SEMESTER- V CHILD HEALTH NURSING-I Modern child care emphasizes a holistic approach, nurturing a child's physical, emotional, social, and cognitive development. Shifting from a disease-centered model, modern child care prioritizes preventive care and fostering healthy growth in children. The modern concept of child care recognizes the family as a crucial partner, advocating for family-centered care that addresses individual needs. Incorporating play, proper nutrition, and a safe environment, modern child care fosters optimal child development in all domains. Modern child care empowers nurses to act as advocates, educators, and caregivers, ensuring the well-being of children at every stage.

1. CHILD HEALTH NURSING - I
Introduction:
Modern Concepts of Child-Care
Mr. Sachin Sharma
Assistant Professor
Child Health Nursing Department
SEMESTER-V UNIT-1

2. OBJECTIVES
• Historical development of child health
• Philosophy and modern concept of child-
care
• Cultural and religious considerations in
child-care
• Internationally accepted rights of the child

3. Abraham Jacobi
(6 May 1830 – 10 July 1919)
Father of Pediatric

4. The term pediatric is derived from the
Greek words-
3
Pedia iatrike ics
child treatment branch of
science
Pediatric means the science of child care and scientific treatment
of childhood disease.

5. DEFINITION
“Pediatric can be defined as the branch of medical
science that deals with the care of childhood from
conception to adolescent in health and illness. It
concern with prevention, promotion, curative and
rehabilitative care of children.”
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6. TERMINOLOGIES
Neonate: Aneonate is a child under 28 days of age.
Infant: Infancy is the period from birth through the completion
of the 12th month of life.
Toddler: Toddlers are children between the age of 13 months to
3 years of age.
Preschoolers/early childhood: Children between the age of 3–5-
year-old are called preschoolers.
School-going children/middle childhood: Children between the
age group of 6 and 11 years are called as school- going children.
Adolescence: It is the phase of life between childhood and
adulthood. Early adolescence is the age group between 12 and
18 years.
Late adolescence is the age group between 19 and 21 years.

7. HISTORICALDEVELOPMENT OF CHILD HEALTH
In terms of the Convention on the Rights of the Child (CRC), a child means “every
human being below the age of eighteen years unless under the law applicable to the child,
majority is attained earlier.
The historical development of pediatrics and pediatrics nursing is as follows:
• 600 to 501 BC: Kashyap was the father of Devas and Asuras as per Indian mythology.
In his book onAyurveda named as Kashyap Samhita, he has written chapters on
galactagogues, embryology, management of children with diarrhea, colic, vomiting,
dyspnea, hiccups, marasmus.

8. • 460 to 370 BC: Hippocrates the ‘father of modern medicine’ made
a significant contribution to diseases found in children. He wrote
about epilepsy, diphtheria, and cerebral palsy.
• 50 AD: The author of de Medicina, Roman physician Celsus, first
suggested that children should be treated as tiny adults.
• 1465 AD: Turkish manuscript with pediatric surgery
procedures was published.
• 1472 AD: The first book was printed on diseases of children in
Italy. The book was named ‘Bagallarders’.
• 1545 AD: The first English book on children’s disease
written by Thomas Phare was published.
• 1646 AD: Hildanus, trocar was discovered for surgery of
hydrocephalus.

9. • 1860: The first textbook on children’s surgery was
published by J Cooper Forster.
• 1880: The first fully enclosed incubator was invented by
Parisian obstetrician Etienne Stephane Tarnier. ‘Pediatric
medicine’ was promoted as a speciality in the USA.
• 1882: Pasteurization of milk was discovered which
significantly decreased the diarrhea-associated mortality
among children.
• 1906: Articles on the needs of children were published
in the nursing journal by Farrar.
• 1908: Pioneering pediatric nurse Anna Haswell stressed
the special personality type required for nursing
children.

10. • 1944: The Diploma in Child Health (DCH) was started at the Bai
Jerbai Wadia Hospital for children.
• 1946: United Nations International Children’s Emergency Fund
(UNICEF) started working in India for the health, safety and
wellbeing of the children.
• 1950s: Pediatric nursing was included in the undergraduate
nursing programs of India.
• 1951: John Bowlby published his paper on the effect of maternal
deprivation on hospitalized children which gained worldwide
attention.
• 1963: The Indian Academy of Pediatrics was formed in
Hyderabad.
• 1970s: Genetic counseling, evolved as a new profession with
education at the master’s level.

11. • 1977: Certification of Pediatric nurse practitioners started
specially focusing on pediatric oncology.
• 1983: Guidelines on the minimal requirements for pediatric ICUs
were introduced by the Committee on Hospital Care and the
Pediatric Section of the Society of Critical Care Medicine
(SCCM).
• 1987: The first comprehensive pediatric critical care
textbook written by Dr. Mark Rogers was published.
• 1989: United Nations General Assembly adopted the
‘Convention on the Rights of the Child’.
• Middle of 1990s: Masters degree in pediatric nursing started in
India.
• 1995: The first textbook on pediatric cardiac critical care
written by Dr David Nichols was published.

12. PHILOSOPHY OF CHILD-CARE
Philosophy is a set of beliefs that try to explain the
meaning of a discipline and also governs rules about the
pattern of behavior that should be reflected as a part of the
discipline.
Child care is based on two
aspects:
Philosophy of individualism.
Philosophy of holism.
main philosophical

13. Philosophy of Individualism
• This philosophy was developed by Thomas Hobbes
(1588– 1679). It is based on the understanding that each
individual is unique, every person must have
independence, i.e., they must have the right to make
decision for their own self.
Philosophy of Holism
• The philosophy of holism is based on the understanding that
people are not a single entity they are the sum of
other parts. It means when planning care for an
individual one must consider the family, culture,
religion and spiritual aspects also as all these influence the
individuals’perspectives toward health and illness.

14. Family-Centered Care
• The concept of family-centered care started its
momentum in 1940. Carl Rodgers initiated his patient-
centered care in the field of psychology and introduced
it as a continuous process for dealing with
problematic children. In 1959, Rodgers presented a
diagram for the therapeutic relationship of family and
society.

15. Family-centered care model

16. Atraumatic Care:- therapeutic care to minimize or eliminate
psychological and physical distress for children and families.
The main focus of atraumatic care is not to harm. The principles
are:
• Identifying the factors causing stress in the child and family
(physical problems, psychological problems, environmental
factors).
• Minimizing the time that the child remains separate from family.
• Improving the feeling of control among the child and the family.
This is done by providing culture-congruent care and allowing
them to make decisions on their treatment.

17. MODERN CONCEPT OF CHILD-CARE
The incorporation of modern scientific evidence have made
certain changes in societal norms and has also given rise to
certain policies in relation to human rights. Pediatrics has also
developed as a separate speciality as a result of such
development.
The factors responsible for growth of modern pediatrics are as
follows:
• Progress in medical science and advancement of technology.
• Enormous research activities in the social sciences have
identified various factors affecting children. This has led to
development of social laws and programmes for protection of
children.

18. Dynamic shift of pediatrics concepts

19. CULTURALAND RELIGIOUS
CONSIDERATIONS IN CHILD-CARE
Culture
‘Culture’ is the affiliation or self-declared identification
within an ethnic group of the society.
It is defined as a socially transmitted system of shared
knowledge, ideas, values, norms, patterns and/or practices
that vary across groups, and individuals within these groups
have a critical mode of adaptation into society.

20. Religion
‘Religion’ is guided by traditional, values, beliefs, rules
and culture. It is defined as a personal set or
institutionalized system of attitudes, beliefs and
practices directed toward the service or worship of God
or the supernatural.
In every human community, the rules of socialization
are learned by the child by following the cultural and
religious practices. The practice of praying regularly
helps in developing concentration, and having faith in
supreme power helps in the spiritual development of the
child.

21. Common Malpractices
Affecting Child Health
The antibody rich colostrum is avoided by most mothers
considering the thick yellow discharge is ‘bad’ for their child.
The practice of giving ‘honey’, and ‘janam ghutti’ to the
newborn baby is common in India. Such practices lead to diarrhea
and lactation failure in newborns.
Poring oil into the ear of the newborn is practiced to ensure
clear hearing but it actually damages the growing ear drums.
In many communities, male babies undergo circumcision in their
neonatal period. If this procedure is done in unhygienic settings
other than in hospital, it lead to sepsis and other untoward effects.

22. It is believed that the application of ‘Kajal’ (Kohl) promote good
eyesight in children. Though lead rich ‘kajal’ results in high risk
of lead poisoning.
In some areas of the world cow dung is applied on the umbilical
cord to facilitate drying it and dried cow dung is used as talcum
powder (in some villages of Hindu Kush of Pakistan) on babies.
Shaving neonates’ hair is a common practice in various
religions. It has been reported by various research studies that
such practices lead to community-acquired infection, sepsis,
necrotizing fasciitis of the scalp and even death of the baby.

23. GOALS OF PEDIATRIC NURSING
• To provide intelligent, skillful, need-based
comprehensive and prompt care to the children.
• To identify the basic needs of the children and reflect
them to their parents and community members in an
attempt to provide culture-congruent care to them.
• To promote well-being of the children and their family
toward optimal functioning.
• To prevent disease and alleviate the suffering of the
child and the family.
• To integrate the developmental needs of the children into
the scientific principles of holistic nursing care.

24. QUALITIES OFACHILD HEALTH NURSE
• Aloving person who likes to get along with children.
• Calm, composed, and have a positive presence to reciprocate
positivity.
• Honest, friendly, gentle and have a good sense of humor to be
playful with children.
• Intelligent, knowledgeable, good observer with critical
thinking and judgment skills to identify nonverbal cues.
• Dedicated, trustworthy, truthful, creative in nature.
• Skillful, confident, emotionally stable with
communication skills.
• Sensitive, attentive and respectful toward others.
good

25. ROLE OFAPEDIATRIC NURSE
1.Primary Care Giver
2.Coordinator and Collaborator
3.Health Educator
4.Counselor
5.Nurse Advocate
6.Nurse Consultant
7.Case Manager
8.Recreationist

26. MODERN CONCEPT IN CHILD
HEALTH CARE
1. In recent years, due to advancement of
technology child health care has changed
dramatically.
2. Today, Pediatrician's study and practice, sub-
specialty of pediatrics focusing on specific types
of ailments and health conditions in children.
3. Modern concept have significantly changed
the health care system and role of the
nurses to care for the child's health.
4. As the advancement occurs in medical science
and other related fields, the child health concept
was also changed to promote health of mothers
and children, so that nation will get healthy
mothers and healthy children.
by Mr. Sachin Sharma (M.Sc. N.)
26

27. Traditional
Concept
Pediatric
1. Care was only disease focused.
2. Family was not involved in child
care.
3. Insufficient attention given to
family and society.
4. There were limited programmes
for child health care.
5. Care was only given to
hospitalized child.
6. Female child was neglected in
providing special care.
7. Before pregnancy, care of woman
was not the topic of concern.
8. Provide routine care.
9. Care was limited to hygiene and
treatment only.

28. Modern
Concept
Pediatric
1. Care is focused both on illness and wellness
of child.
2. Consider the family as a one unit and care the
child within the family.
3. Contemporary pediatrics has new approach
to child in family and family in society.
4. There are many programmes running in India
to promote the health of children.
5. Child health care starts from conception till
adolescent period.
6. Female child is taking special care as she is
the future mother.
7. Guidance and counseling is given to eligible
couple before conception and maternal health
is considered as priority.
8. Quality care in terms of play recreation,
nutrition, etc.
9. Care is need based, problem oriented, risk
approach and warmth.

29. TRENDS IN PEDIATRIC
NURSING
CHILD HEALTH NURSING
by Mr. Sachin Sharma (M.Sc. N.) 29

30. TRENDS IN PEDIATRIC NURSING
1. Scientific treatment from infancy to adolescence.
2. Administration of vaccines for preventable disease.
3. Monthly assessment of growth and development.
4. Focus on prevention.
5. Advancement of science and technology in medical field.
6. Practice by registered nurses and pediatricians.
7. Problem-solving approach.
8. Evidence-based practices.
9. Family centered care.
10.Regular laboratory examination in schools, families and
communities.
11.Knowledgeable health workers.
12.Focus on promotion of child health.
13.Providing ordered medical therapies in home and hospital.
14.Motivate people and families to participate in childcare.
15.Educate and aware public about communicable diseases.
by Mr. Sachin Sharma (M.Sc. N.)

31. INTERNATIONALLY ACCEPTED
RIGHTS OF THE CHILD

32. The United Nations adopted the
“Declaration of the Rights of the child”,
on 20th November 1959.

33. Aims
• To meet the special needs of the child.

34. The 10 basic rights of the child are……..

35. 1. Right to develop in an atmosphere of
affection and security and protection
against all forms of neglect, and traffic.

36. 2. Right to enjoy the benefits of social
security, including nutrition, housing
and medical care.

37. 3. Right to a name and nationality.

38. 4. Right to free education.

39. 5.Right to full opportunity for
play and recreation.

40. 6. Right to special treatment, education
and appropriate care If handicapped.

41. 7. Right to be among the first to receive
protection and relief in times of
disaster.

42. 8.Right to learn to be a useful member
of society and to develop in a healthy
and normal manner and in conditions
of freedom and dignity.

43. 9.Right to be brought up in a spirit of
understanding, tolerance, friendship
among people, peace and universal
brotherhood.

44. 10. Right to enjoy these rights,
regardless of race, color, sex, religion,
nation or social origin.

45. LEGAL RIGHTS OF THE CHILDREN
AND THEIR PARENTS

46. 1. When the children are too
young to care for themselves
parents or their substitutes
are required to provide food,
clothing, shelter, education
and medical care for them.

47. 2. If the children are “at risk”
such as neglected or abused,
other persons such as
neighbores, relations and
nurses as professional
persons are legally mandated
to report these problems and
to intervene for help.

48. 3.Children who are physically or mentally handicapped,
State Government have established some additional
rights for them such as,
 Right to live in a normal setting as possible.
 Right to equal opportunity for public education.
 Right to quality medical care.
 Right to equal employment opportunity.

49. 4.Children have the right to express their
desires, when decisions are made about them.

50. 5.When custody of children is followed,
the court often appoints separate legal
council for children

51. 6. Parents do not have the legal right to
withhold the medical care from a child.
Eg: Consent for a blood transfusion, if
parents neglect, court may assume this
responsibility.

52. 7.Children have the
right to know who
is responsible for
their care,
including all
members of their
health and nursing
teams.

53. 8.Adolescent has the right to obtain
information about and confidential
management of birth control measures,
pregnancy, abortion, STD, alcohol, drug
abuse and psychiatric problems.

54. SPECIAL LAWS RELATING TO
CHILDREN
1.THE CHILD LABOUR ACT
1986
Child labor is applied due to
poverty,unemployement and lack of
education. According to their law
the children are not permitted to
work in occupation concerned.

55. 2.THE CHILDREN ACT 1960
In India it develops for the care,
maintenance, welfare, education and
rehabilitation of the delequent child.
It covers the neglected and socially
handicapped.

56. 3.JUVENILE JUSTICE ACT 1986
This rectifies the inadequacy of
children act, provides a comprehensive
scheme of care,protection,treatment
development and rehabilitation for
deliquent juveniles.

57. Some of the special features of the act are:
It provides a uniform legal network for
juvenile justice in the country, so as to
ensure that no child under any
circumstances is put in jail or police
lock up.

58. Conti…
It approaches towards prevention and
treatment of juvenile delinquencies in
keeping with the developmental need of
children.
It establishes norms and standard for
administration of juvenile justice in
terms of investigation, care, treatment
and rehabilitation.

59. It lays down appropriate linkage and
co-ordination between formal
system of juvenile justice and
voluntary organization.

60. 4.CHILD ABUSE PREVENTION AND
TREATMENT ACT 1974
It provides a rational centered approach on
child abuse and child neglected, makes
funds available for research,
identification of causes, prevention and
treatment for the establishment of
regional child abuse centers.

61. 5.HEALTH MAINTENANCE
ORGANIZATION ACT 1973
It assists and encourages the local and state
government non profit organization,
insurance companies and agency to change
the health delivery system

62. so that improved care could be
provided. This service
includes, other illness and
wellness related care.

63. 6.EDUCATION FOR ALL HANDICAPPED
CHILDREN ACT 1975
A state mandated divisional special
education within the department of
education, provides service based on
children need and special programmes,
services through their division.

64. THANK YOU