Paeds

1. Overview of paediatrics
MaJ J GOMA

2. Definition
A branch of medicine dealing with the development, care, and
diseases of infants, children, and adolescents
 Pediatrics also deals with:
 Biological, Social and environmental influences on the
developing child the impact of disease and dysfunction on
development

3. . Children differ from adults:
Anatomically
Physiologically
Immunologically
Psychologically
Developmentally
 metabolically.

4. SCOPE AND HISTORY OF PEDIATRICS
 Medical specialty that emerged more than a centuary ago in
response to :
increasing awareness that the health problems of children differ from those
of adults
that a child's response to illness and stress varies with age.
The emphasis and scope of pediatrics continue to change, but these
basic observations remain valid

5. The health problems of children vary widely worldwide
This depends on a number of factors which include:
prevalence and ecology of infectious agents and their hosts;
climate and geography
agricultural resources and practices
educational, economic, social, and cultural considerations
Stage of industrialization and urbanization
in many instances, the gene frequencies for some disorders

6. Top five causes of mortality in Zambia
Pneumonia
Diarrhoea
Malaria
Malnutrition
HIV related diseases

7. Some indicators monitored in paediatrics
Under-five mortality rate: Probability of dying between birth and exactly
5 years of age, expressed per 1,000 live births
Infant mortality rate: Probability of dying between birth and exactly
1 year of age, expressed per 1,000 live births
Neonatal mortality rate: Probability of dying during the first 28 days of
life, expressed per 1,000 live births
Probability of dying among children aged 5–14: Probability of dying at
age 5–14 years expressed per 1,000 children aged 5

8. Ethics in Pediatric Care
The proper scope of parental decision-making is bounded by the
concept of:
a child's best interest
 the emerging desire capacity for autonomy self-determination of an older
child or adolescent
Additionionally, the pediatric clinician has an independent
professional obligation to act in a child's “best interest,”
There possibility of conflict among child, parent, and clinician.

9. The approach to the ethical issues that arise in pediatric practice
must include respect for both:
parent's responsibility for the life and health of a child
 Child's developing capacity and autonomy
 Further complexity is added by
the varying social, cultural, and religious views of the role of family,
parental authority, appropriate methods for disciplining a child, the
age of majority, and alternative approaches to health care

10. INFORMED CONSENT, PARENTAL PERMISSION, AND CHILD ASSENT
A competent adult patient has the right to decide, after consultation with
a physician, which medical interventions he or she will or will not accept
This right of self-determination (or autonomy) based on personal
preferences and values is reflected in the doctrine of voluntary and
informed consent
This doctrine, however, has limited direct application to children and
adolescents who lack the decisional capacity or legal empowerment to give
informed consent to medical care.

11. The capacity for informed decision-making in health care is generally
thought to involve the ability to :
i. understand and communicate
ii. reason and deliberate
iii. analyze conflicting elements of a decision using a set of personal
values
The age at which a competent patient may legally exercise voluntary
and informed consent for medical care varies from state to state

12. THANKS
FOR YOUR ATTENTION!