under five children assessment

1. PHYSICAL EXAMINATION OF UNDER-FIVE CHILDRENS
INTRODUCTION
Under five assessment in necessary for decision concerning provision of appropriate
health services to the children. Children are susceptible to get many health problems. Most of the
diseases are easily preventable. Children under year of age require special health care.
PURPOSE:-
1. To assess the health status of children
2. To know the existing health problems among children.
3. To assess the growth and development of children.
4. To provide health education to their parents.
5. To treat the diseases if any.
ARTICELS REQUIRED:-
1. Weighing machine to record weight.
2. Inch tape to measure the height.
3. Snellen’s chart.
4. Shakir tape to measure MAUC, bangle 4cm radius.
5. Nutrition cups.
6. Infant meter to measure the length of infant.
7. Flash card and posters.
STEPS IN UNDER-FIVE ASSESSMENT:-
1. Take hand washing articles from the bag.
2. Wash hands thoroughly with soap and water.
3. Allow hands to dry in the air.
4. Get the paper bag ready.
5. Take out the article from the bag such as inch tape, shakir tape, nutrition cup, bangles
4cm radius.
6. Explain the procedure the parent or the group.
7. Weight the infant using the weight balance or Barscale weighing machine or path
weighing machine.
8. Remove the shirt of the child.
9. Weight the individual and record.

2. For height and length:-
1. Place the scale and measuring rod in a well lighted or well ventilated area.
2. Hold the head and heal form and read the measure.
3. Check the scale for accuracy.
4. Remove extra clothing or shoes otherwise weight will vary.
5. Record it accurately.
6. Use infant meter if child’s age is below 2 years.
7. Place the infant on the board, hold head and feet in a straight line and record the
measurement where the tape is fixed on the board.
8. If the child is more than 2 years, instruct the child to stand with his feet together with his
back to measure, arms and hand down, head erect and eyes straight.
9. Tell the height and weight of the child to the parents.
10. Chest and head circumference can be measured
11. Anthro-pometry should be entered in health card.
CLINICAL EXAMINATION OF THE CHILD:-
1. Screen the child from head to foot.
2. Screen the child in the following order (and find out the abnormalities if any).
Vital signs
Temperature:
Heart rate:
Respiratory rate:
Blood pressure:
Growth parameters:
Weight:
Height/length:
 General appearance of the child:
-Body position:
-Posture:
-Evidence of pain;
-crying:
-Hygiene:
-Nutritional status:
-Mental alertness:
-Behaviour:

3.  Head and Neck:-Examine head for shape and size, fontanelle,sutures ,hair colour
and texture, presence of infection or any lesion,dandruff,webbing of neck,
enlarged of thyroid or neck swelling etc.
 Face: - Examine the face for expression, asymmetry, paralysis, nose bride, size of
maxilla and mandible, tenderness over sinus.
 Eyes:- Observer eyes for infection,periorbital edema,photophobia,distance
between the eyes, distribution of eyebrows,Xerophthalmia,and vision.
 Ears :- Examine the ear for the shape ,size, position, discharge, hearing ability,
 Nose :- Examine the nose for patency , discharge, bleeding, deviated septum
,foreign body,
 Mouth and Throat: - Examine the color of lips , lesion, cleft lip or cleft palate,
number of teeth, evidence of dental caries, gum bleeding, swelling and lesion of
baccal mucosa, tongue and pharynx, tonsilitis.
 Chest: - Observe the size, shape and symmetry of chest, pigeon chest, condition
of breast and nipple, breath sound, heart sound etc.
 Abdomen: - Examine for size and shape, distension, scar, condition of umbilical
cord in neonate, hernia.
 Limbs :- Examine for any deformity, asymmetry, bow legs, knock-knees, edema,
limitation of the joints, paralysis, clubbing of finger, number of fingures,
 Spine and Back :- sign of abnormal spine curvature, hair, spina bifida, neck
stiffness,
 Genitalia: - Male genitalia assess for urethral opening and its abnormalities,
hypospadias, epispadias, phimosis, hydrocele, hernia, underscended testes,size of
penis.
 Anus and Rectum :- Observe for patency of anus, presence of fistula, perinanal
erythema.
 Behaviour pattern :- irritable, depressed, nervous, apathetic ,excited, aggressive,
 Abnormal signs and symptoms :- Examine for presence of cough and cold,
bleeding, vomiting, loose motion, lack of hygiene, oliguria, anaemia, edema,
wound, ulcer etc.
3. Inform the parent about the condition of the child.
4. Record the finding in the individual health card.
5. Refer the child if needed.
6. Give health talks according to the felt heads of the child.