Consideration of the Nutrition Components of the Sick Child Initiative (1995) / Chapter Skim
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3 Answers to the Five Questions Posed to the Committee
3 Answers to the Five Questions Posed to the Committee
Pages 9-16
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From page 9... ...
In many countries, the health sector, and in particular the primary health care component of that sector, is the entry point for the poor into the larger societal support structure. The SCI algorithms thus must establish and incorporate appropriate links to other health and social services programs.
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From page 10... ...
The organization of referrals to other programs and the competence of these programs to deal with their responsibilities effectively is a challenge that must be met in the future for the SCI to achieve maximum effectiveness. The impact of the initiative will be greatly enhanced if the paths for integrating SCI activities with any other resources for the treatment and prevention of illness and disease, including malnutrition, are clearly identified when the algorithms are adapted for each location.
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From page 11... ...
This includes blood transfusion for life-threatening anemia and intensive feeding of children with marasmus and kwashiorkor, including gastric intubation and intravenous electrolyte stabilization and antibiotic treatment when necessary. Intensive feeding is always a critical component of the management of marasmus and kwashiorkor, both initially and as treatment proceeds.
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From page 12... ...
Nutritional Management of Sick Children Who Are Not Malnourished The basic SCI approach of fostering and encouraging the continued feeding of the sick child, with special emphasis on continued breastteeding during illness, is now recognized as correct and appropriate (Brown, 1994~. Prevention of Malnutrition within the Management of the Sick Child The face-to-face meeting between the caretaker of the sick child and the primary health worker provides an opportunity to improve present and future feeding practices, with the goal of preventing malnutrition.
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From page 13... ...
Validating the Diagnosis The approach of the SCI to validating diagnoses for severe malnutrition and severe anemia is logical, because it separates validating the diagnosis of severe malnutrition from that of less severe malnutrition in the same way as they are separated in their immediate management. Further data collection and the use of methodologies to analyze these data are pending.
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From page 14... ...
Nutrition expertise at this juncture in the development of the nutrition component of the SCI, whether at WHO or elsewhere, is needed to define the nutritional goals of the SCI and the means to attain them, validate the diagnostic screens, evaluate the nutrition assessment algorithms, develop and evaluate feeding recommendations (especially for complementary feeding) , evaluate the effectiveness of the SCI advice in changing feeding behavior, design monitoring to ascertain whether the goals have been met, and to deal with the inevitable changes in knowledge as experience develops.
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From page 15... ...
ANSWERS TO THE FIVE QUESTIONS 15 mobilize scientists with the appropriate expertise and experience to focus attention on the many issues in the SCI that require further research and testing.
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