A mother (or other family member such as the
father, grandmother, sister or brother) usually brings a child to the clinic
because the child is sick. But mothers also bring children for well-child
visits, immunization sessions and for treatment of injuries. The steps on the ASSESS & CLASSIFY chart describe
what you should do when a mother brings her child to the clinic because he is
sick. The chart should not be used for a well-child brought for immunization or
for a child with an injury or burn.
When patients arrive at most clinics, the
clinic staffs identify the reason for the child's visit. Clinic staffs obtain
the child's weight height, or
length and temperature and record them
on a patient chart, another written record, or on a small piece of paper. Then
the mother and child see a health worker.
When you see
the mother and her sick child:
•
Greet the mother appropriately and ask her to
sit with her child.
•
You need to know the child's age so you can
choose the right case management chart; Look at the child's record to
find the child's age.
•
If the child age is 2 months up to 5 years,
assess and classify the child according to the steps on the ASSESS &
CLASSIFY chart.
•
If the child from birth up to 2 months, assess
and classify the young infant according to the steps on the YOUNG INFANT chart.
(You will learn more about managing sick young infants later in the course.)
•
Look to see if the child's weight, length or
height, mid- upper arm circumference (MUAC) and temperature have been measured
and recorded. If not, weigh the child and measure his length or height, (MUAC)
and temperature later when you assess and classify the child's main
symptoms. Do not undress or disturb the child now.
• Ask
the mother about the child's problems.
Record what the
mother tells you about the child's problems; An important reason for asking
this question is to open good communication with the mother. Using of good
communication helps to reassure the mother that her child will receive good
care. When you treat the child's illness later in the visit, you will need to
teach and advise the mother about caring for her sick child at home. So, it is
important to have good communication with the mother from the beginning of the
visit.
·
Use Good Communication skills:
o
Listen carefully to what the mother tells you. This will
show her that you are taking her concerns seriously.
o
Use words the mother understands. If she does
not understand the questions you asked her, she cannot give the information you
need to assess and classify the child correctly.
o
Give the mother time to answer the questions. For example,
she may need time to decide if the sign you asked about is present.
o
Ask additional questions when the mother is not
sure about her answer. When you ask about a main symptom or related
sign, the mother may not be sure if it is present. Ask her additional questions
to help her give clear answers.
• Determine
if this is an initial or follow-up visit for this problem.
-If this is the
child's first visit for this episode of an illness or problem, then this is an initial
visit.
-If the child
was seen a few days ago for the same illness, this is a follow- up
visit.
A follow-up visit has a different purpose than
an initial visit. During a follow-up visit, the health worker finds out if the
treatment he gave during the initial visit has helped the child. If the child
is not improving or is getting worse after a few days, the health worker
refers the child to a hospital or changes the child's treatment.
How
you find out if this is an initial or follow-up visit depends on how your
clinic registers patients and identifies the reason for their visit. Some
clinics give mothers follow-up slips that tell them when to return. In other
clinics, the health worker writes a follow-up note on the multi-visit card or
chart. Or, when the patient registers, clinic staffs ask the mother questions
to find out why she has come.
You
will learn how to carry out a follow-up visit later in the course. The examples
and exercises in this module describe children who have come for an initial
visit.
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