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Addressing the health needs of children in complex emergencies is critical to the success of relief efforts and requires coordinated and effective interventions. However, little systematic work has been undertaken to evaluate such care. To address this need, this monograph presents a review of the published literature in this area, providing background on the burden of disease, the major causes of morbidity and mortality, and the evidence base for effective interventions. It also describes surveys of nongovernmental organizations (NGOs) and international agencies providing care to children in complex emergencies, which were conducted to identify guidelines commonly used to provide such care and assesses the content and limitations of these guidelines. A more in-depth survey of several organizations was also conducted to assess obstacles to this kind of care. On the basis of the survey findings and the review of the published literature, the working group recommended that evidence-based, locally adapted guidelines to address the curative and preventive care of children in complex emergencies and health systems planning should be adopted by ministries of health and supported by the World Health Organization (WHO) and UNICEF. The guidelines should target, as much as possible, the different levels of health care workers providing care to children to ensure appropriate, effective, and uniform care in a variety of situations. Child Health in Complex Emergencies presents specific examples of areas for further research and guideline development. This report is not intended to be an exhaustive and definitive assessment of child health in complex emergencies. The topic is much too vast and complex, and different individuals and institutions will have incompatible perspectives. Rather, we aim to provide a starting point for discussion and debate on how to improve the care of children in these settings.
Children are particularly vulnerable in complex emergencies. They are often the first and most common victims of human rights violations, violence, disease, malnutrition, and death. Addressing their specific needs, including health, in complex emergencies is critical to the success of relief efforts and requires child-specific, effective and coordinated interventions. The provision of health care to children in complex emergencies differs from that of children in stable situations. The severity and magnitude of childhood diseases is often exacerbated by forced migration, conflict or disaster, necessitating the rapid assessment and treatment of large numbers of severely ill children. In complex emergencies, the provision of health care is often less uniform than in stable situations and ensuring comprehensive, coordinated and appropriate care is difficult where multiple organizations are working, different levels of referral services, supply and delivery systems are lacking or insufficient, and health care workers with minimal training are often the primary providers. Disease surveillance systems must be rapidly established, particularly for diseases known to cause outbreaks with high mortality, such as measles and diarrheal diseases. The logistics of drug delivery and distribution are complicated by the myriad of organizations involved, inadequate communication, delivery and transportation systems and threats to security.
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).
A comprehensive, best practices resource for public health and healthcare practitioners and students interested in humanitarian emergencies.
Emergencies in Children's and Young People's Nursing is a one-stop quick reference for children's and young people's nurses providing emergency care in the acute hospital setting.
Preparedness, Response and Recovery Considerations for Children and Families is the summary of a workshop convened in June, 2013 by the Institute of Medicine Forum on Medical and Public Health Preparedness for Catastrophic Events to discuss disaster preparedness, response, and resilience relative to the needs of children and families, including children with special health care needs. Traditional and non-traditional medical and public health stakeholders from across federal, state, and local government health care coalitions, community organizations, school districts, child care providers, hospitals, private health care providers, insurers, academia, and other partners in municipal planning met to review existing tools and frameworks that can be modified to include children's needs; identify child-serving partners and organizations that can be leveraged in planning to improve outcomes for children; highlight best practices in resilience and recovery strategies for children; and raise awareness of the need to integrate children's considerations throughout local and state emergency plans. Communities across the United States face the threat of emergencies and disasters almost every day, natural and man-made, urban and rural, large and small. Although children represent nearly 25 percent of the U.S. population, current state and local disaster preparedness plans often do not include specific considerations for children and families. The preparedness and resilience of communities related to children will require a systems framework for disaster preparedness across traditional and non-traditional medical and public health stakeholders, including community organizations, schools, and other partners in municipal planning. This report examines resilience strategies that lead to successful recovery in children after a disaster and discusses current approaches and interventions to improve recovery in children.
How can we meet the special needs of children for emergency medical services (EMS) when today's EMS systems are often unprepared for the challenge? This comprehensive overview of EMS for children (EMS-C) provides an answer by presenting a vision for tomorrow's EMS-C system and practical recommendations for attaining it. Drawing on many studies and examples, the volume explores why emergency care for childrenâ€"from infants through adolescentsâ€"must differ from that for adults and describes what seriously ill or injured children generally experience in today's EMS systems. The book points the way to integrating EMS-C into current emergency programs and into broader aspects of health care for children. It gives recommendations for ensuring access to emergency care through the 9-1-1 system; training health professionals, from paramedics to physicians; educating the public; providing proper equipment, protocols, and referral systems; improving communications among EMS-C providers; enhancing data resources and expanding research efforts; and stimulating and supporting leadership in EMS-C at the federal and state levels. For those already deeply involved in EMS efforts, this volume is a convenient, up-to-date, and comprehensive source of information and ideas. More importantly, for anyone interested in improving the emergency services available to childrenâ€"emergency care professionals from emergency medical technicians to nurses to physicians, hospital and EMS administrators, public officials, health educators, children's advocacy groups, concerned parents and other responsible adultsâ€"this timely volume provides a realistic plan for action to link EMS-C system components into a workable structure that will better serve all of the nation's children.
The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.