Pediatrics deals with the health of children from birth until age 18. The goals of pediatrics include reducing infant and child mortality, controlling infectious diseases, and promoting healthy lifestyles. Pediatricians diagnose and treat conditions like infections, genetic disorders, cancers, and organ diseases in children. Pediatrics differs from adult medicine in that children's bodies are still developing physiologically. National indicators like infant mortality rate are used to monitor child health. The leading causes of neonatal death in Nepal are respiratory/cardiovascular issues during birth and delivery complications. Government programs like CB-IMNCI aim to reduce under-five mortality through managing childhood illnesses at the community level.

1. PEDIATRICS
DR.DEEP NARAYAN JHA
MBBS,MS (ORTHO)
INTRODUCTION

2. INTRODUCTION

3. DEFINITION
• Pediatrics is the branch of medicine dealing
with the health and medical care of infants,
children, and adolescents from birth up to the
age of 18.

4. DEFINITION
• The word “paediatrics” means “healer of
children”; they are derived from two Greek
words: (pais = child) and (iatros = doctor or
healer).
• Paediatrics is a relatively new medical
specialty, developing only in the mid-19th
century.
• Abraham Jacobi (1830–1919) is known as the
father of paediatrics.

5. AIMS OF PEDIATRICS
• The aims of the study of paediatrics is to
reduce infant and child rate of deaths
• control the spread of infectious disease,
promote healthy lifestyles for a long disease-
free life and help ease the problems of
children and adolescents with chronic
conditions.

6. CONTD…
• Paediatricians diagnose and treat several
conditions among children including:-
• injuries
• infections
• genetic and congenital conditions
• cancers
• organ diseases and dysfunctions

7. CONTD….
• Paediatrics is concerned not only about
immediate management of the ill child but
also long term effects on quality of life,
disability and survival

8. CONTD..
Paediatricians are involved with the prevention,
early detection, and management of problems
including
• developmental delays and disorders
• behavioral problems
• functional disabilities
• social stresses
• mental disorders including depression and
anxiety disorders

9. DIFFRENCE BETWEEN PEDIATRICS
AND ADULT MEDICINE

10. CONTD..
• Paediatrics is different from adult medicine in more ways
than one. The smaller body of an infant or neonate or a
child is substantially different physiologically from that of
an adult. So treating children is not like treating a miniature
adult.
• Congenital defects, genetic variance, and developmental
issues are of greater concern to pediatricians than
physicians treating adults.
• In addition, there are several legal issues in paediatrics.
Children are minors and, in most jurisdictions, cannot make
decisions for themselves. The issues of guardianship,
privacy, legal responsibility and informed consent should be
considered in every pediatric procedure.

11. PERIODS OF GROWTH

12. INDICATORS
• Child mortality :
• the mortality of children under the age of
five. The child mortality rate, also under-five
mortality rate, refers to the probability of
dying between birth and exactly five years of
age expressed per 1,000 live births

13. INDICATORS
• Neonatal mortality refers to death of a live-
born baby within the first 28 days of life. Early
neonatal mortality refers to the death of a
live-born baby within the first seven days of
life, while late neonatal mortality refers to
death after 7 days until before 28 days.

14. CONTD..
• Infant mortality is the death of young children
under the age of 1.

15. INDICATORS FORMULA
• Neonatal mortality rate(NMR) = (Neonatal
deaths*/ Live births)*1000
Postneonatal mortality
rate(PNMR) =(Postneonatal deaths/Live
births)*1000
• Infant mortality rate(IMR) = Deaths of
infants/Live births*1000
Under-5 mortality rate (U5MR) =(Deaths of
children < 5 years/Live births)*1000

16. NATIONAL DEMOGRAPHIC HEALTH
SURVEY 2022
• EARLY CHILDHOOD MORTALITY
• Neonatal mortality: The probability of dying within the first
month of life.
• Postneonatal mortality: The probability of dying between
the first month of life and the first birthday (computed as
the difference between infant and neonatal mortality).
• Infant mortality: The probability of dying between birth and
the first birthday.
• Child mortality: The probability of dying between the first
and fifth birthday.
• Under-5 mortality: The probability of dying between birth
and the fifth

17. CONTD..
• The government of Nepal’s target for SDG , is
to reduce the under-five mortality rate to 27
deaths per 1,000 live births by 2022 and to 20
deaths per 1,000 live births by 2030. Similarly,
the government’s target for SDG , is to reduce
the neonatal mortality rate to 16 deaths per
1,000 live births by 2022 and to 12 deaths per
1,000 live births by 2030 (National Planning
Commission, 2020).

19. Thank You
• ASSIGNMENTS:
• 1.Calculate infant mortality rate of mechi zonal
hospital for example number of live birth in 2078-
79 is 900 and death of infant is 70.
• 2. pediatrics aim and its role
• 3.differnce between adult and pediatric patient
• List out 17 points of sustainable Development
goal of the world.

20. CAUSES OF NEONATAL DEATHS
• According to NDHS 2016:
• Most common underlying causes of neonatal
death are respiratory and cardiovascular
disorders of the perinatal period 31% and
complications of pregnancy ,labor, and delivery
31%
• Neonatal sepsis : 16%
• Congenital malformations and deformations :7%
• Hypothermia : 4%

21. Factors Responsible for Child
Morbidity in Nepal
• ARI (pneumonia)
• Diarrhoea
• F.MALARIA
• Non Falcipurum Malaria
• Febrile disease
• Measles
• Ear infection
• Malnutrition
• Anemia
• LBW
• Birth injiry birth Asphyxia
• Congenital anomalies

22. OTHERS FACTORS
• Gender discrimination
• Poverty
• Inadequate interval resources
• Low socio economic
• Health , water, sanitation
• Illiteracy

23. Nepal Government Programs
• CB-IMNCI is an integration of CB-IMCI and CB-NCP
Program that is being implemented across the country
after the decision of MoH on 2071/6/28 (October 14,
2015). This integrated package of child‐survival
intervention addresses the major problem of sick
newborn such as birth asphyxia, bacterial infection,
jaundice, hypothermia, low birth weight, counseling of
breastfeeding. Among the age group of 2 months to 59
months children, it addresses major childhood illnesses
like Pneumonia, Diarrhea, Malaria, Measles and
Malnutrition in a holistic way.

24. (CB-IMNCI) stands for
• Community-Based Integrated Management of
Neonatal and Childhood Illnesses

25. Contd..
• In CB‐IMNCI program, FCHVs are expected to carry out health
promotional activities for maternal, newborn and child health and
dispensing of essential commodities which do not require
assessment and diagnostic skills like distribution of iron, zinc, ORS,
chlorhexidine and immediate referral in case of any danger signs
appear among sick newborn and child. And health workers will
counsel, and provided the health service like management of
non‐breathing cases, skin to skin contact and management of
neonatal sepsis and common childhood illness. Also program has
provisioned the post‐natal visits by trained health workers through
primary health care outreach clinic. For treatment of possible
severe bacterial infection (PSBI), treatment recommended is
injection Gentamicin and inj. Ampicillin or oral Amoxicillin.

26. Contd…
• Goal: Improve new born and child survival and
healthy growth and development.

27. • Targets of Nepal Health Sector Strategy (2015-
2020)
• Reduction of Under-five mortality rate (per 1,000
live births) to 28 by 2020
• Reduction of Neonatal mortality rate (per 1,000
live births) to 17.5 by 2020
• Benefits:-
Children can benefit from the diagnosis and
treatment of major childhood killer diseases
(Pneumonia, Diarrhoea, Malnutrition, Measles
and Malaria). Key interventions include:

28. CONTD…
• Newborn Specific Interventions
• Promotion of birth preparedness plan
• Promotion of essential newborn care practices and postnatal care
to mothers and newborns
• Identification and management of nonbreathing babies at birth
• Identification and management of preterm and low birth weight
babies
• Management of sepsis among young infants (0-59 days) including
diarrhea
• Child Specific Interventions
• Case management of children aged between 2‐59 months for 5
major childhood killer diseases (Pneumonia, Diarrhoea,
Malnutrition, Measles and Malaria)
•