Overview

This manual was developed based on the recommendations of a global technical consultation on child health in humanitarian emergencies co-organized by WHO and UNICEF at the end of 2003. WHO in collaboration with the Centre for Refugee and Disaster Response, Bloomberg School of Public Health, Johns Hopkins University undertook a systematic review in 2004. It demonstrated that existing guidelines, including The Integrated Management of Childhood Illness (IMCI), do not cover all priority conditions in emergencies.

The objective of this manual is to provide comprehensive guidance on child care in emergencies. Existing guidelines, such as IMCI, assume a functioning health system that facilitates the referral of children, which may not be available in emergency situations. So this manual also includes the initial management of severe conditions. It was also realized that existing manuals do not cover injuries, burns, neonatal illness, psychosocial problems etc, which are considered of high priority in emergency settings. These are addressed in this manual as well as issues on mental health, psychosocial support and common preventive interventions such as immunization.

Each chapter summarizes the main ways of diagnosis, treatment and prevention using flow charts. The flow charts are arranged in such a way that they can be enlarged for use as job aids/wall charts, or for modular training at convenient times on the management of each condition. The manual is a collaborative work of three technical areas within WHO - Child and Adolescent Health and Development (CAH), Health Action in Crises (HAC), and Disease Control in Humanitarian Emergencies (DCE).

Contents

• Acknowledgments
• Introduction
• Module 1. Triage and emergency management
  • 1. Triage and emergency assessment
    • The triaging process
    • When and where should triaging take place?
    • Who should triage?
    • How to triage?
    • Emergency signs
    • Priority conditions
  • 2. Management of emergency signs
    • Emergency management of airway and breathing problems
    • Emergency management of the shocked child
    • Emergency management of the unconscious child
    • Emergency management of the convulsing child
    • Management of the child with low blood sugar (glucose)
• Module 2. Integrated management of childhood illness in emergencies
  • 3. Diarrhoea and dehydration
    • Assessment of the child with diarrhoea
    • Types of diarrhoea
  • 4. Cough or difficult breathing
    • Assessment of the child with cough or difficult breathing
  • 5. Fever
    • Malaria
    • Measles
    • Severe febrile disease: meningitis and sepsis
    • Ear problem
    • Skin lesions: local bacterial infection or abscess
  • 6. Malnutrition
    • Assessment the child with malnutrition
  • 7. Pallor/anaemia
    • Assessment the child with anaemia
  • 8. Newborn and young infant up to 2 months
    • Newborn assessment and resuscitation
    • Immediate care of the newborn
    • Early care of the newborn
    • Assessment of the infant up to 2 months of age
  • 9. HIV/AIDS
  • 10. Injuries
    • Assessment of the injured child
    • Examination of the injured child
    • Management of the injured child
  • 11. Burns
    • Assessment of the child with burns
  • 12. Poisoning
    • General measures
• Module 3. Prevention of child morbidity and mortality
  • 13. Immunization and other public health measures
    • Introduction
    • Public health measures
    • Immunization schedule
    • Prevention of measles
    • Routine deworming
    • Prevention of diarrhea and dehydration
    • Prevention of acute respiratory infection (ARI)
    • Prevention of malaria
    • Prevention of severe bacterial infections
    • Prevention of illness in the young infant age up to 2 months
    • Prevention of anaemia
    • Prevention of malnutrition and micronutrient deficiencies
    • Vitamin A supplementation
  • 14. Prevention of HIV infection in children
    • HIV-infected and HIV-exposed children
    • Prevention of HIV infection
    • Prevention of mother-to-child transmission (MTCT) of HIV infection
    • HIV post-exposure prophylaxis (PEP)
  • 15. Mental health and psychosocial support
    • Assess the child in need of mental health or psychosocial support
    • Classify the child in need of mental health or psychosocial support
    • Management of the young child in need of mental health or psychosocial support
• Annex 1 Glossary
• Annex 2 Weight-for-age chart
• Annex 3 Chapter resources
• Annex 4 Drug dosages for children (Formulary)
• French

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