept of Child Health Nursing
1. Health of the children has been considered as a
vital importance to all societies because children
are the basic resource for the future of human
2. Nursing care of children is concerned for both the
health of the children and for the illnesses that
affects their growth and development.
3. The increasing complexity of medical and
nursing science has created a need for
special area of child care, i.e. child health
4. Child health nursing is the specialized area
of nursing practice concerning the care of
children during wellness and illness.
5. It includes preventive, promotive, curative
and rehabilitative care of children.
6. It emphasize on all round development of
body, mind and spirit of the growing
7. Thus, child health nursing involves in giving
assistance, care and support to the growing
and developing children to achieve their
individual potential for functioning with
fullest capacity. 11
12. Goals of Child Health Nursing
To provide skillful, intelligent, need based
comprehensive care to the children in healthy
To interpret the basic needs of the children to
their parents and family members and to guide
them in child care.
To promote growth and development of
children towards optimum state of health for
functioning at the peak of their capacity in
To prevent disease and alleviate suffering in
14. Qualities of Child Health Nurse
• Be friendly, honest, gentle, diligent and
• Be a loving person and have liking for the
• Patience, pleasant appearance and ability to
understand and the child’s behaviour.
• Able to provide safety and security to the
• Have good observation, judgement and
communication ability based on scientific
knowledge and experience.
• Be well informed, skillful, responsible,
truthful and trustworty.
16. Historical Overview of Child Health
and Child Health Nursing
The modern child care is part of a great historical
pageantry. Child health nurses can gain a better
understanding of the current and future status of
child health nursing.
• Study of pediatrics began in the last of
1800s under the influence of Prussian born
physician, Abrahan Jacobi(1830-
1919)referred as “the father of pediatrics”.
• Before pediatrics became a speciality,
newborns were delivered by midwives and
cared for in the home
The end of the 19th century is often
regarded as ‘’the dark ages of pediatrics’’.
The first half of the 20th century is regarded
as ‘’the dawn of improved health care for
19. Child care in Pre-Historic
Period(Before 3000 BC)
There was no written documents to
validate the practice of people regarding
It is quite natural to assume that individual
of each generation followed the prescribed
pattern of life taught by their parents.
21. Pre-Historic Period(Contd…)
• The society ruled that malformed and sick
children would drain the resources of the
group. The sick child was killed or left behind.
• Sometimes infants were killed simply because
they were females, who could not contribute as
much productive labour to the group as males
could. This practice is termed as female
22. Pre- Historic Period(Contd…)
• The medical practice was a combination of
indigenous customs, magic,and superstition.
Most of the ancient society believed that
disease was caused by the anger of god and
supernatural power existed in the nature.
• All human activities were governed by that
power, for which they used to worship to get
free from sickness.
23. Child Care in Early Civilization
Period (3000 BC to 1350 AD)
The concept of the importance of child to
society graduall improved instead of liability the
child slowly became an asset to society.
Early civilization brought change in the course
of human life. People started re- habiting in the
fertile land. In early civilization brought change
in the course of human life.
24. Child Care in Early Civilization
• People started re-habiting in the fertile land.
In early civilization of egypt, China and India
children were reared according to tradition
passed down from previous generation.
• The medical practice was a combination of
indigenous customs, medicine, and
superstition. Local practitioners used to treat
children with diet,rituals and superstition
along with herbs.
25. Child Care in Early Modern
Due to the emergence of the middle class and
world trade along with the development of
international commerce, there were tremendous
changes seen in the area of child care.
But the incidence of child morbidity and
mortality was still high due to an increment of
child labour and overcrowding, unsanitary
working conditions and poor management of
26. Child Care in Early Modern World
Despite this, rousseau wrote his famous book
that included a section about the right of
children and another on hygiene and nutrition
He also mentioned that children are not
miniature adults. The first book on pediatric in
Italian was written by bagallarder’s ‘little book
on a disease of children’’ in 1472.
27. Child Care in the Early Modern
Renaissance brought termendous changes in the course
of human life. In 16th century two great medical books
were published. ‘’The Book of children’’ by Thomas
Phare (father of English pediatrics) and’’The Children’s
Book’’ by felix wurtz in Germany.
They found there were lots of hazardous practices in
feeding, clothing and rearing. Rarely infant were breast
feed, instead infant received different types of soups and
sugar solutions or water.
28. Child care in the Modern world
The industrial revolution brought a remarkable
change in the way of people’s living and a lot of
development happened in the field of science
People made great progress with regard to
disease and treatment. Knowledge about human
body and the causes of disase helped to invent
new medical intervention in treating children
29. Child Care in The Modern
• Likewise, great attention was given to reduce
unhealthy child care practices such as encouraging
breast feeding instead of sugar water or soups.
30. Child Care in The Modern World
The first pediatric hospital was the Children’s
Hospital of Pennsylvania (United State),
founded in 1855. Abraham pediatric
department in several New York hospital and
was one of the founder of the American
pediatric society in 1888.
Jacobi is best recognized for his
achievements in infant nutrition. He studied
breast feeding and safe breast milk substitutes.
31. Child Care in The Modern
• After the safety of pasteurization (Louis
Pasteur) was proven , he fought to dispel the
old belief that raw milk was beneficial. He
advised parents to boil milk until bubbles
appeared and advocated diluting milk. He
supported that the boiled milk was thought to
have saved more lives than any measure
32. Child Care Practice in Nepal
• In almost all ethnic groups of Nepal, the birth
of a child is a welcome event. In every ethnic
group, a male child is valued as future bread
winner and considered necessary for the
continuation of the family lineage.
• People still believe in traditional healers but
also prefer modern treatment.
33. Child Care Practice in Nepal
• The superstitious belief still exists throughout
the country , especially in rural area and illness
is considered to be caused by the evil eyes.
• So, they usually worship god expecting for the
cure when a child falls sick.
• Because of various factors like ignorance,
poverty, lack of transportation and time people
do not go to health centre untill it is too late.
34. Child Care Practice in Nepal
• Provision of effective health service and easy
access to these facilities are essential to
improve child health care and creation of
35. Child Care Practice (Contd…)
• Nepal Pediatric Society(NEPAS) was
established in 1981 A.D. by a group of
pediatricians working in Nepal, which is the
professional social welfare organization of the
pediatricians of Nepal commited to strive for
the overall development of the children of
• At present, child health practitioners engage in
research related to children.
36. Child Care Practice(Contd…)
• The official journal of Nepal Pediatric Society
i.e. namely journal of Nepal Pediatric Society
was established by INASP in 2007 A.D.
• It is a pediatric journal which publishes articles
related to all aspects of health care in neonates,
children and adolescents.
37. Child Care Practice (Contd…)
• Pediatric Nurses Association (PNAN) was
established in 2018 which is a professional
organization of pediatric nurses with mission
of promoting child health and wellbeing
through the advancement of pediatric nursing
education, research and practice.
38. Development of Pediatric Nursing
Care in Nepal
• There were no separate pediatric hospitals
for the care and treatment of children before
1963 AD in Nepal.
• Children were treated in a small unit of Bir
hospital but there were no specialized
pediatrician and pediatric nurses.
• After the establishment of Kanti children
hospital in Maharajgunj, nurses worked in that
39. Kanti Children Hospital
• Kanti children hospital is one of the
government hospital of Nepal under MoHP.
• In the year 1963 AD, 50 bedded hospital was
established with the support of USSR
Government as a general hospital.
• In 1970 AD, this hospital was upgraded to 100
bedded and was converted to the kanti
children’s Hospital as a referral center. In 2015
AD, it has 320 beds.
40. Kanti Children Hospital (Contd…)
• The hospital provides medical, surgical
emergency care, pediatric and neonatal care,
intensive care as well as sub-specialities like
cadiology, nephrology, endocrinology,
respiratory and asthma, neurology as well as
HIV, malnutrition and oncology OPD, child
psychiatric service and under five clinics.
41. Kanti Children Hospital (Contd…)
• This is the only tertiary care pediatric hospital
and a clinical learning site for pediatric
medicine, pediatric surgery as well as pediatric
nursing in Nepal.
• Gradually, other private pediatric hospital also
started in child health services.
42. Development of Pediatric Nursing
Education in Nepal
• In Nepal, Nursing education has started in
2013 B.S.(1956A.D.) as Proficiency
• Since then child health nursing was
incorporated in curriculum as compulsory
43. Development of Pediatric Nursing
Education in Nepal
• In Nepal, Nursing education has started in 2013
B.S.(1956A.D.) as Proficiency Certificate
Level(PCL)Nursing. Since then child health
nursing was incorporated in curriculum as
• In 1985 A.D.(2004), TU , Institute of Medicine
initiated Post Basic Bachelor in Nursing (PBBN)
with speciality in Child Health Nursing. It was
continued for next 3 batches then Child Health
Nursing included in Nursing Concept.
44. Development of Pediatric Nursing
• Different Universities like BPKIHS
(1996),KU(2004),TU(2005) are running
• 4 years B.Sc. Nursing program which has
included Child Health Nursing as a
compulsory subject in their curriculum.
45. Development of Pediatric
• By the year 2001 AD, TU IOM and by the year
2015 AD, NAMS, Bir Hospital Nursing Campus
started 2 years Master in Child Health Nursing.
• By the year 2011 AD, BPKIHS started 3 years
M.Sc. Nursing in Pediatric Nursing.
46. Development of Pediatric(Contd…)
• By the year 2013 AD, TU IOM, started
speciality in Child Health Nursing in PBBN
• By the year 2021 AD, NAMS, Kanti Children’s
Hospital started 3 years Bachelor in Pediatric
Critical Care Nursing.
47. Present Status of Child Health in
• Population of Nepal has approximately
29,033,914 ( july 2016). Among tham 30.93%
are under 14 years of age .remarkable
reductions have been seen in child mortality
rates in Nepal over the last decades.
• The burden of child mortality is still high in
48. Present Status(Contd…)
• After much prioritization and investment in
child health programs such as nutrition,
immunization , management of childhood
illness, and maternal and newborn survival
programs, still the progress is far from
49. Present Status (Contd…)
• Biannual distribution of vitamin ‘’A’’ and A
Albendazole , Iodine fortification of salt, Iron
fortification in the wheat flour, routine
• Supplementary immunization activities and
many other activities have helped in achieving
improved chils health in Nepal.
50. TRENDS IN CHILD HEALTH
Historically, the concept of pediatrics was
limited to the curative aspects of diseases
peculiar to the children.
Hippocrates (460-370BC) made many
significant observations on disease found in
children and devoted a great part of his
treatize to children. 50
Galen of rome (1200-1300AD)wrote on the
care of Rome (1200-1300 AD) wrote on the
care of infants and children. Rhazes of Arab
(850-923AD) devoted much of his treatize to
the subject of childhood illness.
The first book printed on pediatrics was in
Italian(1472) by Bagallarder’s “Little Book on
disease in Children .‘’ the first English book
on children’s disease was ‘’Book of
Children’’. Written by Thomas Phaer
52. Trends (Contd…)
The world’s first padiatrician’s were two
indians, Kashyapa and Jeevaka , of sixth
Their pioneering works on child care and
childhood disease are as relevant today as
many of the modern concepts of child health.
Sushruta, also wrote many aspects of child
rearing and charka wrote about care and
management of newborn.
Child health care has changed dramatically in
recent years due to advances in medical
knowledge and under-standing of emotional
response of children.
Advancement of different aspect of human
development influences the changing
concept of health.
54. Trends (Contd…)
• Modern concept of child health emphasizes
on continuous care of ‘whole child’ .
According to United Nations International
Children’s Emergency Fund (UNICEF),assistance
for meeting the needs of children should no
longer be restricted to only one aspect like
nutrition, but it should be broad- based and
geared to their long- term personal
development ensuring holistic health care of
55. Trends (Contd…)
In developed countries child health care extended up
to adolescent , where as in developing countries and
in India , child care is extended up to 10 to 12 years
Recently special emphasis is given on adolescent
health through reproductive and child health (RCH)
package service in our country.
Special attention is given on the children at –risk like,
orphans, destitute, disastrous, pavement dwellers,
slum, child labours and handicapped children.
56. Trends (Contd…)
• Movement against gender bias, female
fetocide, child abuse and neglect and
maltreatment are in highlight at present.
• Interest of the political leaders and
undrestanding the importance of child health,
constitution of national health policy for
children and implementation of various health
programs for improvement of child health are
great achievements for children.
57. Trends (Contd…)
• Population control and family welfare
approach, improvements of educaational status
specially women education and women
empowerment, involevement of government
and non government organizations
• political commitment and special budgetary
allocation for child healthnactivities,
international guodance by World Health
Organizations for improvement of child health
58. Trends (Contd…)
• Growth of sub specialities for the
superspecialized care of children is recent
• The subareas are neonatology, perinatology,
pediatric surgery , pediatric cardiology,
pediatric neurology, pediatric hematology,
pediatric nephrology, preventive pediatrics,
child psychology, child psychiatry, pediatric
intensive care unit, neonatal intensive care
unit, etc. 58
59. Trends (Contd….)
Medical science is advancing in every
So, child health will also progress by varios
movements towards the aims to improve the
survival and well being of all children,.
As per WHO theme of the year 2005 , ‘
healthy mothers and haelthy children’
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Wilson. Maternal Child Nursing Care. 3rd
edition. Mosby Elsevier Publications
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edition. CBS Publishers & Distributors; 2009.
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Pediatrics. 5th edition. Elsevier publication;
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