This document provides an overview of modern concepts in childcare for a pediatric nursing course. It discusses internationally accepted children's rights, national policies and agencies related to child welfare in India, key national health programs, and changing trends in child health indicators. It also outlines child morbidity and mortality distribution, important dates related to child health, current trends in pediatric nursing, and ethics considerations in pediatric nursing care. The goal is for students to understand factors influencing child health and their role in promoting children's wellbeing.

1. Child Health/Pediatric Nursing
UNIT 1
MODERN CONCEPTS IN CHILDCARE
Prof. (Dr.) Smriti Arora
Amity College of Nursing, Amity University Haryana
smritiamit@msn.com

2. UNIT 1
MODERN CONCEPTS IN CHILDCARE
Objective: At the end of this unit, the students will be able to:
1. Describe internationally accepted rights of child
2. Discuss national policies, legislation and agencies related to child welfare
3. Explain National Health Programs related to child health
4. Enumerate changing trends in child health
5. Outline child morbidity and mortality
6. Describe the ethics in Pediatric Nursing

3. 1. Internationally accepted rights of child
The UN Convention on the Rights of the Child is a human rights treaty which sets out the civil,
political, economic, social, health and cultural rights of children. India is a party to the
UN declaration on the Rights of the Child, 1959. These 10 rights are:
1 The child shall enjoy all the rights set forth in this Declaration. Every child, shall be entitled to
these rights, without distinction or discrimination on account of race, colour, sex, language,
religion, political or other opinion.
2 The child shall enjoy special protection, and shall be given opportunities and facilities, by law
and by other means, to enable him to develop physically, mentally, morally, spiritually and socially
in a healthy and normal manner and in conditions of freedom and dignity.
3 The child shall be entitled from his birth to a name and a nationality.
4 The child shall enjoy the benefits of social security. He shall be entitled to grow and develop
in health; special care and protection shall be provided both to him and to his mother, including
adequate pre-natal and post-natal care. The child shall have the right to adequate nutrition,
housing, recreation and medical services.
5 The child who is physically, mentally or socially handicapped shall be given the special
treatment, education and care required by his particular condition.

4. 1. Internationally accepted rights of child
6 The child, for the full and harmonious development of his personality, needs love and understanding. He
shall, wherever possible, grow up in the care and under the responsibility of his parents, and, in any case, a
child of tender years shall not, except in exceptional circumstances, be separated from his mother.
7 The child is entitled to receive education, which shall be free and compulsory, at least in the elementary
stages.
8 The child shall in all circumstances be among the first to receive protection and relief.
9 The child shall be protected against all forms of neglect, cruelty and exploitation. He shall not be the
subject of traffic, in any form. The child shall not be admitted to employment before an appropriate
minimum age of 18 years.
10 The child shall be protected from practices which may foster racial, religious and any other form of
discrimination. He shall be brought up in a spirit of understanding, tolerance, friendship among peoples,
peace and universal brotherhood.

5. Rights of Child according to The Constitution of India
1. Right to free and compulsory elementary education for all children in the
6-14 years age group (Article 21 A).
2. Right to be protected from any hazardous employment till the age of 14
years (Article 24).
3. Right to be protected from being abused and forced by economic
necessity to enter occupations unsuited to their age or strength (Article
39(e)).
4. Right to equal opportunities and facilities to develop in a healthy manner
and in conditions of freedom and dignity and guaranteed protection of
childhood and youth against exploitation and against moral and material
abandonment (Article 39 (f)).

6. 2. National policies, legislation and agencies
related to child welfare
National Policies
• National Policy for Children, 1974
• National Nutrition Policy, 1993
• National Population Policy, 2000
• National Charter for Children, 2003
• National Plan of Action for Children, 2005
• National Guidelines on Infants and Young Child Feeding, 2006

7. Schemes of Ministry of Women and Child Development related to child welfare
• Under ICDS umbrella, 1975
• Rajiv Gandhi National Crèche Scheme for the Children of Working Mothers,
2006
• Scheme for Adolescent Girls (Kishori Shakti Yojna), 1991, 2010
• ‘Pradhan Mantri Matru Vandana Yojana’ (PMMVY),2017- a cash incentive of `
5000/- is provided directly to the Bank / Post Office Account of Pregnant
Women and Lactating Mothers for first living child of the family.
• National Nutrition Mission – Poshan abhiyaan , 2018- strives to reduce the
level of stunting, under-nutrition, anemia and low birth weight babies.
• Integrated Child Protection Scheme (ICPS) - a centrally sponsored scheme
aimed at building a protective environment for children in difficult
circumstances, as well as other vulnerable children, through Government-
Civil Society Partnership

8. Schemes of Ministry of Women and Child
Development related to child welfare
• Balika Samriddhi Yojana (BSY), 1997
• Swadhar Scheme, 2001
• Ujjawala Scheme , 2007- a comprehensive Scheme for Prevention of
Trafficking and; Rescue, Rehabilitation and Re-integration of Women
and Child Victims of Trafficking and Commercial Sexual Exploitation

9. Laws relating to Children
2015 Juvenile Justice (Care and Protection of Children Act) Act, 2015
2012 Protection of Children from Sexual Offences (POCSO) Act
2006, 1929 Prohibition of Child Marriage Act, 2006, Child Marriage Restraint Act, 1929
1994 The Pre-conception and Pre-natal Diagnostic Techniques (PCPNDT, Prohibition of Sex
Selection) Act
1992 Infant Milk Substitutes, Feeding Bottles and Infant Foods (Regulation of Production,
Supply and Distribution) Act
1986 Child Labour (Prohibition and Regulation) Act, Immoral Traffic Prevention Act,
1960 Children Act

10. International agencies related to Welfare of Children
1 UNICEF - United Nations International Children’s Emergency Fund
2 International Labour Organisation - ILO
3 World Health Organisation- WHO
4 Food and Agriculture Organization (FAO)1945- It helps the people of the world to fight against
hunger and malnutrition
5 The United Nations Educational, Scientific and Cultural Organization (UNESCO) helps to develop
text books and promotion and teaching of national languages to the children of migrant workers,
training of staff for pre-school children and assists projects to set up production of children’s books
and libraries especially for destitute children.
6 USAID- US Agency for International Development
7 CARE- Cooperative for Assistance and Relief Everywhere

11. National Agencies R/T Child welfare
1. Indian Red Cross Society, 1920
2. Ford Foundation, 1936
3. Kasturba Gandhi Memorial Trust, 1945
4. All India Blind Relief Society, 1946
5. Indian Council for Child Welfare (ICCW), 1952
6. Central Social Welfare Board, 1953
7. Mobile Crèches, 1969
8. Child Rights and You (CRY), 1979
9. Smile Foundation, 1982
10.Childline, 1996- Child Helpline, a toll free telephone service (1098) which anyone can call for
assistance in the interest of children.
11.SOS Children’s Villages

12. National agencies R/T child welfare
Under Ministry of Women and Child Development
• National Institute of Public Cooperation and Child Development (NIPCCD)
• Central Social Welfare Board (CSWB)
• National Commission for Protection of Child Rights- a national level apex statutory body
constituted in the March 2007 for protecting and safe guarding the rights of children.
• Central Adoption Resource Authority (CARA)- the national central authority for regulating
Inter-country Adoptions and facilitating domestic adoptions. CARA became a Statutory Body
under the provisions of the Juvenile Justice (Care and Protection of Children) Act, 2015.

13. 1951 Family Planning Program- Maternal and Child Health (MCH) Programme
1961 Dept of Family Planning created
1975 Integrated Child Development Services (ICDS) Scheme
1977 Family Welfare Program, School Health Programme
1978 Diarrhoeal Disease Control Programme, Expanded Programme on Immunization
1985 Universal Immunization Programme
1990 Acute Respiratory Infection Control Programme (ARI)
1992-1996 Child Survival & Safe Motherhood Program (CSSM)
1997, 2005 Reproductive and Child Health Programme RCH-1, RCH-2
1996 Integrated Management of Neonatal and Childhood Illness (IMNCI)
3. National Health Programs related to Child Health

14. 2005 National Rural Health Mission (NRHM), Janani Suraksha Yojana (JSY)
2011 Facility Based Newborn Care
F-IMNCI
Janani Shishu Suraksha Karyakaram (JSSK)
2012 Navjat Shishu Suraksha Karyakram (NSSK)
2013 Rashtriya Bal Swasthya Karyakram (RBSK) under NRHM
NUHM, NHM
Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A)
In 2014 the Planning commission was abolished and in 2015 the NITI Aayog, (National Institution for
Transforming India) was established with the aim to achieve SDG. NITI Aayog is undertaking the extensive exercise
of measuring India and its States’ progress towards the SDGs for 2030, culminating in the development of the first
SDG India Index.
2014 India Newborn Action Plan (INAP)
Rashtriya Kishor Swasthya Karyakram (RKSK)- weekly iron and Folic Acid supplementation (WIFS)
2014, 2017 Mission Indradhanush, Intensified Mission Indradhanush
2017 Ayushman Bharat Yojana (National Health Protection Scheme)
‘Pradhan Mantri Matru Vandana Yojana’ (PMMVY)
2019 Surakshit Matritva Aashwasan (SUMAN)

16. Nutritional programs R/T children
• Mid-Day Meal Programme, 1961
• Vitamin A Prophylaxis programme, 1970
• National Nutrition Anaemia Prophylaxis Programme, 1970
• Special Nutrition Programme, 1970
• Balwadi Nutrition Programme, 1970
• Applied Nutrition Programme, 1973
• Rashtriya Kishor Swasthya Karyakram (RKSK) 2014- weekly iron and Folic
Acid supplementation (WIFS)
• National Nutrition Mission (Poshan Abhiyaan)- Intensified National Iron
Plus initiative (I- NIPI) and Anemia Mukt Bharat (6x6x6), 2017

18. Health care delivery system In India
• Tertiary- Medical colleges, District hospitals, Hospitals
• Secondary- Community Health Centre- First referral Unit (FRU)
• Primary – Sub Centre, PHC

19. Populati
on
Total
Staff
Staffing pattern Beds
Sub
Centre
1/5000,
1/3000
3-4 Type A- No delivery facility
MPHW- M-1
MPHW F-1
SK-1
Type B – Delivery
MPW- M-1
MPW-F/ANM-2
SK-1
0
PHC 1/30,000,
1/20,000
13-21 Type A- <20 deliveries conducted
Type B- >20 deliveries conductor
MBBS doctor-1
AYUSH doctor-1
HA-M-1, HA-F-1
Type B- >20
deliveries conducted
MBBS doctor-2
AYUSH doctor-1
HA-M-1, HA-F-1
4-6
CHC
(1st
FRU)
1/1,20,000 46-52 Specialists - 9
Physician -1, Surgeon -1
Obg- 1, Pedatrician – 1
Anaesthetist-1
Ophthalmologist-1
Public health specialist-1
Dental surgeon -1
Ayush -1
Health Supervisor-
M-1
HS-F-1
30

20. 4. Changing trends in child health
• NMR
• IMR
• U5MR

21. Key heath indicators related to child health
Indicator Definition
Neonatal mortality
rate
Number of deaths among all live births during the first 28
days of life expressed per 1000 live births.
Early neonatal
mortality rate
Number of neonatal deaths <7 days of life expressed per
1000 live births.
Late neonatal
mortality rate
Number of neonatal deaths between 7 and 28 days of life
expressed per 1000 live births

22. Key heath indicators related to child health
Indicator Definition
Perinatal mortality
rate
Number of deaths of fetuses weighing at least 500 g (or if birth weight
unavailable, after 22 completed weeks of gestation or crown heel length of 25 cm
or more) plus the number of early neonatal deaths per 1000 total births.
Stillbirth Death of a fetus weighing at least 500 g (or if birth weight unavailable, after 22
completed weeks of gestation or crown heel length of 25 cm or more) before the
complete expulsion from its mother.
Infant Mortality rate Probability of dying between birth and 1 year of age expressed per 1000 live
births.
Under 5 mortality rate Probability of dying between birth and 5 years of age expressed per 1000 live
births.

23. MDGs (2000-2015)
1. To eradicate extreme poverty and hunger
2. To achieve universal primary education
3. To promote gender equality and empower women
4. To reduce child mortality
5. To improve maternal health
6. To combat HIV/AIDS, malaria, and other diseases
7. To ensure environmental sustainability
8. To develop a global partnership for development
Millennium Development Goals by UN

24. Sustainable Development Goals to be achieved by 2030

25. Current state of Child health and Goals
NHP-
2017
Target
SDG
(2016-
30)
Goal 3.2
Achieved by
2017
(SRS)
NMR 16 by
2025
12/1000 23
Still birth
rate
“single
digit”
by 2025
IMR 28 by
2019
33
UFMR 23 by
2025
25/1000 37

26. 5. Distribution of causes of under-5 deaths in
2015
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30080-4/fulltext

27. Days related to Child Health
24th January National Girl Child Day
16 March
National Immunization Day , Measles
Immunization Day
1 to 7 Aug World Breast Feeding Week
1 to 7 Sep National Nutrition Week
11 Oct International Girl Child Day
10 Nov World Immunization Day
17-Nov World Prematurity Day
15 to 21 Nov New Born Care Week

28. Current trends in pediatric nursing
• Atraumatic care
• Primary nursing
• Kangaroo mother care
• Nursing process approach
• Family centered care
• Evidence based practice
• Child Oriented Environment
• Cost Containment
• High-tech High-touch approach

29. 6. Ethics in Pediatric Nursing
1) Autonomy -refers to the right to accept or refuse any medical treatment based
on the individual’s values, priorities, and preferences. Parents have the
autonomy to make health care decisions for their child and sometimes
adolescents are granted the autonomy to consent to their health care.
2) Beneficence refers to the duty of health-care providers to perform things that
are beneficial to children.
3) Nonmaleficence means avoiding causing harm, intentionally or unintentionally.

30. 6. Ethics in Pediatric Nursing
4. Justice refers to act fairly to all children and their families. The
treatment decision should not be based on factors such as age, gender,
religion, socioeconomic status or ethnic group.
5. Veracity is telling the truth about diagnosis, treatment or prognosis.
6. Fidelity is keeping promises and maintaining confidentiality and
privacy.

31. Summary
• Children have specific needs
• Govt is working to provide safe, equitable and
affordable health for all
• Nurses need to know the existing laws, welfare
services available, various rules and regulations while
managing children with various developmental needs.

32. ThankYou!!!