WHO Regional Menu Of Essential Health Interventions

Condition: Meningitis

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness on prevention and control methods of meningitis Create awareness on meningitis including prevention measures (IPC) Distribution of IEC materials Community mobilisation for routine immunisation	Frequent hand washing Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal Advocacy for proper sanitation and good housing Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal	Recognition of meningitis signs and symptoms	Isolate child suspected with meningitis Immediate transfer to a higher-level health care facility	Home-based physical rehabilitation	Psychological and emotional support for meningitis sequel
Primary Care
Health education and information on prevention and treatment of meningitis	Chemoprophylaxis for close contacts Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal Oral antimicrobials chemoprophylaxis for contacts "Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal"	History Physical examination Rapid blood agglutination test	Antibiotic treatment Immediate transfer to a higher-level health care facility	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: General
Health education and information on prevention and treatment of meningitis	Chemoprophylaxis for close contacts Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal	History Physical examination Lumbar puncture CSF analysis CSF culture CSF PCR Rapid CSF agglutination test Blood culture Throat swab Serology Full blood count C reactive protein (CRP) Clotting studies Basic metabolic panel	Parenteral antibiotics Parenteral corticosteroids	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological support to parents of children with meningitis sequel
Referral Facility: Specialist
Health education and information on prevention and treatment of meningitis	Oral antimicrobials chemoprophylaxis for contacts "Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal"	History Physical examination Lumbar puncture CSF analysis CSF culture CSF PCR Rapid CSF agglutination test Blood culture Throat swab Serology Full blood count C reactive protein (CRP) Clotting tests Basic metabolic panel	Parenteral antibiotics Intravenous fluids Anti-TB treatment for TB meningitis Antifungal treatment for fungal meningitis Parenteral corticosteroids	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological support to parents of children with meningitis sequel

Condition: Whooping Cough

Health Promotion	Disease Prevention	Diagnostic	Curative	Palliative
Community Level
Community-based awareness on prevention and control of VPDs Community education on proper nutrition for young children	Good hygiene practices including hand hygiene Stay at home if any symptoms of whooping cough Avoiding close contact with patient Pertussis-containing vaccination	Recognition of whooping cough signs and symptoms	Antipyretics Hydration Feeding Immediate transfer to a higher-level health care facility	Psychosocial support counselling for parents and families spiritual support
Primary Care
Health education and information to parents, families on immunization including vaccination schedule	Pertussis-containing vaccination Chemoprophylaxis to contacts Vitamin A supplementation	History Physical examination	Antipyretics Hydration Nutritional support Vitamin A Immediate transfer of unresponsive or sever cases to a higher-level health care facility	Psychosocial support counselling for parents and families spiritual support
Referral Facility: General
Isolate hospitalized patients Chemoprophylaxis to contacts (family and health workers)	Post exposure prophylaxis for close contacts	History Physical examination Serologic assays	Antibiotics Antipyretics Hydration Nutritional support Vitamin A	Psychosocial support counselling for parents and families spiritual support
Referral Facility: Specialist
Health education and information to parents, families on immunization including vaccination schedule	Isolate hospitalized patients Chemoprophylaxis to contacts (family and health workers)	History Physical examination Bacterial culture PCR Serologic assays	Physical and Clinical examination Hospitalisation of infants Administration of antibiotics Monitoring /special attention to infants to prevent and manage any complications e.g apnea and pneumonia ICU services for severely ill Laboratory tests,B pertussis,culture, polymerase chain reaction (PCR), serologic testing, and direct fluorescent antibody (DFA) testing follow up	Psychosocial support counselling for parents and families spiritual support

Condition: Encephalitis

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Create awareness to families and communities on the disease and prevention measures Information to the communities on the importance of immunization for children Information/creation of awareness on healthy living Awareness on good nutrition Provision of IEC materials Awareness/education on animal handling and animal health e.g. Dogs (rabies)	Childhood vaccinations against diseases-measles, mumps, rubella Vectors/mosquitos control (as a carrier for some of the virus arbovirus) Parasites such as * Parasites such as Ticks control		Community based rehabilitation Continued Rehabilitation at community level and follow up of patients referred backwards from the health facilities (those who may have had complications) Physical therapy to improve motor coordination Occupational therapy to develop everyday skills Speech therapy	Psycho-social support for parents/families of children with encephalitis Counselling Psycho- therapy to learn coping strategies and new behavioral skills
Primary Care
Create awareness to families and communities on the disease and prevention measures Information on the importance of immunization for children Information/creation of awareness on healthy livingAwareness on good nutrition Provision of IEC materials Awareness/education on animal handling and animal health e.g.dogs (rabies) Training/sensitizing health workforce	Childhood vaccinations against diseases -measles, mumps, rubella Vectors/mosquitos control (as a carrier for some of the virus arbovirus) Parasites such as Ticks control	Clinical examination/Physical examination Supportive and symptomatic management for encephalitis before urgent referral to hospital including; Bed rest Fluids therapy/Plenty of fluids Adminstration of Anti-inflammatory drugs Management of fever using anti pyretics Management if pain with analgesisc Suction to remove secretions Monitor for any danger signs e.g.lethargy, unconsciousness, convulsions Urgent referral of a child suspected to have encephalitis to the nearest hospital	Rehabilitation and follow up of patients referred backwards from the Hospitals Physical therapy to improve motor coordination and mobility Occupational therapy to develop everyday skills Referral downwards to communities for further/continued rehabilitation	Psycho-social support parents and families with children with encephalitis Counselling Psycho- therapy to learn coping strategies and new behavioral skills Spiritual support
Referral Facility: General
Creation of awareness toparents/families on encephalitis prevention measures Information/creation of awareness on healthy living Guidance on good nutrition for children Training/sensitizing health workforce on encephalitis management	Guidance/advise to families on importance of immunisation for the children Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus), Parasites such as Ticks control Training/sensitizing health workforce on encephalitis management	Early recognition and treatment of encephalitis Initiate anti-viral treatment immediately Initiate anti-microbial therapy including appropriate therapy for presumed bacterial meningitis (use antibiotics for acute bacterial meningitis For Viral encephalitis use of antiviral treatment.e.g. for herpes simplex virus /Antiviral medications e.g. Acyclovir Initiate specific regimen after determining the etiology of encephalitis Antimicrobial therapy targeting the identified infectious agent, Supportive care for severe encephalitis including: * Breathing assistance, Intravenous fluids adminstration Anti-inflammatory drugs administration Administration of Anticonvulsant medications Admissions for persons with encephalitis Management of any complications Prevention /or management of shock or hypertension Prevention/Management of seizures Management of hydrocephalus and increased intracranial pressure ICU services Laboartory diagnostic interventions for Encephalitis including: Blood and urine tests- lumbar puncture (LP) -CSF culture - Blood cultures for bacterial pathogens Serologic tests for Toxoplasma Imaging such Computerized Tomography CT Magnetic Resonance Imaging MRI	Follow-up therapy for complications of encephalitis Physical therapy to improve motor coordination anf function - Speech therapy Occupational therapy to develop everyday skills Speech therapy Referral downwards to primary care facilities and to communities for follow up and rehabilitation	Psycho-social support for parents /families of children with encephalitis Counselling Psycho- therapy to learn coping strategies and new behavioral skills Spiritual support
Referral Facility: Specialist
Creation of awareness toparents/families on encephalitis prevention measures Information/creation of awareness on healthy living Guidance on good nutrition for children Training/sensitizing health workforce on encephalitis management	Guidance /advise to families on importance of immunisation for the children Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) ; Parasites such as Ticks control	Initiate anti-viral treatment immediately Initiate anti-microbial therapy including appropriate therapy for presumed bacterial meningitis (use antibiotics for acute bacterial meningitis Initiate specific regimen after determining the etiology of encephalitis For Viral encephalitis use of antiviral treatment.e.g. for herpes simplex virus /Antiviral medications e.g. Acyclovir Antimicrobial therapy targeting the identified infectious agent, Supportive care for severe encephalitis including: * Breathing assistance, Intravenous fluids adminstration Anti-inflammatory drugs administration Administration of Anticonvulsant medications Admissions for persons with encephalitis Management of any complications Prevention /or management of shock or hypertension Prevention/Management of seizures Management of hydrocephalus and increased intracranial pressure ICU services Laboartory diagnostic interventions for Encephalitis including: Blood and urine tests lumbar puncture (LP) -CSF culture Blood cultures for bacterial pathogens Serologic tests for Toxoplasma Imaging such as: Computerized Tomography CT Magnetic Resonance Imaging MRI	Physical therapy to improve motor coordination anf function Speech therapy Occupational therapy to develop everyday skills Referral downwards to primary care facilities and to communities for follow up and rehabilitation	Psycho-social support for parents /families of children with encephalitis Counselling Psycho- therapy to learn coping strategies and new behavioral skills Spiritual support

Condition: Measles

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
community-based awareness on VPDs including transmission and prevention measures * Community education on proper nutrition for young children	Routine on schedule vaccination Good hygiene practices including hand hygiene Stay at home if any symptoms of measles Avoiding close contact with measles cases	Recognition of measles signs and symptoms	Psychological and emotional support for meningitis sequel	Home-based physical rehabilitation	Psycho social support/counseling to the parents/families of young children with complications of measles e.g. deafness, blindness.
Primary Care
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination	Antipyretics Hydration Proper nutrition Vitamin A Immediate transfer of unresponsive or sever cases to a higher-level health care facility	Physical therapy Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: General
Information and health education on VPDs and immunization	Routine on schedule vaccination Vitamin A supplementation	History Physical examination Serologic test Complete blood count Chest radiography	Antibiotics when indicated Antipyretics Vitamin A Hydration	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel
Referral Facility: Specialist
Information and health education on VPDs and immunization	Isolation of patients with measles to prevent spread Measles vaccination according to the national schedule	History Physical examination Complete blood count Serologic test PCR test Blood culture Chest radiography	Antibiotics Vitamin A Hydration Intensive care for severely ill	Linkage with rehabilitation centres for deafness, learning impairment or behavioural problems	Psychological and emotional support for meningitis sequel

Condition: Tuberculosis

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Social and behavioural change communication for parents Promote cough etiquette and cough hygiene	BCG vaccination Contact tracing, screening and management TB Prevention Therapy (TPT) Isolation of confirmed or presumptive adult TB cases	Recognition of tuberculosis signs and symptoms	Directly Observed Therapy (DOTs) Referral of presumptive TB TB drugs refill Trace and follow defaulters	Home-based self-management rehabilitation	Psychosocial support Linkage with support groups
Primary Care
Promote cough etiquette and cough hygiene Promote strong TB Infection control measures	Triage people with presumptive TB for “fast-track” or separation Ensure rapid diagnosis and initiation of treatment Improve room ventilation Protect health care workers	Contact history Physical examination Anthropometric measurement AFB microscopy Rapid molecular test Chest radiography	Directly Observed Therapy (DOTs) Trace and follow defaulters Referral of people with adverse reactions and complications	Breathing exercise	Psychosocial support Linkage with support groups
Referral Facility: General
Promote cough etiquette and cough hygiene Promote strong TB Infection control measures	Strong TB Infection control measures Triage people with presumptive TB for “fast-track” or separation Ensure rapid diagnosis and initiation of treatment Improve room ventilation Protect health care workers	Contact history Physical examination Anthropometric measurement AFB microscopy Tuberculin skin test Rapid molecular test HIV testing Chest radiography Ultrasound	Directly Observed Therapy (DOTs) Manage adverse reactions and complications	Breathing exercise	Psychosocial support Linkage with support groups
Referral Facility: Specialist
Promote cough etiquette and cough hygiene Promote strong TB Infection control measures	Strong TB Infection control measures Triage people with presumptive TB for “fast-track” or separation Ensure rapid diagnosis and initiation of treatment Improve room ventilation Protect health care workers	Contact history Physical examination Anthropometric measurement Tuberculin skin test (TST) Interferon gamma release assay HIV testing Rapid molecular diagnostic tests Chest radiography Ultrasound Fluid analysis Drug sensitivity test (DST) CT scan MRI Fine-needle aspiration Biopsy of tissues	Direct Observed Therapy (DOT) Manage severe adverse infections and complications Anti TB medication Anti MDR/XDR TB Intensive care as clinically indicated	Breathing exercise	Psychosocial support Linkage with support groups

Condition: Other STDs

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
	Education of parents on the risks and prevention of sexual abuse of children
Primary Care

Referral Facility: General

Referral Facility: Specialist

Condition: HIV/AIDS

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Social and behavioural change communication for parents Community awareness on the risks and prevention of sexual abuse of children	Primary prevention of HIV in adolescents and women of child bearing ages Screening pregnant women for HIV	Recognition of HIV/AIDS signs and symptoms HIV counselling and testing DBS collection	Early testing for HIV exposed infants Support treatment adherence to ARV for HIV infected children Refills /Supply of antiretroviral Trace loss to follow-ups	Self-management education for parents Support parents for disclosure	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage with support groups
Primary Care
Social and behavioural change communication for parents Community awareness on the risks and prevention of sexual abuse of children	Primary prevention of HIV in adolescents and women of child bearing ages Screen pregnant women for HIV Contraceptives ARV for HIV positive pregnant women ARV prophylaxis to HIV exposed infant	Antibody/Antigen based RDT Rapid molecular HIV test Clinical staging Complete blood count POC CD4 testing POC Viral load testing Chest radiograph	Antiretroviral therapy Opportunistic infection prophylaxis Patient follow-up Adverse drug reactions (ADR) monitoring Treatment of mild opportunistic infections TB/HIV co-infection Nutritional support Adherence support Referral to higher level for advanced HIV infection, severe adverse effects, complications and non-compliance	Self-management education for parents Support parents for disclosure	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage with support groups
Referral Facility: General
Health education and risk reduction counselling to parents	Screen pregnant women for HIV ARV for HIV positive pregnant women ARV prophylaxis to HIV exposed infant Contraceptives	HIV counselling and testing Rapid molecular HIV test Clinical staging Complete blood count CD4 testing Basic metabolic panel Viral load testing Chest radiograph HBV and HCV tests Ultrasound	First-line antiretroviral therapy Second-line antiretroviral therapy Manage moderate to severe adverse reactions * Viral load monitoring Treat moderate to severe OIs Treat TB/HIV co-infection Manage co-morbidities Referral to higher level for to non-responders	Self-management education for parents Support parents for disclosure	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage with support groups
Referral Facility: Specialist
Health education and risk reduction counselling to parents	Screen pregnant women for HIV ARV for HIV positive pregnant women ARV prophylaxis to HIV exposed infant Contraceptives	HIV counselling and testing Rapid molecular HIV test Clinical staging Complete blood count CD4 testing Basic metabolic panel Viral load testing Chest radiograph HBV and HCV tests Ultrasound Magnetic resonance imaging (MRI) Computed tomography (CT)	First-line antiretroviral therapy Second-line antiretroviral therapy Manage moderate to severe adverse reactions * Viral load monitoring Management moderate to severe opportunistic infections Treat TB Manage co-morbidities Intensive care as clinically indicated	Self-management education for parents Support parents for disclosure	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage with support groups

Condition: Gonorrhoea

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level

Primary Care
			Referral of infants with purulent conjunctivitis to hospital for treatment
Referral Facility: General
			Treatment of Gonococcal conjunctivitis in newborns with Tetracycline and saline irrigation Systemic treatment of newborns with Gonococcal conjunctivitis with IM Ceftriaxone
Referral Facility: Specialist
			Systemic treatment of newborns with Gonococcal conjunctivitis with IM Ceftriaxone Treatment of Gonococcal conjunctivitis in newborns with Tetracycline and saline irrigation

Condition: Diarrhoeal diseases

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Community-based awareness campaign Mass media based awareness Community mobilisation for routine immunisation Create awareness on diarrhoea including prevention measures Distribution of IEC materials on diarrhoea Advocacy for proper sanitation and good housing Community mobilisation for routine immunisation	Breastfeeding Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements Vaccination: rotavirus Observation of good hygiene practices in food preparation for the children Encourage utilization of safe portable water in homes and communities Counselling on WASH services (use of safe water supply, sanitation and hygiene) Early recognition of danger signs by the family members Preventive zinc supplements Vaccination: rotavirus	Recognition of diarrhoea signs and symptoms	Oral rehydration salts (ORS) solution Oral sugar-salt solution Nutrient-rich foods including breast feeding Zinc supplements Immediate transfer of severe cases to a higher-level health care facility Home based provision of oral rehydration therapy Zinc tablets in mild cases Vitamin A supplementation Refer moderate to severe cases and cases with vomiting or fever
Primary Care
Health education on prevention and treatment of diarrhoea	Vaccination: rotavirus Vaccination: typhoid Oral vitamin A supplementation for children Observation of good hygiene practices in food preparation for the children Encourage utilization of safe portable water in homes and communities Counselling on WASH services (use of safe water supply; sanitation and hygiene) Early recognition of danger signs by the family members Preventive zinc supplements Vaccination: rotavirus Access to safe drinking water Use of improved sanitation Monitoring of correct hand washing techniques Early recognition and action on danger signs Preventive zinc supplements Vaccination: Rotavirus	History Physical examination Stool exam for ova and parasites Serological assays	Oral rehydration salts (ORS) solution Intravenous hydration Antibiotics for bacterial infections Zinc supplements Nutrient-rich foods including breast feeding Immediate transfer of severe or complicated cases to a higher-level health care facility History and physical examination for diarrhoea, abdominal pain. Assess and classify for diarrhoea using IMNCI strategy Point of care testing Basic laboratory tests Oral zinc supplementation Oral rehydration solution Counselling on increased fluid intake Oral antimicrobials for enteric and diarrhoeal infections Intravenous fluids Oral multivitamins for persistent diarrhoea Referral for management of severe dehydration for other complications.
Referral Facility: General
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements
Referral Facility: Specialist
Health education on prevention and treatment of diarrhoea	Access to safe drinking water Use of improved sanitation Hand washing with soap	Stool culture Blood culture	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Condition: Chlamydia

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
			Referral of infants with purulent conjunctivitis to hospital for investigation and treatment
Primary Care
			Physical and clinical examination Referral of infants with purulent conjunctivitis to hospital for treatment
Referral Facility: General
			Physical and clinical examination Treatment of Chlamydia conjunctivitis in infants with antibiotics Referral as may be indicated
Referral Facility: Specialist
			Physical and clinical examination Treatment of Chlamydia conjunctivitis in infants with antibiotics Referral as may be indicated

Condition: Dengue

Health Promotion	Disease Prevention	Curative
Community Level
Community awareness and education On Dengue Proper solid waste disposal and improved	Primary prevention through Vector control against the mosquito using Indoor Residual
Primary Care
Community awareness and education On Dengue Proper solid waste disposal and improved use of mosquito repellents, mosquito bed nets, mosquito coils, protective clothing and regularly removing sources of stagnant water to prevent mosquito breeding	Community awareness and education On Dengue Proper solid waste disposal and improved use of mosquito repellents, mosquito bed nets, mosquito coils, protective clothing and regularly removing sources of stagnant water to prevent mosquito breeding	Able to conduct NS1 Ag, IgA and IgM antigens by rapid test Able to conduct Overall assessment, diagnosis and identification of phase of severity Management of non-severe dengue without warning signs by providing medical advice, supervising rest and drinking of plenty of fluids and prescribing of Paracetamol
Referral Facility: General
Community awareness and education On Dengue Proper solid waste disposal and improved water storage practices, including covering of containers to prevent access by egg-laying female mosquitoes are among methods that are encouraged through community-based programmes		In addition to primary care interventions Conduct virus isolation, genome detection, NS1 Ag, IgA and IgM antigens by rapid test, ELISA and in addition for IgA by IHS and neutralization assays. Implement case management decisions for severe dengue with warning signs (Group B and C) including treatment of profound/compensated shock, electrolyte imbalances, metabolic acidosis, ensure glucose control, hemorrhagic complications
Referral Facility: Specialist
Community awareness and education On Dengue Proper solid waste disposal and improved water storage practices, including covering of containers to prevent access by egg-laying female mosquitoes are among methods that are encouraged through community-based programmes		Conduct virus isolation, genome detection, NS1 Ag, IgA and IgM antigens by rapid test, ELISA and in addition for IgA by IHS and neutralization assays. Implement case management decisions for severe dengue with warning signs (Group B and C) including treatment of profound/ compensated shock, electrolyte imbalances, metabolic acidosis, ensure glucose control, hemorrhagic complications In addition to primary care interventions

Condition: Lymphatic filariasis

Health Promotion	Disease Prevention	Rehabilitative
Community Level
Community awareness and education of families and communities on Lymphatic Filariasis to promote positive attitudes towards people with disabilities	Primary prevention through - Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC) - Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC) Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Primary prevention through Improvement in community Water Sanitation and Hygiene (WASH) Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Primary prevention through Community screening of patients with scrotal swelling. Either the patient himself or a community health worker identifies scrotal swelling and the patient is referred or reports to a level II facility Management of Acute dermatolymphangioadenitis with antibiotics, antipyretics, analgesics Management of Lymphoedema and elephantiasis through limb washing and improved hygiene practices, wound care, foot care, wearing of suitable footwear, physiotherapy and exercise, and the application of antibacterial creams and antifungal creams	Tertiary prevention Counseling - Occupational and physiotherapy
Primary Care
Community awareness and education Education of families and communities on Lymphatic Filariasis Promote positive attitudes towards people with disabilities
Referral Facility: General

Referral Facility: Specialist

Condition: Diphtheria

Health Promotion	Disease Prevention	Curative
Community Level
Information and health education to parents, families and Communities on immunization including vaccination schedule for the young children Families and community education on transmission and prevention of Diphtheria Community education on proper nutrition for young children/under 5s Education on hygiene measures for young children Promoting proper planning especially in urban areas to avoid over-crowding through multi-sectoral approach Community health workers education on Diphtheria including recognition of signs and symptoms in children and on prevention measures	Routine vaccination for diphtheria according to the national schedule (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Proper Nutrition for children under 5 years of age Defaulter tracing for children who are not fully immunize Identify trends of the disease in the community/Active surveillance and early detection of diphtheria Record keeping/reporting Contact tracing for those in contact with infected persons Quarantine suspected cases 0utreach services to the communities Recording and reporting of diphtheria cases through established reporting mechanisms	Recognition of features of Diphtheria in under 5s which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice Supportive management for children under 5 years of age with Diphtheria Breastfeeding for the infants - Plenty of rest - Proper nutrition for a child with diphtheria Referral to a health facility of the child with worsening condition due to suspected diphtheria
Primary Care
Sensitize parents and care givers to recognize when the child is sick and when to seek treatment Sensitize parents and care givers regarding transmission and prevention of diphtheria in under 5s Information and health education to parents, families and on immunization including vaccination schedule Guidance to the parents and families on proper nutrition for the under 5s Training/sensitizing health workforce on diphtheria, its prevention and management in under 5s Update/training of health care workers on immunization as recommended in national immunization schedules.	Routine vaccination for diphtheria according to the national schedule (use of Diphtheria toxoid-vaccine combined with tetanus toxoid (Td) as well with other antigens such as pertussis (DTwP/DTaP/Tdap) Defaulter tracing for children who are not fully immunized Outreach services to the communities Active surveillance and early detection of diphtheria Contact tracing for under 5s who have been in contact with persons infected with diphtheria Post exposure vaccination for unvaccinated under 5s Prophylactic antibiotics (penicillin or erythromycin) for under 5s who have been in close contact with some with diphtheria Recording and reporting of diphtheria cases through established reporting mechanisms	History; Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria - including Supportive management to an under 5 with diphtheria to/Relieve common symptoms· Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Provide nutritional support for the under 5s with diphtheria Immunization with diphtheria toxoid vaccine for children who have not been vaccinated or have not completed the appropriate course Monitoring and recognition for any features of worsening of diphtheria in under 5s which includes, shortness of breath/breathing difficulties Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Emergency care with an aim of stabilizing the under 5s with complications due to diphtheria before referral Referral of a child with diphtheria to a hospital
Referral Facility: General
Guidance to parents on prevention of diphtheria among children Guidance to parents on hygiene practices for children Education on importance of immunization for the children Guidance to parents on proper nutrition for children Health workers education on management of diphtheria among children	Identify close contacts such as caretakers, relatives, sexual contacts, friends; - Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series	Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Isolation. Respiratory droplet isolation of children under 5s with respiratory diphtheria and contact precautions for under 5s children with cutaneous diphtheria Antitoxin treatment with DAT immediately diphtheria is strongly suspected in children under 5 years (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for children who have not been vaccinated/have not completed the appropriate course Tests, nasal/pharyngeal swabs for culture Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to parents on hygiene practices for children Guidance to parents on prevention of diphtheria among children Education on importance of immunization for the children Guidance to parents on proper nutrition for children Health workers education on management of diphtheria among children	Identify close contacts such as caretakers, relatives, sexual contacts, friends; - Health care workers Monitor close contacts for signs and symptoms of diphtheria Prophylactic antibiotics (penicillin or erythromycin) for close contacts Recording and reporting of diphtheria cases through established reporting mechanisms Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series	Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever Antitoxin treatment with DAT immediately diphtheria is strongly suspected in children under 5 years (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for children who have not been vaccinated/have not completed the appropriate course Isolation. Respiratory droplet isolation of children under 5s with respiratory diphtheria and contact precautions for under 5s children with cutaneous diphtheria Tests, nasal/pharyngeal swabs for culture Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions

Condition: Acute Hepatitis B

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Community health workers training on Hepatitis B, including prevention measures among children Health Education to parents/families /communities on Heaptitis B Awareness creation among parents/communities on Hepatitis B including transmission and prevention measures Distribution of IEC materials on Hepatitis B Create awareness on the importance of Hepatitis B vaccination for the children Mass awareness campaigns such as World Hepatitis Day and World immunization Week Promote Child Welfare Clinics CWC attendance	Catch-up immunization for older children who missed immunization as infants / ie hepatitis B vaccine for: Children not vaccinated at birth. Screening for Hepatitis B especially among under 5s at risk i.e those living with someone with Hepatitis B Linkage to health facilities	Recogition of symptoms and signs Testing with RDT	Supportive management Relieve of pain Optimum fluid Healthy diet Promote breastfeeding Referral to the next level health facility
Primary Care
Education and awareness creation among parents/communities on Hepatitis B including transmission and prevention measures Create awareness on the importance of Hepatitis B vaccination for the children Promote CWC attendance Health workers training on Hepatitis B, including prevention measures among children	Hepatitis B Vaccination for those not vaccinated at birth Screening for Hepatitis B for those at risk ; those living with someone who has hepatitis B Safe injection practices, including eliminating unnecessary and unsafe injections,- Avoid re-use of needles and syringes	• History • Physical examination • Viral hepatitis B serology • Point of care Viral load testing • Complete blood count • Liver function tests • Liver ultrasound	Provision of high caloric diet Adequate of fluids Restricted physical activity Avoid hepatotoxic drugs Referral to next level health facility
Referral Facility: General
Education and awareness creation among parents/c on Hepatitis B including transmission and prevention measures Create awareness on the importance of Hepatitis B vaccination for the children Promote CWC attendance Guidance to parents on nutrition for the children Health workers training on Hepatitis B,including prevention measures among children	Hepatitis B Vaccination for under 5 years children not vaccinated at birth Screening for Hepatitis B for under 5s at risk ; those living with someone who has hepatitis B Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the under 5s Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes		Supportive management Healthy diet Plenty of fluids Enough sleep/rest Pain reliefe Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications
Referral Facility: Specialist
Create awareness on the importance of Hepatitis B vaccination for the children Education and awareness creation among parents/c on Hepatitis B including transmission and prevention measures Guidance to parents on nutrition for the children Health workers training on Hepatitis B,including prevention measures among children Promote CWC attendance	Hepatitis B Vaccination for under 5 years children not vaccinated at birth Screening for Hepatitis B for under 5s at risk ; those living with someone who has hepatitis B; Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the under 5s Safe injection practices, including eliminating unnecessary and unsafe injections, -Avoid re-use of needles and syringes		Supportive management Healthy diet Optimum fluids Enough sleep/rest Pain relief Admission for severe Acute Hepatitis B Anti-retroviral drugs for severe acute Hepatitis B Monitoring and management of any complications

Condition: Hepatitis A

Health Promotion	Disease Prevention	Curative
Community Level
Create awareness to mothers and families/communities on Hepatitis A including risk factors Families and community education on proper hygiene measuresSensitize communities on use of clean, safe waterEducation families on proper human waste disposal -including for children Community health workers training/sensitization on Hepatitis A including prevention measure	Reduce chances of infections and transmission to others through advice and sensitization on Observation of personal hygiene practices such as; Regular hand-washing before meals and after going to the bathroom Proper disposal of human waste within communities Proper food hygiene including proper cooking/heating Use clean safe water for drinking Strict personal hygiene and hand washing to prevent faecal -oral transmission to others for those already infected Proper cleaning of Contaminated surfaces/with disinfectant	Recognition of features of Hepatitis A in children under 5 years of age including yellowing of the skin and whites of the eyes N/B Most children under 6 don’t usually experience noticeable symptoms, and only 10% develop jaundice. Supportive Home remedies; Plenty of rest Plenty of fluids/hydration Breastfeeding for the infants Referral to a health facility if symptoms worsen
Primary Care
Create awareness to mothers and families/communities on Hepatitis A including risk factors Families and community education on proper hygiene measures Sensitize communities on use of clean, safe waterEducation to families on proper human waste disposal -including for children Health workers training/sensitization on Hepatitis A ,including prevention measures and management	Education/sensitization to families on Strict personal and hand hygiene Hepatitis A Vaccine for children older than 1 year especially children who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A.	Physical and Clinical examination,Diagnosis of Hepatitis A based on signs and symptoms fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and yellowing of the skin and whites of the eyes. Relieve any symptom -fever, dehydration i.e.(no specific medicines except to relive symptoms) Advice on home remedies; Plenty of rest Plenty of fluids/hydration Monitor for any worsening of the condition/any complications Referral to a hospital if symptoms worsen
Referral Facility: General
Create awareness to mothers and families/communities on Hepatitis A including risk factors Families and community education on proper hygiene measures. Including for children Sensitize communities on use of clean, safe water Education to families on proper human waste disposal -including for children Health workers training/sensitization on Hepatitis A , including prevention measures and management	Education/sensitization to families on Strict personal and hand hygiene Hepatitis A Vaccine for children older than 1 year especially children who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A.	History taking & Clinical examination Relieve any symptom -fever, dehydration i.e.(no specific medicines except to relive symptoms) Investigations :- Blood test - To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood * Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA - Liver function tests Test also for hepatitis B and C Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)
Referral Facility: Specialist
Create awareness to mothers and families /communities on Hepatitis A including risk factors Families and community education on proper hygiene measures. Including for children Sensitize communities on use of clean, safe waterEducation to families on proper human waste disposal -including for children Health workers training /sensitization on Hepatitis A , including prevention measures and management	Education/sensitization to families on Strict personal and hand hygiene Hepatitis A Vaccine for children older than 1 year especially children who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A.	Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms ) Investigations - Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood - Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA Liver function tests Test also for hepatitis B and C Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)

Condition: Hepatitis E

Health Promotion	Disease Prevention	Curative
Community Level
Create awareness to mothers and families/communities on Hepatitis A including risk factors Families and community education on proper hygiene measuresSensitize communities on use of clean, safe waterEducation families on proper human waste disposal -including for children. Community health workers education/sensitization on Hepatitis E including prevention measures	Monitoring and Proper record keeping/reporting especially in out breaks situation Proper disposal of human waste/feaces Maintaining individual hygiene practices Consumption of clean safe water Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases	Recognition of features indicative of Hepatitis E including initial mild fever, reduced appetite nausea and vomiting, abdominal pain, itching (without skin lesions), yellow color of the skin and whiteness of the eyes, with dark urine and pale stools Supportive treatment including; - proper nutrition - Adequate rest Relieving fever through use of pain killers/tepid sponging Referral to a health facility in case symptoms worsens
Primary Care
Create awareness to mothers and families/communities on Hepatitis A including risk factors Families and community education on proper hygiene measures Education families on proper human waste disposal -including for children Sensitize communities on use of clean,safe water Health workers education/sensitization on Hepatitis E including prevention measures and management	Guidance/education to parents/families on proper hygiene practices including: - Consumption of clean safe water - Proper disposal of human waste/feaces Maintaining individual hygiene practices Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases Monitoring and Proper record keeping/reporting especially in out breaks situation	Physical and clinical examination,Diagnosis of Hepatitis E based on signs and symptoms including initial mild fever, reduced appetite nausea and vomiting,abdominal pain, itching (without skin lesions),jaundice,with dark urine and pale stools Supportive treatment including; - proper nutrition - Adequate rest Relieving fever through use of pain killers Referral to a health facility in case symptoms worsens
Referral Facility: General
Create awareness on Hepatitis E disease,the transmission mode and preventive measures to the parents Guidance on good hygiene practices for the childrenGuidance on use of clean and safe drinking water Awareness on good sanitation/including safe human waste disposal in communities. Health workers education on Hepatitis E transmission, prevention and management	Guidance/education on proper hygiene practices including; - Proper disposal of human waste/feaces Maintaining individual hygiene practices Consumption of clean safe water Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases Monitoring and Proper record keeping/reporting especially in out breaks situation	Physical and clinical examination Supportive treatment including: proper nutrition, Adequate rest Admissions for children who may develop severe Hepatitis E (usually due to co-infection with Hep.A) Diagnosis based on Strong link in appropriate epidemiology settings, e.g. when several cases occur in localities in known disease-endemic areas, or in settings with risk of water contamination. Relieving fever through use of pain killers Monitoring and management of any complications main one being fulminant hepatitis (acute liver failure) Rule out hepatitis A Blood tests for detection of specific IgM antibodies to the virus for definitive diagnosis.
Referral Facility: Specialist
Create awareness on Hepatitis E disease,the transmission mode and preventive measures to the parents Guidance on good hygiene practices for the childrenGuidance on use of clean and safe drinking waterAwareness on good sanitation /including safe human waste disposal in communities. Health workers education on Hepatitis E transmission, prevention and management	Guidance /education on proper hygiene practices including: Proper disposal of human waste /feaces Maintaining individual hygiene practices Consumption of clean safe water Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases Monitoring and Proper record keeping/reporting especially in out breaks situation	Monitoring and management of any complications main one being fulminant hepatitis (acute liver failure) N/b There is no specific treatment capable of altering the course of acute hepatitis E.; usually self-limiting disease Supportive treatment including: ** proper nutrition, Adequate rest relieving fever through use of pain killers* Admissions for children who may develop severe Hepatitis E (usually due to co-infection with Hep.A) Physical and clinical examination Diagnosis based on Strong link in appropriate epidemiology settings, e.g. when several cases occur in localities in known disease-endemic areas, or in settings with risk of water contamination. Rule out hepatitis A Blood tests for detection of specific IgM antibodies to the virus for definitive diagnosis.

Condition: Diabetes mellitus

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Create awareness to parents, families and communities on type 1 diabetes Awareness creation on measures to prevent complications of type 1 diabetes among children Awareness creation on healthy diets for children, physical activity Community health workers education on diabetes including type 1 diabetes and its management	Interventions to prevent complications for type 1 diabetes including Helping the child maintain good blood sugar control Teaching the child the importance of eating a healthy diet and participating in regular physical activity Scheduling regular check ups for the child with the health workers -including eye check up	Recognition of signs that are indicative of diabetes in children including Increased thirst, Frequent urination, (possibly bed-wetting in a toilet-trained child), extreme hunger, Unintentional weight loss, Fruity-smelling breath Referral of child suspected to have diabetes to a health facility for definitive diagnosis and management Adherence to medication/administration of insulin injection for the child with type I diabete Giving the child healthy foods Encouraging and helping the child to Exercise regularly Frequent blood sugar monitoring Management of suspected low blood sugar in the child (with a fast-acting carbohydrate, such as fruit juice, glucose tablets, hard candy, soda Recognition of signs of acute diabetic emergencies (low blood sugar and high blood sugar) Emergency referral to a health facility	Community based rehabilitation services - physical speech rehabilitation to help with mobility, speech impairments related to diabetes	Psychosocial support to incorporate total quality of life in diabetics including behavioral, mood, attitude, and emotional support and also to improve adherence to treatment Enrollment to support groups
Primary Care
Create awareness to parents, families and communities on type 1 diabetes Awareness creation on measures to prevent complications of type 1 diabetes among children Awareness creation on healthy diets for children, physical activity Health workers training on diabetes including type 1 diabetes and its management	Interventions to prevent complications for type 1 diabetes including. Helping the child maintain good blood sugar control Teaching the child the importance of eating a healthy diet and participating in regular physical activity Scheduling regular check-ups for the child with the health workers-including eye check up	Clinical examination, Recognition of signs that are indicative of diabetes in children including Increased thirst, Frequent urination, (possibly bed-wetting in a toilet-trained child), extreme hunger, Unintentional weight loss, Fruity-smelling breath Screening for type 1 diabetes through random blood sugar test Referral of child suspected to have diabetes to a health facility for definitive diagnosis and management Recognition and stabilizing the child with acute diabetic emergencies (low blood sugar and high blood sugar) Insulin refill for a child with diabetes/type 1 diabetes Advice to parents on healthy foods for the child with diabetes Guidance and encouraging Exercise regularly Advice on Adherence to medication/(insulin injection) for the child with type I diabetes Frequent blood sugar monitoring Management of suspected low blood sugar in the child before referral Emergency referral to a hospital for management of diabetic complications	Physical, occupational and speech rehabilitation to help with mobility, speech and cognitive impairments related to diabetes	Psycho social support to - incorporate total quality of life in diabetics including behavioral, mood, attitude, and emotional support and also to improve adherence to treatment Linkage of the children and parents/families to support groups
Referral Facility: General
Create awareness to parents, families on type 1 diabetes Awareness creation on measures to prevent complications of type 1 diabetes among children Awareness creation on healthy diets for children, physical activity Health workers training on diabetes including type 1 diabetes and its management	Interventions to prevent complications for type 1 diabetes including Helping the child maintain good blood sugar control Teaching the child the importance of eating a healthy diet and participating in regular physical activity Scheduling regular check-ups for the child with the health workers-including eye check up	Physical and Clinical examination Random and fasting blood sugars for diagnosis of type 1 diabetes Advice to parents on healthy foods for the child with diabetes Guidance and encouraging Exercise regularly Management of type 1 diabetes with insulin injection Frequent blood sugar monitoring and blood glucose control Recognition and management of acute diabetic emergencies (hypoglycaemeia and hyperglycaemia emergencies) Monitoring and control of blood pressure Monitoring and management of any complications including Screening for and management of blood lipid (to regulate cholesterol levels) screening for early signs of diabetes-related kidney disease and treatment Regular examination of the feet and management of any foot ulcers to prevent diabetic foot screening and treatment for retinopathy Follow up	Physical, speech rehabilitation to help with mobility, speech impairments related to diabetes	Counseling for children with diabetes type 1 and their parents/families To help them adjust with the diagnosis and long term treatment Linkage to support groups Psychological support to he child and parents to promoted adherence to medication
Referral Facility: Specialist
Create awareness to parents, families on type 1 diabetes Awareness creation on measures to prevent complications of type 1 diabetes among children Awareness creation on healthy diets for children, physical activity Health workers training on diabetes including type 1 diabetes and its management	Interventions to prevent complications for type 1 diabetes including Helping the child maintain good blood sugar control Teaching the child the importance of eating a healthy diet and participating in regular physical activity Scheduling regular check-ups for the child with the health workers-including eye check up	Physical and Clinical examination Random and fasting blood sugars for diagnosis of type 1 diabetes Advice to parents on healthy foods for the child with diabetes Guidance and encouraging Exercise regularly Screening for and management of blood lipid (to regulate cholesterol levels) screening for early signs of diabetes-related kidney disease and treatment Management of type 1 diabetes with insulin injection Recognition and management of acute diabetic emergencies (hypoglycaemeia and hyperglycaemia emergencies) Regular examination of the feet and management of any foot ulcers to prevent diabetic foot screening and treatment for retinopathy Monitoring and control of blood pressure Monitoring and management of any complications including Frequent blood sugar monitoring and blood glucose control Follow up	Physical, speech rehabilitation to help with mobility, speech impairments related to diabetes	Counseling for children with diabetes type 1 and their parents/families To help them adjust with the diagnosis and long term treatment Linkage to support groups Psychological support to he child and parents to promoted adherence to medication

Condition: Rabies

Health Promotion	Disease Prevention	Curative
Community Level
Awareness creation on rabies and prevention measures including preventing dog bites Education on dog behavior and bite prevention Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites and immediate care measures after a bite Community Health workers training on rabies , prevention measures and its management	Eliminating rabies in dogs- through Vaccinating dogs (multi-sectoral approach with veterinary departments) Advice and Referral to hospitals for Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites,may not report bites.) Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly Record keeping and reporting to the public health departments and veterinary departments	Recognition of animal bite exposures categorized as carrying a risk of developing rabies which include:if the biting mammal is a known rabies reservoir or vector species, the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound was contaminated by the animal’s saliva, the bite was unprovoked, the animal has not been vaccinated. The vaccination status of the suspect animal is questionable First aid to a child following a deep bite or scratch from an animal suspected to have rabies, through extensive wound washing—i.e thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent/anti septic’s such povidone iodine Relive any pain with pain killers such as paracetamol Immediate Referral to a health facility Report/alert the veterinary services to remove the biting animal from the community/quarantined
Primary Care
Awareness creation on rabies and prevention measures including preventing dog bites. Education on dog behavior and bite prevention Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, immediate care measures after a bite. Health workers education on rabies,prevention measures and its management		Advice and Referral to hospital for Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites, may not report bites.) Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly Record keeping and reporting to the public health departments and veterinary departments
Referral Facility: General
Awareness creation on rabies and prevention measures including preventing dog bites. Education on dog behavior and bite prevention Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite. Health workers training on rabies ,prevention measures and its management	Immunization for children with rabies vaccine after exposure (PEP) or before exposure Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites, or may not report bites.) Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly Record keeping and reporting to the public health departments and veterinary departments	Physical and clinical examination, Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include:if the biting mammal is a known rabies reservoir or vector species, the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound or mucous membrane was contaminated by the animal’s saliva; the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable Immediate post exposure prophylaxis of all categorized exposures assessed as carrying a risk of developing rabies; Extensive washing; flushing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure; Administration of rabies vaccine the administration of rabies immunoglobulin (RIG), if indicated. Relieve of any other symptoms such as pain with analgesics Monitor and manage any complications depending on the two forms of rabies – such as cardiopulmonary arrest as a result of furious rabies or muscle paralysis and coma due to paralytic rabies ICU services for patients with complications e.g. those in coma Integrated bite case management/alert the veterinary services to remove the biting animal from the community/quarantined.
Referral Facility: Specialist
Awareness creation on rabies and prevention measures including preventing dog bites. Education on dog behavior and bite prevention Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite. Health workers training on rabies ,prevention measures and its management	Immunization for children with rabies vaccine after exposure (PEP) or before exposure Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites, or may not report bites.) Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly Record keeping and reporting to the public health departments and veterinary departments	Physical and clinical examination, Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include:if the biting mammal is a known rabies reservoir or vector species,the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound or mucous membrane was contaminated by the animal’s saliva; the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable Immediate post exposure prophylaxis of all categorized exposures assessed as carrying a risk of developing rabies; Extensive washing ; flushing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure; Administration of rabies vaccine under supervision of a physician the administration of rabies immunoglobulin (RIG), if indicated. Relieve of any other symptoms such as pain with analgesics Admission services/inpatient services Monitor and manage any complications depending on the two forms of rabies – such as cardiopulmonary arrest as a result of furious rabies or muscle paralysis and coma due to paralytic rabies ICU services for patients with complications e.g. those in coma Integrated bite case management/ alert the veterinary services to remove the biting animal from the community/quarantined.

Condition: Yellow Fever

Health Promotion	Disease Prevention	Curative
Community Level
Education and awareness creation on yellow fever including transmission and prevention measures Awareness creation on yellow fever vaccination Education on vector/mosquito control measures Distribution of IEC materials on Yellow fever Mass awareness campaigns on yellow fever Community health workers training on yellow fever including prevention measures	Promote Vaccination of children for life-long protection against yellow fever disease through Promote Routine infant immunization mass vaccination campaigns designed to increase coverage in countries at risk Promote vaccination for travelers going to yellow fever endemic areas Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities, human disease surveillance and testing Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites. Recording and reporting on yellow fever to health departments	Recognition of features indicative of yellow fever including fever, headache, yellowing of the skin and eyes, muscle pain, nausea, vomiting and fatigue Relieve symptoms through * Relieve fever through use medicines such as paracetamol Relieve pain through use of painkillers such as paracetamol * Give fluids to the patient Referral to a health facility for further management
Primary Care
Education and awareness creation on yellow fever including transmission and prevention measures Education on the need for yellow fever vaccination Education on vector/mosquito control measures Distribution of IEC materials Mass awareness campaigns on yellow fever Health workers training on yellow fever including prevention measures	Promote Vaccination of children for life-long protection against yellow fever disease through Promote Routine infant immunization Mass vaccination campaigns designed to increase coverage in countries at risk Promote vaccination for travelers going to yellow fever endemic areas Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Requirement for travelers to provide certificate of yellow fever vaccine in line with the International Health Regulations (IHR) Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities, human disease surveillance and testing Guidance to children/parents on Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites Recording and reporting on yellow fever to health departments	Physiacl examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including; - Relive pain - Management of fever - Hydration Monitoring for any complications/severity of the disease Stabilize the patient with complications due to yellow fever before referral e.g. administration of oxygen Monitoring, supportive management for any Adverse Events Following Immunization (AEFI) with Yellow fever Vaccine Referral to a hospital for a patient with severe yellow fever and for those with complications due to AEFI for further management
Referral Facility: General
Education and awareness creation on yellow fever including transmission and prevention measures Awareness creation on yellow fever vaccination Education on the need for yellow fever vaccination Education on vector/mosquito control measures Distribution of IEC materials Health workers training on yellow fever including prevention measures	Vaccination of children for life-long protection against yellow fever disease Mass vaccination campaigns designed to increase coverage in countries at risk Vaccination for travelers going to yellow fever endemic areas Yellow fever disease surveillance and Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Requirement for travelers to provide certificate of yellow fever vaccine in line with the International Health Regulations (IHR) Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas ü Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities, human disease surveillance and testing Guidance on Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites Isolation of infected individuals indoors or under mosquito netting to prevent further mosquito exposure and hence cut off the transmission Recording and reporting on yellow fever to health departments	Physiacl examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including Relive pain and fever Monitoring and specific management of the disease depending on the severity including Oxygen administration - Intravenous fluid administration for dehydration Blood pressure control -medications to increase collection/blood_pressure in cases of circulatory collapse - transfusion of blood products in cases of severe bleeding Antibiotics for secondary bacterial_infections Management for any complication due to AEFI with yellow fever vaccine Diagnostic Tests- Blood tests to detect the virus in the early stages of the disease Or demonstrate the presence of virus-specific antibodies (IgM and IgG) in late stages of yellow fever.
Referral Facility: Specialist
Education and awareness creation on yellow fever including transmission and prevention measures ** Education on the need for yellow fever vaccination Education on vector /mosquito control measures Distribution of IEC materials Health workers training on yellow fever including prevention measures	Vaccination of children for life-long protection against yellow fever disease Vaccination for travelers going to yellow fever endemic areas Mass vaccination campaigns designed to increase coverage in countries at risk Yellow fever disease surveillance and Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Requirement for travelers to provide certificate of yellow fever vaccine in line with the International Health Regulations (IHR) Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas ü Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities, human disease surveillance and testing Guidance on Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites Isolation of infected individuals indoors or under mosquito netting to prevent further mosquito exposure and hence cut off the transmission Recording and reporting on yellow fever to health departments	Physical examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including Relive pain and fever Monitoring and specific management of the disease depending on the severity including Oxygen administration Intravenous fluid administration for dehydration Blood pressure control -medications to increase collection/blood_pressure in cases of circulatory collapse · transfusion of blood products in cases of severe bleeding Antibiotics for secondary bacterial_infections_ ICU services for endotracheal intubation and mechanical ventilation in cases of respiratory failure Management for any complication due to AEFI with yellow fever vaccine Diagnostic Tests;- Blood tests to detect the virus in the early stages of the disease or demonstrate the presence of virus-specific antibodies (IgM and IgG) in late stages of yellow fever. Follow up

Condition: Acute Hepatitis C

Health Promotion	Disease Prevention	Curative
Community Level
Create awareness to parents and families on Hepatitis C including transmission, risk factors and prevention measures Mass awareness campaigns during health days such as World Hepatitis Day Community health workers training/sensitization on Hepatitis C, including	Guidance to children on primary prevention measures including Avoiding sharing personal care items that might have blood on them (razors, toothbrushes, nail clippers) Guidance to children on safe handling and disposal of sharps and waste Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver Screening for Hepatitis C infection	Recognition of features indicative of Hepatitis C in children under 5 years of age including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes Supportive Home therapies for Children with Hepatitis C including; - proper nutrition - Plenty of fluids - plenty of rest - relieve pain Referral to a health facility if symptoms worsens
Primary Care
Mass awareness campaigns during health days such as World Hepatitis Day Create awareness to parents and families on Hepatitis C including transmission, risk factors and prevention measures Health workers training on Hepatitis C, including on transmission and prevention measures	Primary prevention measures Injection safety - safe and appropriate use of health care injections Safe handling and disposal of sharps and waste Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver Screening for hepatitis C infection	Physical and clinical examination Diagnosis of hepatitis C in children under 5 years of age based on signs and symptoms including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes. Supportive therapies for under 5s with Hepatitis C including - proper nutrition; fluids therapy - plenty of rest - relieve of pain Monitor for any complications Referral to a hospital if symptoms worsens
Referral Facility: General
Create awareness to parents and families on Hepatitis C including transmission, risk factors and prevention measures Mass awareness campaigns during health days such as World Hepatitis Day Health workers training on Hepatitis C, including transmission, prevention measures and management	Primary prevention measures; Injection safety -safe and appropriate use of health care injections Safe handling and disposal of sharps and waste Training of health personnel on hepatitis C Screening for hepatitis C infection Immunization with the hepatitis A and B vaccines for children with hepatitis C to prevent coinfection from these hepatitis viruses and to protect their liver	Physical and clinical examination Diagnosis of hepatitis C in children based on signs and symptoms including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes Supportive therapies for children with Hepatitis C including - proper nutrition - fluids therapy - PLenty of rest - relieve of pain Monitor for any progression to Chronic Hepatitis C Follow up Deferring anti-retroviral treatment for children aged less than 12 years with chronic HCV infection until 12 years of age
Referral Facility: Specialist
Health workers training on Hepatitis C, including transmission, prevention measures and management Mass awareness campaigns during health days such as World Hepatitis Day Create awareness to parents and families on Hepatitis C including transmission, risk factors and prevention measures	Primary prevention measures Injection safety -safe and appropriate use of health care injections Safe handling and disposal of sharps and waste Training of health personnel on hepatitis C Immunization with the hepatitis A and B vaccines for children with hepatitis C to prevent coinfection from these hepatitis viruses and to protect their liver Screening, for hepatitis C infection	Physical and clinical examination Diagnosis of hepatitis C in children based on signs and symptoms including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes Supportive therapies for children with Hepatitis C including proper nutrition; fluids therapy ; PLenty of rest; relieve of pain Monitor for any progression to Chronic Hepatitis C Follow up WHO -recommends Deferring anti-retroviral treatment for children aged less than 12 years with chronic HCV infection until 12 years of age

Condition: Leprosy

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Strengthening patient and community awareness of leprosy Community Health education to raise suspicion of leprosy by the community members Demand creation for community to seek early diagnosis and treatment Community Capacity building on basic facts about leprosy, signs and symptoms and mode of transmission will improve early diagnosis and treatment Community knowledge that leprosy disease is curable will reduce stigma and discrimination Involving communities in actions for improvement of leprosy services Multi-sectoral approach in addressing leprosy Community Health workers sensitization on Leprosy	Avoidance of close and frequent contacts with persons with untreated leprosy Community screening to identify presumptive leprosy cases Early case detection through active case finding Contact tracing Guidance on prompt start and adherence to treatment Strengthening surveillance for leprosy	Identification of a presumptive leprosy case based on signs including presence of pale (lighter than normal skin) or Hypo pigmented skin patches, Numbness in the hands and feet; Weakness and difficulty in normal movement of fingers/thumb/wrist/toes/ankles or eyelids, Painless injuries, blisters, burns or ulcers in hands and feet; presence of deformities such as clawing of fingers/ thumb, clawing of toes or inability to close eyes properly Guidance/Advice to the parents/families on care for a child with leprosy including Care of Eyes,care of hands and feet, guidance on voluntary muscle testing and sensory testing,use of correct footwear supportive managemnet Referral of a patient suspected to have Leprosy to a health facility for management Supporting a known leprosy patient o Ensure adherence to medicines	Promoting societal inclusion by addressing all forms of discrimination and stigma Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services Promoting coalition-building among persons affected by leprosy including self care groups –such groups encourage each other on self care needs Supporting community-based rehabilitation for people with leprosy-related disabilities Working towards abolishing discriminatory laws and promote policies facilitating inclusion of persons affected by leprosy through a multi sectoral approach	Provide psycho social and counseling support services for families/parents of children affected by leprosy
Primary Care
Strengthening patient and community awareness of leprosy Health education to raise suspicion of leprosy in the community Demand creation for the community/parents with under 5s to seek early diagnosis and treatment for under 5s with Leprosy Community/parents/families Capacity building on basic facts about leprosy,signs and symptoms and mode of transmission will improve early diagnosis and treatment Community knowledge that leprosy disease is curable will reduce stigma and discrimination Involving communities in actions for improvement of leprosy services Health workers education on leprosy including prevention,diagnosis and management	Guidance to parents/families to ensure the under 5s does not come into close and frequent contacts with persons with untreated leprosy Early case detection through active case finding contact tracing. Surveillance for leprosy Recording and reporting ON leprosy (health information systems for program monitoring and evaluation) Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities		History and clinical examination,Diagnosis of Leprosy based on the cardinal signs; 1.loss of sensation in a pale (hypo pigmented)reddish skin patch 2. Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve 3. Presence of acid-fast bacilli in a slit-skin smear (confirmatory test) Hospital admission Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatmentFollow up for patients Management of Leprosy with Multidrug therapy (MDT)(dapsone,rifampicin and clofazimine) Prevention and management of disabilities Guidance /Advice to parents on care for children with leprosy including Care of Eyes, care of hands and feet, guidance on voluntary muscle testing and sensory testing use of correct footwear Strengthening surveillance for antimicrobial resistance including laboratory network Follow up for patients	Psycho-social support and counseling services,for parents/families with under 5s affected by leprosy
Referral Facility: General
Strengthening patient and community awareness of leprosy Community Health education to raise suspicion of leprosy by the community members Demand creation for community to seek early diagnosis and treatment Community Capacity building on basic facts about leprosy, signs and symptoms and mode of transmission will improve early diagnosis and treatment Community knowledge that leprosy disease is curable will reduce stigma and discrimination Involving communities in actions for improvement of leprosy services Multi-sectoral approach in addressing leprosy Health workers training on leprosy including prevention, diagnosis and management		physical and clinical examination Presumptive diagnosis of Leprosy based on cardinal signs: Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch * Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve* Guidance to the elderly leprosy patient on adherence to treatment, Guidance /Advice to elderly patients with leprosy on self-care including Care of Eyes; care of hands and feet; guidance on voluntary muscle testing and sensory testing use of correct footwear Hospital admission Management of Leprosy with Multidrug therapy (MDT) Prevention and management of disabilities. Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment Strengthening surveillance for antimicrobial resistance including laboratory network. Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities	Guidance and Ensuring adherence to treatment for known leprosy patients Guidance/Advice to parents on care for the child with Leprosy including Care of Eyes,care of hands and feet, guidance on voluntary muscle testing and sensory testing use of correct footwear History and clinical examination Presumptive diagnosis of Leprosy based on cardinal signs; Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch, Thickened or enlarged peripheral nerve with loss of sensation or weakness of the muscles supplied by that nerve Referral to a hospital for definitive diagnosis and for further management Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs,eyes	Promoting societal inclusion by addressing all forms of discrimination and stigma Promoting coalition-building among persons affected by leprosy including self care groups –such groups encourage each other on self care needs Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services Supporting community-based rehabilitation for people with leprosy-related disabilities.
Referral Facility: Specialist
Strengthening patient and community awareness of leprosy Community Health education to raise suspicion of leprosy by the community members Demand creation for community to seek early diagnosis and treatment Community Capacity building on basic facts about leprosy, signs and symptoms, and mode of transmission will improve early diagnosis and treatment Community knowledge that leprosy disease is curable will reduce stigma and discrimination Involving communities in actions for improvement of leprosy services Multi-sect oral approach in addressing leprosy Health workers training on leprosy including prevention, diagnosis and management		physical and clinical examination Presumptive diagnosis of Leprosy based on cardinal signs: Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch * Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve* Prevention and management of disabilities. Hospital admission Management of Leprosy with Multidrug therapy (MDT) Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment Strengthening surveillance for antimicrobial resistance including laboratory network. Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities	Physical rehabilitation services for under 5s with complications of Leprosy/leprosy related disabilities Linkage of parents/families of under 5s with leprosy to support groups /self care groups Guidance to communities on need for inclusion of families with under 5s affected by leprosy by addressing all forms of discrimination and stigma. Guidance to parents with under 5s affected by leprosy on how to participate actively in leprosy services..	Promoting coalition-building among persons affected by leprosy including self care groups –such groups encourage each other on self care needs Promoting societal inclusion by addressing all forms of discrimination and stigma Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services Supporting community-based rehabilitation for people with leprosy-related disabilities.

Condition: Ascariasis

Health Promotion	Disease Prevention	Curative
Community Level
Education and social mobilization for successful prevention and control of ascariasis Community-led total sanitation with market approaches (CLTS+), promotion of hygiene, building of latrines, and related SBC.	Proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Avoidance of consuming or contact with soil that may be contaminated with human faecal matter Community-based deworming campaigns	Antispasmodics Analgesics Nutritional support Referral to health facility for definitive diagnosis and treatment
Primary Care
Health education on risk factors for ascariasis and preventive measures such as good sanitation and hygiene practice	Mass drug administration with albendazole
Referral Facility: General
Health education to parents/families on ascariasis and prevention measures in children Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter Health workers training on ascariasis including prevention measures and its management in children	Guidance parents/children on primary prevention measures incluidng; Proper cleaning and cooking of food proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Avoidance of consuming or contact with soil that may be contaminated with human feacal matter Proper waste disposal/ not passing stool in the soil or outdoors Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure Taking safety precautions like wearing gloves when handling soil/manure Promoting good nutrition for children	Anthelmintic Steroids for complication Surgery for obstruction
Referral Facility: Specialist
Health education to parents/families on ascariasis and prevention measures in children Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter Health workers training on ascariasis including prevention measures and its management in children	Guidance parents/children on primary prevention measures incluidng : Proper cleaning and cooking of food proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Avoidance of consuming or contact with soil that may be contaminated with human feacal matter Proper waste disposal/ not passing stool in the soil or outdoors Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure Taking safety precautions like wearing gloves when handling soil/manure Promoting good nutrition for children	Anthelmintic Steroids for complication Surgery for obstruction

Condition: Tetanus

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Awareness Creation among communities/families on Tetanus and preventive measures Creation of awareness on importance of child vaccination and on vaccination schedule Health education activities to increase community awareness of the importance of tetanus immunization Distribution of IEC materials on Tetanus Training the community Health workers on tetanus, including prevention measures/on vaccination including schedules/detection of Tetanus	Immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes Advise to parents/families on proper wound care Proper care for minor Wounds in children-thorough cleaning of the wound and covering to prevent infections Effective surveillance to identify areas or populations at high risk of tetanus Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards Outreach activities in order to increase TT immunization coverage	Recognition of symptoms indicative of tetanus in a child including jaw cramping or the inability to open the mouth (lock jaw), muscle spasms often in the back, abdomen and extremities, sudden painful muscle spasms often triggered by sudden noises, trouble swallowing, seizures, Headache, fever and sweating Immediate referral to a health facility for a child suspected to have tetanus	Home based/community based physical therapy rehabilitation for muscle movements	Psycho social support and counseling Linkage to patient support groups
Primary Care
Awareness Creation among parents and families on Tetanus and preventive measures Creation of awareness on importance of infant/child vaccination and on vaccination schedule Training Health care workers on Tetanus prevention measures and management among under 5s	Immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes Proper wound care for the under 5s Effective surveillance to identify areas/populations at high risk of tetanus Effective tetanus vaccination monitoring sy stem including immunization register,personal vaccination cards Outreach activities in order to increase TT immunization coverage Data keeping/monitoring the impact of interventions and reporting	Physical and clinical examination Clinical diagnosis of tetanus based on Clinical features Non-neonatal tetanus requires at least one of the following signs; a sustained spasm of the facial muscles in which the person appears to be grinning, painful muscular contractions And with a history of injury or wound, tetanus (but may also occur in patients /in a child whose parents/family are unable to recall a specific wound or injury) Relieve of other symptoms such as headache with analgesics, fever with anti pyretic Proper wound care Immediate referral of the child to a hospital for management	Physiotherapy, rehabilitation for muscle movements	Psycho social support to parents/families and counseling Linkage to patient/parents/families to support groups
Referral Facility: General
Awareness Creation among parents and families on Tetanus and preventive measures Creation of awareness on importance of infant/child vaccination and on vaccination schedule Training Health care workers on Tetanus, prevention measures and management among under 5s	Immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes Proper wound care for the under 5s Proper wound care for surgical and dental procedures Effective surveillance to identify areas or populations at high risk of tetanus Data keeping/monitoring the impact of interventions and reporting	** Physical and clinical examination Clinical diagnosis of tetanus based on Clinical features Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions and with a history of injury or wound, tetanus (but may also occur in children whose parents/families are unable to recall a specific wound or injury) Relieve of other symptoms such as headache with analgesics, fever with anti pyretic Management/control of muscle spasms Administration of antibiotics Tetanus Vaccination for the under 5 since infection with tetanus does not confer natural immunity Prevention and management of any complications such as respiratory failure Referral to specialised Intensive care services to manage any complications/severe tetanus e.g for ventilation follow up	Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor movements	Psycho social support of the parents/families and counseling Linkage to parents/families to support groups
Referral Facility: Specialist
Awareness Creation among parents and families on Tetanus and preventive measures Creation of awareness on importance of infant/child vaccination and on vaccination schedule	Immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes Proper wound care for the under 5s Proper wound care for surgical and dental procedures Data keeping/monitoring the impact of interventions and reporting Effective surveillance to identify areas or populations at high risk of tetanus Outreach activities in order to increase TT immunization coverage	Physical and clinical examination Clinical diagnosis of tetanus based on Clinical features Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in children whose parents /families are unable to recall a specific wound or injury)* Relieve of other symptoms such as headache with analgesics, fever with anti pyretic Immediate admission for under 5 with tetanus(Tetanus is a medical emergency) Immediate management with medicines human tetanus immune globulin (TIG) Aggressive wound care for the under 5 with tetanus Prevention and management of any complications such as respiratory failure Intensive care services to manage any complications/severe tetanus e.g for ventilation Management/control of muscle spasms Administration of antibiotics Tetanus Vaccination for the under 5 since infection with tetanus does not confer natural immunity Follow up	Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor movements	Psycho social support of the parents /families and counseling Linkage to parents/families to support groups

Condition: Trichuriasis

Health Promotion	Disease Prevention	Curative
Community Level
	Proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Avoidance of consuming or contact with soil that may be contaminated with human faecal matter Mass drug administration with albendazole Deworming	Anthelmintic Antispasmodics Analgesics
Primary Care
Health education on risk factors for trichuriasis and preventive measures such as good sanitation and hygiene practice	Guidance to parents on Proper cleaning and cooking of food for the under Teaching children on proper handwashing/good hand hygiene practices Teaching children on avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter Guidance to children on Proper waste disposal-Not passing stool in the soil or outdoors Guidance to parents to Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure before giving children Taking safety precautions for children like wearing gloves when handling soil/manure Promoting good nutrition for children	Anthelmintic Antispasmodics Analgesics
Referral Facility: General
Health education to parents/families on Trichuriasis and prevention measures in children Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter Health workers education on Trichuriasis including prevention measures and its management in children	Guidance to parents on Proper cleaning and cooking of food for the under 5s Teaching children on proper handwashing/good hand hygiene practices Teaching children on avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter Guidance to children on Proper waste disposal-Not passing stool in the soil or outdoors Guidance to parents to Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure before giving children Taking safety precautions for children like wearing gloves when handling soil/manure Promoting good nutrition for children	Anthelmintic
Referral Facility: Specialist
Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter Health education to parents/families on Trichuriasis and prevention measures in children Health workers education on Trichuriasis including prevention measures and its management in children	Guidance to parents on Proper cleaning and cooking of food for the under 5s Teaching children on proper handwashing/good hand hygiene practices Teaching children on avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter Guidance to children on Proper waste disposal-Not passing stool in the soil or outdoors Guidance to parents to Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure before giving children Taking safety precautions for children like wearing gloves when handling soil/manure Promoting good nutrition for children	Anthelmintic

Condition: Birth asphyxia

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Educate pregnant women on the need for regular ANC and facility births attended by a skilled birth attendants * Promote good maternal nutrition/including nutritional supplementation	Education of mothers and caregivers about signs and symptoms of asphyxia using job aides Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	Timely referral to the next level	Health Education to pregnant women to create awareness on birth asphyxia Health education to pregnant women on the need for regular ANC follow up and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth asphyxia including management	Psychological support to parents of babies with birth-related complications Physical therapy for children with neurological complications
Primary Care
Health Education to pregnant women to create awareness on birth asphyxia Health education to pregnant women on the need for regular ANC follow up and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth asphyxia including management	Educate pregnant women to deliver at health facility by skilled birth attendant Full assessment of all newborn with Apgar score Monitoring quality of care and instituting remedial measures Timely referral for mothers Use partograph for labour monitoring. Ensure supportive 2nd stage management based on foetal and maternal condition. Manage pre-eclampsia correctly.	Assess, look and classify all new born using IMNCI guidelines Manage neonate based on the IMNCI classification * Refer to next level with ongoing resuscitation if not responsive to procedures Refer responsive neonates to next level for further assessment and observation	Follow up neonates treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones Referral for management of any complications eg speech therapy if speech is affected, physical rehabilitation	Psychological support to parents of babies with birth-related complications Physical therapy for children with neurological complications
Referral Facility: General
Health Education to pregnant women to create awareness on birth asphyxia Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth asphyxia including management	Educate pregnant women to deliver at health facility by skilled birth attendant * Full assessment of all newborn with Apgar score Monitoring quality of care and instituting remedial measures Timely referral for mothers Use partograph for labour monitoring. Ensure supportive 2nd stage management based on foetal and maternal condition. Manage pre-eclampsia correctly.	History and physical examination Bag and mask ventilation Maintain normal temperature Oxygen by nasal cannula or hood. *Normal saline bolus Transfuse in case of blood loss Intravenous dextrose Anti-epileptic drugs IV fluids Intra gastric tube feeding Monitor urine output Resuscitate in special care baby unit (SCBU) for those not responding Refer If no improvement or deterioration	Managemnet of any complications eg speech therapy if speech is affected, physical rehabilitation Follow up children treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech
Referral Facility: Specialist
Health Education to pregnant women to create awareness on birth asphyxia Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth asphyxia including management	Educate pregnant women to deliver at health facility by skilled birth attendant * Full assessment of all newborn with Apgar score Monitoring quality of care and instituting remedial measures Timely referral for mothers Use partograph for labour monitoring. Ensure supportive 2nd stage management based on foetal and maternal condition. Manage pre-eclampsia correctly.	History and physical examination Dry neonate and place supine under overhead warmer Antibiotics therapy for neonates with possible severe bacterial infections Neonatal resuscitation including oxygen therapy Suctioning of airways Tactile stimulation to encourage spontaneous breathing Bag-mask ventilation (Ambu bag) for non-responsive neonates Chest compression if heart rate does not improve Encourage kangaroo mother care /or kangaroo father care ICU Services -e.g. for life support where indicated Laboratory tests e.g. blood gases analysis, Imaging modalities such as ultrasound, CT scan, MRI Electroencephalogram (EEG)	managemnet of any complications eg speech therapy if speech is affected; physical rehabilitation Follow up children treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones

Condition: Birth trauma

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Health Education to pregnant women to create awareness on birth trauma Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth trauma including management	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	Refer neonates with suspected birth trauma to next level for further assessment	Follow up children with residual effects of birth trauma with any needed home based physiotherapy support Referral of children with permanent nerve injuries to hospital for specialist assessment and advice on further management	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Primary Care
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk	Refer neonates with confirmed birth trauma to next level Safe transportation of neonates/small babies Kangaroo father care and/or Kangaroo mother care Breastfeeding/nutritional support	Health Education to pregnant women to create awareness on birth trauma Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth trauma including management	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Referral Facility: General
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk Full assessment of all newborn with Apgar score * Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression	Admit to special care baby unit (SCBU) for intensive care management Laboratory services /investigations that include but are not limited to: blood film microscopy, blood group and cross-match, blood chemistry, CSF and stool and urine microscopy, gram stain,	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk * Full assessment of all newborn with Apgar score * Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Referral Facility: Specialist
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size to identify those in high risk (narrow pelvis, big babies, etc.) * Ultrasound examination for gestational age, foetal presentation and foetal weight for early identification	Admit to SBCU for intensive care management Imaging modalities including x-ray, ultrasound, MRI and CT scan Laboratory investigations as indicated * Blood grouping and transfusion if indicated	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc

Condition: Iodine deficiency

Health Promotion	Disease Prevention	Curative
Community Level
Educate mothers and families on ways of providing nutritious diets for children Educate on the benefits of cooking with iodized salt	Education of proprietors of pre-school facilities on adding provision of one healthy meal to children in their facilities Educate on the benefits of cooking with iodized salt Examine children during home visits for signs of goiter and other signs of iodine deficiency	Follow up cases of iodine deficiency being managed at home to ensure compliance with treatment and advice Refer children with suspected iodine deficiency next level for further assessment and management
Primary Care
Educate mothers and families on ways of providing nutritious diets for children Educate on the benefits of cooking with iodized salt		Refer cases of iodine deficiency and cases of goiter to hospital for treatment
Referral Facility: General
		Treat iodine deficiency cases with iodide with or without levothyroxine
Referral Facility: Specialist
		Treat iodine deficiency cases with iodide with or without levothyroxine

Condition: Neonatal sepsis and infections

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Early initiation and exclusive breastfeeding of neonates Appropriate cord care Emphasis on the need for early referral to health facility for every sick young infant	Early Referral to the next level for neonates suspected with neonatal sepsis Keeping baby warm all times including on the way to hospital	Physical therapy for children with neurological complications	Psychological support from the community to parents of babies with birth-related complications
Primary Care
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Clean delivery practices and handwashing during delivery Appropriate cord care	Clean cord with chlorhexidine antiseptics Refer to hospital if neonate is not improving		Psychological and social support to parents of babies with birth-related complications Psychological and social support to parents of babies with birth-related complications
Referral Facility: General
Education of mothers and other caregivers about signs and symptoms of neonatal infection using job aides * Education of mothers on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord.	Clean delivery practices and handwashing during delivery Appropriate cord care	Antibiotics IV hydration Oxygen support Appropriate feeding including breast feeding Blood products transfusion Vasopressor agents		Psychological and social support to parents of babies with birth-related complications
Referral Facility: Specialist
Education of mothers and other caregivers about signs and symptoms of neonatal infection using job aides Education of mothers on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord.	Training of health workers on the nine steps on essential newborn care to prevent neonatal sepsis	Antibiotics IV hydration Oxygen support Blood products transfusion Vasopressor agents		Psychological and social support to parents of babies with birth-related complications

Condition: Protein-energy malnutrition

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness on appropriate and timely complementary feeding and healthy infant and young child nutrition Education on use of safe water and good compound practices	Examine children during home visits for signs of protein energy malnutrition and advise parents accordingly Education of proprietors of pre-school facilities on adding provision of one healthy meal to children in their facilities	Recognition of protein energy malnutrition signs and symptoms Community based MUAC and bilateral oedema screening	Community-based therapeutic feeding Immediate transfer of sever cases to a higher-level health care facility	Home based nutritional rehabilitation	Emotional and social support for the child and family
Primary Care
Health education on feeding, good hygiene practices and regular growth monitoring	Group and focused counselling of mothers and carers on MIYCN- Early initiation of breastfeeding, appropriate and timely complementary feeding, food demonstrations. Improved sanitation and hygiene practices	History Physical examination Mid-upper arm circumference (MUAC) Weight-for-height z-score (WHZ) Presence or absence of oedema	F-75 and F-100 therapeutic milks Ready-to-use therapeutic food (RUTF) Vitamin A supplementation Folic acid Deworming Antibiotics Measles vaccination Antimalarial	Nutritional rehabilitation	Emotional and social support for the child and family
Referral Facility: General
Health education on timely complementary feeding and good hygiene practices		History Physical examination Mid-upper arm circumference (MUAC) Weight-for-height z-score (WHZ) Presence or absence of oedema	F-75 and F-100 therapeutic milks Ready-to-use therapeutic food (RUTF) Vitamin A supplementation Folic acid Deworming Antibiotics Measles vaccination Antimalarial Blood transfusion Manage hypothermia Manage hypoglycaemia Mange electrolyte imbalances	Nutritional rehabilitation	Emotional and social support for the child and family
Referral Facility: Specialist
Health education on timely complementary feeding and good hygiene practices		History Physical examination Mid-upper arm circumference (MUAC) Weight-for-height z-score (WHZ) Presence or absence of oedema	Educate mothers on feeding of children through provision of practical examples using local foods Treat existing infections in severe cases Provide macronutrients for severe cases by appropriate means (orally, feeding tube, nasogastric tube, gastrostomy tube) Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide children with multivitamin supplement Treat mild to moderate cases with balanced oral diet Correct fluid and electrolyte imbalances for severe cases Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide children with multivitamin supplement	Nutritional rehabilitation	Emotional and social support for the child and family

Condition: Preterm birth complications

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
				Follow up of babies delivered preterm who have been discharged home for monitoring of neuro-developmental milestones
Primary Care
				Follow up of babies delivered preterm who have been discharged home for monitoring of neuro developmental milestones
Referral Facility: General

Referral Facility: Specialist

Condition: Vitamin A deficiency

Health Promotion	Disease Prevention	Curative
Community Level
Educate mothers and families on ways of providing nutritious diets for children and whole family using locally available foods with emphasis on Vitamin A rich foods	Examine children during home visits for signs of Vitamin A deficiency and advise parents accordingly Education of proprietors of pre-school facilities on adding provision of one healthy meal to children in their facilities Vitamin A supplementation for children under 5	Recognition of symptoms that may be indicative of vitamin A defficeincy eg Dry and rough skin.; Eye inflammation affecting the eyelids, surrounding tissues, and even eyes Guidance to parents/families on feeding child with viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables. Vitamin A supplemnts Refer people with suspected Vitamin A deficiency next level for further assessment and management Follow up cases of Vitamin A deficiency being managed at home to ensure compliance with treatment and advice Vitamin A treatment for children and infants with complicated measles
Primary Care
Educate mothers and families on ways of providing nutritious diets for children and whole family using locally available foods with emphasis on Vitamin A rich foods	Educate parents/ families on feeding of children through provision of practical examples using local foods with emphasis on Vitamin A rich foods Vitamin A supplementation for children under 5	Physical and clinical assessmnet Guidance to parents/families on feeding child with viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables. Treat Vitamin A deficiency with Vitamin A supplemnts Treating underlying causes /conditions Referrals to hospital Follow up
Referral Facility: General
		Physical and clinical assessmnet Guidance to parents/families on feeding child with viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables. Treat Vitamin A deficiency with Vitamin A supplemnts Treating underlying causes /conditions Follow up
Referral Facility: Specialist
		Physical and clinical assessmnet Guidance to parents/families on feeding child with viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables. treat Vitamin A deficiency with Vitamin A supplemnts Treating underlying causes /conditions Follow up

Condition: Leukemia

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
	Refer people with anaemia or easy bruising and bleeding or recurrent infection to next level for assessment	Immediate transfer of suspected cancer cases to a higher-level health care facility	Psychosocial support for people diagnosed with the disease Supervision of people diagnosed with the condition for compliance with management	Community and home-based care for providing pain relief Psychosocial support to patients and their families
Primary Care
		Immediate transfer of suspected cancer cases to a higher-level health care facility	Physical therapy
Referral Facility: General
		Immediate transfer of suspected cancer cases to a higher-level health care facility	Physical therapy	Palliative care for providing relief of pain and other associated symptoms Psychosocial support to patients and their families
Referral Facility: Specialist
		Chemotherapy Targeted therapy Immunotherapy Bone marrow or Stem cell transplantation Radiotherapy	Physical therapy Occupational therapy	Palliative care for providing relief of pain and other associated symptoms Psychosocial support to patients and their families

Condition: Breast cancer

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Health and Wellness education on diet management, regular exercise, weight management, reduced exposure to radiation, reducing alcohol intake and avoiding exposure to tobacco smoke Pursue intersectoral collaborations, with Ministry of Agriculture and its agencies, that make nutritious food sources available and affordable Pursue intersectoral collaborations with Ministry of Environment, that reduce exposure to sources of radiation Parents education on need for breastfeeding (exclusive for 6 months and breastfeeding at least upto 2 years	Health Education on Breast Cancer–symptoms, risk factors, available treatment, need for prevention, early detection and early reporting for management		Social Marketing campaigns instituted towards generating empathy and promotion social inclusion of those who have completed a treatment cycle Promotion of manufacturing of prosthetics, post-Surgical treatment	Set up publicly owned-and-run hospices Promote private sector participation in setting up hospices and palliative care centers
Primary Care
			Provision of Clinical Psychology services as part of Primary Care for clients who have completed treatment cycles	Set up publicly run hospices to collaborate with Primary Care Centers
Referral Facility: General
		Institute Specialist teams to offer a combination of Surgery, Chemotherapy and Radiotherapy depending on the stage of the condition Ductal Carcinoma-In-Situ (DCIS) – Surgery and Radiotherapy
Referral Facility: Specialist
		Physical examination supportive therapy relive pain Nutritional support managemnet of any opportunistc infections Investigations Biopsy Ultrasoud MRI N/B Often when children have tumors in their breast tissue, the tumors aren’t cancerous but mainly fibroadenomas. (Benign in nature) Surgery to remove the tumour Radiotherapy follow up

Condition: Corpus uteri cancer

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
	Health Education on Endometrial Cancer – symptoms, risk factors, available treatment, need for prevention, early detection and early reporting for management		Social Marketing campaigns instituted towards generating empathy and promotion social inclusion of those who have completed a treatment cycle Promotion of manufacturing of prosthetics, post-Surgical treatment	Set up publicly owned-and-run hospices Promote private sector participation in setting up hospices and palliative care centres
Primary Care
			Provision of Clinical Psychology services as part of Primary Care for clients who have completed treatment cycles	Set up publicly run hospices to collaborate with Primary Care Centers
Referral Facility: General
		Stage I – Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) Stages II and III – Pelvic Radiation and Chemotherapy Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) may also be done Stage IV – Surgery, Chemotherapy, Radiotherapy and Hormonal Therapy may be used in various combinations
Referral Facility: Specialist
		Stage I – Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) Stages II and III – Pelvic Radiation and Chemotherapy Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) may also be done Stage IV – Surgery, Chemotherapy, Radiotherapy and Hormonal Therapy may be used in various combinations

Condition: African trypanosomiasis

Health Promotion	Disease Prevention	Curative
Community Level
Public education on personal protection against the bites of the tsetse fly Community leaders and advocates engagement to eliminate breeding sites for tsetse fly and identification of barriers to accessing care	Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Use of personal repellents and protective clothing
Primary Care
		Physical and clinical examinaton Direct observation of tredatrmnet offered at the hospital level (for outpatient referred back to primary facilities for obsaervation) Monitor any complicdations including adverse drugs reaction and refer Referal to a hospital for a patient suspected to have african trypanasomiasis
Referral Facility: General
		Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
		Physical and clinical examinaton Experienced staff to conduct clinical assessment For T.b. gambiense * Treatment under direct observation either through outpatient or as inpatients Admission/inpatient services Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated Management of relapses Mananagement of nay complications eg reduce the risk of encephalopathy Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy. Diagnostic tests Microscopy of fresh blood chancre fluid or lymph node aspirate Microscopy of celebral spinal fluid (CSF) (wet preparation)

Condition: Malaria

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Community mobilization and engagement in malaria prevention and control activities Mass media on malaria prevention measures Mass media on malaria prevention measures Community based campaigns to promote use of bed nets, early health seeking behaviour Community mobilization and engagement on malaria prevention and control measures * Environmental Sanitation	''insecticide-treated nets (ITNs)" Indoor residual spraying (IRS) Indoor residual spraying (IRS) plus insecticide treated bed nets (ITN) Larviciding Insecticide-treated nets (ITNs) Indoor residual spraying (IRS) Larvicidal activities Environmental management Perennial malaria chemoprevention (PMC)	Recognition of malaria signs and symptoms Rapid diagnostic tests (RDTs)	Oral antimalarial treatment Pre-referral artesunate rectal suppository Immediate transfer of severe or unresponsive cases to a higher-level health care facility Diagnosis confirmation for malaria parasites using rapid diagnostic tests Oral antimalaria for treatment of uncomplicated P. falciparum malaria * Oral antipyretics for fever * Follow up on malaria treatment adherence Refer unresponsive or severe cases to the next higher level
Primary Care
Health education on early identification of malaria symptoms and early treatment	Integrated vector control management (ITN, IRS, larva source management) Intermittent preventive treatment for infants (IPTi) alongside routine vaccinations RTS, S Malaria vaccine Perennial malaria chemoprevention (PMC) Seasonal malaria chemoprevention (SMC) RTS, S Malaria vaccine Early identification and treatment of malaria Insecticide treated bed net for malaria cases	History Physical examination Microscopy Rapid diagnostic tests (RDTs)	Oral antimalaria treatment Intramuscular antimalarials empiric therapy for initial phase treatment of severe malaria * Pre-referral artesunate rectal suppository Immediate transfer of severe or unresponsive cases to a higher-level health care facility Diagnosis confirmation for malaria parasites- microscopy or RDT * Basic laboratory tests (blood, urine, etc) Oral antimalaria for treatment of uncomplicated P. falciparum malaria Intravenous antimalarials for initial treatment of severe P. falciparum malaria Intramuscular antimalarials empiric therapy for initial phase treatment of severe malaria Intravenous glucose for hypoglycaemia Oral antipyretics for fever * Rectal artesunate suppository for pre-referral therapy Refer unresponsive or severe cases to the next higher level
Referral Facility: General
Health education on early identification of malaria symptoms and early treatment	Early identification and treatment of malaria Insecticide treated bed net for malaria cases	History Physical examination Microscopy Full blood count Renal function tests Liver function tests Blood grouping and cross-match	Intravenous antimalarials for treatment of severe malaria IV Glucose IV anticonvulsants Blood and blood product transfusion Immediate transfer of unresponsive or complicated cases to a higher-level health care facility
Referral Facility: Specialist
	Early identification and treatment of malaria Insecticide treated bed net for malaria cases	History Physical examination Microscopy PCR-based tests Full blood count Renal function tests Liver function tests Blood grouping and cross-match	Intravenous antimalarial for severe malaria IV Glucose IV anticonvulsants * Blood and blood product transfusion Haemodialysis for acute kidney injury Intensive care unit for cerebral malaria

Condition: Schistosomiasis

Health Promotion	Disease Prevention	Curative
Community Level
Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter	Observation of good hygiene practices in food preparation Provision of portable water to homes and communities Early recognition of danger signs by the family members Early health seeking behaviour Mass drug administration	Identification of features/signs indicative Relief of any abdominal pain Oral rehydration with oral fluids, Nutritional support (proper nutrition) Administer treatment for prevalent NTDs Referral to health facility for definitive diagnosis and treatment
Primary Care
Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter	Periodical deworming to eliminate infecting worms, Health education to prevent re-infection, Access to safe water, adequate sanitation and hygiene Mass drug administration (MDA) for lymphatic filariasis (LF), onchocerciasis, schistosomiasis, trachoma, soil-transmitted helminth (STH) infections (ascariasis, hookworm, and trichuriasis) Monitor adverse events during MDA Counselling on to clean and disinfect commonly used surfaces	Confirm diagnosis with laboratory tests Relief of any abdominal pain Nutritional support (proper nutrition) * Administer treatment for prevalent NTDs Follow up and prevention of complications e.g. anaemia Referral to hospital for management of complications
Referral Facility: General
Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter and protection from insect bites	Periodical deworming to eliminate infecting worms, Health education to prevent re-infection, Improved sanitation to reduce soil contamination with infective eggs. * Preventive chemotherapy students including the whole community residing Counselling on to clean and disinfect commonly used surfaces Integrated vector control	Antigen detection (ICT) or microfilaria detection (microscopy) in whole blood, for LF Nodule detection using rapid techniques and skin snip for onchocerciasis Detection of eggs in urine or stool Eyelid examination for follicular inflammation (TF) Relief of any abdominal pain Oral rehydration with oral fluids, Nutritional support (proper nutrition) Administer treatment Follow up and prevention of complications e.g., anaemia Referral to hospital for management of complications
Referral Facility: Specialist
Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter	Periodical deworming to eliminate infecting worms, Health education to prevent re-infection, Improved sanitation to reduce soil contamination with infective eggs. Mass drug administration to infected community	Antigen detection (ICT) or microfilaria detection (microscopy) in whole blood, for LF Nodule detection using rapid techniques and skin snip for onchocerciasis Detection of eggs in urine or stool Eyelid examination for follicular inflammation (TF) Oral rehydration with oral fluids, Nutritional support (proper nutrition) Administer treatment for NTDs Prevention and management of any complications Follow up for children including those who may have cognitive delays Surgical interventions for complications,

Condition: Echinococcosis

Health Promotion	Disease Prevention	Curative
Community Level
Improved water sanitation and hygiene in the community Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)	Public education campaigns on prevention - Limit the areas where dogs are allowed - Prevent animals from consuming meat infected with cysts - Do not allow dogs to feed on rodents and other wild animals - Avoid contact with wild animals such as foxes, coyotes and stray dogs - Do not encourage wild animals to come close to your home or keep them as pets - Prevent dogs from feeding on the carcasses of infected sheep - Control stray dog populations - Restrict home slaughter of sheep and other livestock - Do not consume any food or water that may have been contaminated by fecal matter from dogs - Wash your hands with soap and warm water after handling dogs, and before handling food - Teach children the importance of washing hands to prevent infection - Periodic deworming of domestic carnivores (dogs etc.) with praziquantel (at least 4 times per year) - Vaccination of sheep with an E. granulosus recombinant antigen (EG95) A programme	Treatment - Both albendazole 10 to 15 mg/kg body weight per day (max 800 mg orally in two doses) and, as a second choice for treatment, mebendazole 40-50 mg/kg body weight per day continuously for several months have been highly effective.
Primary Care
Improved water sanitation and hygiene in the community Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)	Public education campaigns on prevention - Limit the areas where dogs are allowed - Prevent animals from consuming meat infected with cysts - Do not allow dogs to feed on rodents and other wild animals - Avoid contact with wild animals such as foxes, coyotes and stray dogs - Do not encourage wild animals to come close to your home or keep them as pets - Prevent dogs from feeding on the carcasses of infected sheep - Control stray dog populations - Restrict home slaughter of sheep and other livestock - Do not consume any food or water that may have been contaminated by fecal matter from dogs - Wash your hands with soap and warm water after handling dogs and before handling food - Teach children the importance of washing hands to prevent infection - Periodic deworming of domestic carnivores (dogs etc.) with praziquantel (at least 4 times per - Vaccination of sheep with an E. granulosus recombinant antigen (EG95) A programme	Diagnosis - Ultrasonography imaging is the technique of choice for the diagnosis of both cystic echinococcosis and alveolar echinococcosis in humans. Treatment - Both albendazole 10 to 15 mg/kg body weight per day (max 800 mg orally in two doses) and, as a second choice for treatment, mebendazole 40-50 mg/kg body weight per day continuously for several months have been highly effective - Percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique
Referral Facility: General
Improved water sanitation and hygiene in the community Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)
Referral Facility: Specialist
Improved water sanitation and hygiene in the community Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)

Condition: Cysticercosis

Health Promotion	Disease Prevention	Curative
Community Level

Primary Care

Referral Facility: General
Widespread Improvement of water, sanitation and hygiene conditions - Strict meat inspection	Health education - Identification and treatment of tapeworm carriers - Cooking pork and beef well - Avoid foods that might be contaminated by human faeces. Food handlers should be educated in good handwashing practices	Anthelminthic therapy using albendazole (conventional dosage 15 mg/kg/day in 2 divided doses for 15 days) may be superior to praziquantel (50 mg/kg/day for 15 days) for the treatment of neurocysticercosis Co-administration of corticosteroids that cross the blood brain barrier (e.g. dexamethasone) is used to mitigate these effects Treatment of edema, intracranial hypertension or hydrocephalus, which may include ventricular shunt or other neurosurgical procedures
Referral Facility: Specialist
Widespread Improvement of water, sanitation and hygiene conditions - Strict meat inspection	Health education - Identification and treatment of tapeworm carriers - Cooking pork and beef well - Avoid foods that might be contaminated by human faeces. Food handlers should be educated in good handwashing practices	Anthelminthic therapy using albendazole (conventional dosage 15 mg/kg/day in 2 divided doses for 15 days) may be superior to praziquantel (50 mg/kg/day for 15 days) for the treatment of neurocysticercosis Co-administration of corticosteroids that cross the blood brain barrier (e.g. dexamethasone) is used to mitigate these effects Treatment of edema, intracranial hypertension or hydrocephalus, which may include ventricular shunt or other neurosurgical procedures

Condition: Autism and Asperger syndrome

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Provision of information on neurodevelopmental disorders to the parents and family members Families and community education to reduce stigma and discrimination Distribution of IEC materials on neurodevelopmental disorders Encourage a multi-sectoral approach to ensure children’s education and opportunities to engage and participate in their communities. Community health workers on neurodevelopmental disorders including recognition of symptoms	Monitoring of child development as part of routine maternal and child health care Encourage child’s physical activity Proper nutrition for child	Recognition of neurodevelopmental disorder symptoms Recognition of any other disorders that may be associated such as sleep disorder Referral to a health facility for management	Home based Physiotherapy support including physical exercises	Family psychosocial support/interactions to prevent other complications such as sleep disorders, anxiety
Primary Care
Provision of information on neurodevelopmental disorders to the parents and family members Health workers on neurodevelopmental disorders including recognition of symptoms	Monitoring of child development as part of routine maternal and child health care Encourage child’s physical activity Proper nutrition for child	Recognition of neurodevelopmental disorder symptoms Recognition of any other disorders that may be associated such as sleep disorder Referral for specialized mental health and other needed services	Physiotherapy support including physical exercises	Linkage with education sector to Promote access to educational facilities for the children Educational therapies/structured educational programs/skills training Linkage to other relevant sectors for economic support/empowerment for the parents and or caregivers Parental/care givers skills training programmes Social support for the child with autisms and their families psychological and pscyo-social support to parents and families of children with autism counselling Spiritual support Long term psychosocial support and care or the children with severe disabilities
Referral Facility: General
Provision of information on neurodevelopmental disorders to the parents and family members Health workers on neurodevelopmental disorders including recognition of symptoms	Monitoring of child development as part of routine maternal and child health care Encourage child’s physical activity Proper nutrition for child	Behaviour therapy Speech-language therapy Play-based therapy Physical therapy Occupational therapy Nutritional support Referral for specialized mental health and other needed services	Physiotherapy support including physical exercises Speech rehabilitation-speech therapy to improve communication skills	psychological and pscyo-social support to parents and families of children with autism counselling Spiritual support Social support for the child with autisms and their families Linkage with education sector to Promote access to educational facilities for the children Educational therapies. / structured educational programs /skills training Long term psychosocial support and care or the children with severe disabilities Linkage to other relevant sectors for economic support/empowerment for the parents and or caregivers Parental/care givers skills training programmes
Referral Facility: Specialist
Provision of information on neurodevelopmental disorders to the parents and family members Health workers on neurodevelopmental disorders including recognition of symptoms	Encourage family interactions to promote social skills and prevent other disorders such as anxiety disorders Encourage physical activity Guidance on Proper nutrition for child with autisms Monitoring of child development as part of routine maternal and child health care	assessments of any developmental delays Behavior and communication therapies.eg to and reduce problem behaviors and teaching new skills. Family therapies. To promote social interactions skills speech therapy to improve communication skills, Occupational therapy to teach activities of daily living, physical therapy to improve movement and balance Psychological support /treatment to promote behavior.skills, Follow up and management of other medical and mental health conditions related to autism such as epilepsy, sleep disorders, anxiety and depression ; Attention Deficit Hyperactivity Disorder (ADHD)	Physiotherapy support including physical exercises Speech rehabilitation-speech therapy to improve communication skills	Social support for the child with autisms and their families psychological and pscyo-social support to parents and families of children with autism counselling Spiritual support Long term psychosocial support and care or the children with severe disabilities Linkage with education sector to Promote access to educational facilities for the children Linkages for Educational therapies/structured educational programs/skills training Linkage to other relevant sectors for economic support/empowerment for the parents and or caregivers Parental/care givers skills training programmes

Condition: Asthma

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke	Short-acting beta-2 agonist.	Emotional, social assessment and support based on cultural needs, values and preferences of parents and families
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of aeroallergen Avoidance of direct or passive exposure to cigarette smoke Vaccination against influenza and pneumonia	Short-acting beta-2 agonist. Inhaled steroids Long-acting beta-2 agonists Breathing techniques
Referral Facility: General
Vaccination against influenza and pneumonia		Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP) Counselling on personalised asthma management plan
Referral Facility: Specialist
Health education on triggers/risk factors of asthma and preventive measures	Vaccination against influenza and pneumonia	Short-acting bronchodilator, Low-dose inhaled corticosteroid (ICS) Long-acting bronchodilator (LABA) Long-acting muscarinic agonist (LAMA) Supplemental oxygen Bilevel Positive Airway Pressure (BiPAP)

Condition: Periodontal disease

Health Promotion	Disease Prevention	Curative
Community Level
Create awareness on oral health including periodontal disease to the communities Increase knowledge and practices among the public through community programmes Fully integrating oral health into community health programmes. Community Health workers training on periodontal disease including prevention measures	Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily) Flossing daily Using an antiseptic mouthwash Chlorhexidine gluconate-based mouthwash Ensuring the child eats healthy balanced diets Regular dental check-ups	Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath, Good oral hygiene/ oral hygiene instructions including brushing and flossing. Guidance on healthy diet/good nutrition Use of antiseptic mouth washes as a temporary primary oral hygiene measure Relieve of symptoms such as pain with analgesics Referral to a health facility for management of under 5s with periodontal disease
Primary Care
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing, flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the child’s oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis and or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.	Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Treatment planning and Patient/parent education on the treatment choice Guidance to patient/parents on their role in improving periodontal health. Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient or parents is/are motivated to achieve and maintain effective plaque removal for the child Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referral to a hospital for further management including management of any underlying conditions such as cardiovascular diseases that predisposes to periodontal disease
Referral Facility: General
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing; flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the childs oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.	Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including; * Study models for diagnostics especially of gingival recession * Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession * Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
Education to the under 5s and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in children	Guidance to under 5s and their parents/families on good oral hygiene practices including brushing; flossing for the child Guidance to parents on their role in improving periodontal health of the under 5s Information and guidance to parents/families on the benefits of a healthy, balanced diet to the childs oral health including prevention of periodontal disease Advice on frequent dental visits for dental prophylaxis or supportive periodontal therapy for the under 5s Screen under 5s for periodontal diseases at every routine examination.	Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth Diagnostics including Study models for diagnostics especially of gingival recession Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support) Use of mouth washes as a temporary primary oral hygiene measure Removal of plaque and calculus including supragingival debridement and root surface instrumentation Ensure that the patient is motivated to achieve and maintain effective plaque removal. Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment

Condition: Attention deficit/hyperactivity syndrome

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Community education/awareness creation on ADHD Advocacy for ADHD including provision of services for persons with ADHD Community Health workers training/sensitization on ADHD	for the school children Reduction of exposure to Children to certain toxic substances, such industrial chemicals, organophosphate insecticides Prevention of child abuse, neglect or social deprivation	Recognition of symptoms indicative of ADHD including inattention, or excessive activity and impulsivity, which are otherwise not appropriate for a person's age. Psychotherapy and Psychosocial Interventions including; Behavioral therapy to help the patient change their behavior *Cognitive behavioral therapy to teach on mindfulness techniques or meditation and help patient adjust to the life changes that come with treatment, Referral to a health facility	Community/home based physical activities/Promote exercises	Children with ADHD need guidance and understanding from their parents, families and teachers to reach their full potential and to succeed. Help to the child and parents develop new skills, attitudes and ways of relating to each other. Linkage to Support groups to help children, their parents and families connect with others who have similar problems and concerns. Linkage with schools and advice on Specific behavioral classroom management e.g. teacher-implemented reward system
Primary Care
Community education/awareness creation on ADHD Advocacy for ADHD including provision of services for persons with ADHD Health workers training on ADHD	Physical exercise for the children Prevention of child abuse, neglect or social deprivation Awareness care on on prevention measures including: Reduction of exposure to Children to certain toxic substances, such industrial chemicals, organophosphate insecticides	physical and clinical examination Symptomatic diagnosis of AHDD-Inattention, hyperactivity, disruptive behavior and impulsivity Diagnosis based on assessment of child’s behavioral and mental development (must be diagnosed by the age of six) Psychotherapy and Psychosocial Interventions including; Behavioral therapy to help the patient change their behavior Cognitive behavioral therapy to teach on mindfulness techniques or meditation; and help patient adjust to the life changes that come with treatment, Referral to a hospital	Physical therapy Promote exercises	Children with ADHD need guidance and understanding from their parents, families, and teachers to reach their full potential and to succeed. Help to the child and parents develop new skills, attitudes and ways of relating to each other. Linkage to Support groups to help children, their parents and families connect with others who have similar problems and concerns. Linkage with pre-schools and advice on Specific behavioral classroom management e.g. teacher-implemented reward system
Referral Facility: General
Community education/awareness creation on ADHD Advocacy for ADHD including provision of services for persons with ADHD Health workers training on ADHD	Awareness caretion on prevention measures including: Reduction of exposure to Children to certain toxic substances such industrial chemicals, organophosphate insecticides Prevention of child abuse, neglect or social deprivation Physical exercise for the children	physical and clinical examination Symptomatic diagnosis of AHDD-Inattention, hyperactivity, disruptive behavior and impulsivity Diagnosis based on assessment of child’s behavioral and mental development (must have been diagnosed by the age of six) Psychotherapy and Psychosocial Interventions including; Behavioral therapy to help the patient change their behavior Cognitive behavioral therapy to teach on mindfulness techniques or meditation and help patient adjust to the life changes that come with treatment, Medication therapy (e.g. use of non-stimulants & stimulants) to reduce hyperactivity and impulsivity and improve ability to focus, work, learn and physical coordination Monitoring and management of complications including those related to medication use including headaches; increased anxiety and irritability Rule out effects of drugs, medications and other medical or psychiatric problems as the cause of ADHD Follow up	Physical therapy Promote exercises	Children with ADHD need guidance and understanding from their parents, families and teachers to reach their full potential and to succeed. Help to the child and parents develop new skills, attitudes and ways of relating to each other. Linkage to Support groups to help school children, their parents and families connect with others who have similar problems and concerns. Linkage with schools and advice on Specific behavioral classroom management e.g. teacher-implemented reward system
Referral Facility: Specialist
Community education/awareness creation on ADHD Advocacy for ADHD including provision of services for persons with ADHD Health workers training on ADHD	Physical exercise Prevention of child abuse, neglect or social deprivation Awareness creation on prevention measures including: Reduction of exposure to Children to certain toxic substances such industrial chemicals, organophosphate insecticides	physical and clinical examination Symptomatic diagnosis of AHDD-Inattention, hyperactivity, disruptive behavior and impulsivity Diagnosis based on assessment of child’s behavioral and mental development (must have been diagnosed by the age of six) Follow up Medication therapy (e.g. use of non-stimulants & stimulants) to reduce hyperactivity and impulsivity and improve ability to focus, work, learn and physical coordination Monitoring and management of complications including those related to medication use including headaches; increased anxiety and irritability Rule out effects of drugs, medications and other medical or psychiatric problems as the cause of ADHD Psychotherapy and Psychosocial Interventions including; Behavioral therapy to help the patient change their behavior Cognitive behavioral therapy to teach on mindfulness techniques or meditation and help patient adjust to the life changes that come with treatment,	Physical therapy Promote exercises	Children with ADHD need guidance and understanding from their parents, families and teachers to reach their full potential and to succeed. Help to the child and parents develop new skills, attitudes and ways of relating to each other. Linkage to Support groups to help school children, their parents and families connect with others who have similar problems and concerns. Linkage with schools and advice on Specific behavioral classroom management e.g. teacher-implemented reward system

Condition: Migraine

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Education and awareness creation/information to Parents/families on migraine headache, prevention measures among the under 5s Community Health worker training on migraine, prevention , recognition and management at the community level	Advice to parents on lifestyle factors that the child need to avoid or the migraine triggers to reduce the frequency of attacks including; irregular or skipped meals irregular or too little sleep a stressful lifestyle lack of exercise obesity Encourage parents of the under 5 patients to participate actively in their treatment and to employ management principles including; Monitoring the child to identify factors influencing migraine Managing migraine triggers effectively Pacing activity to avoid triggering or exacerbating migraine Ensure the child has a lifestyle that does not worsen migraine Ensure the child relaxes enough Ensure the child has good sleep hygiene Help the child to develop stress management skills Using acute and prophylactic medication on the child appropriately	Recognition of features suggestive of migraine headache in children including; Complaints of Pain on the forehead or on both right and left sides of the head; Headache Vomiting irritability gastrointestinal disturbance sensitivity to light and/to sound Supportive therapy for the child with migraine headache through; Ensuring adequate rest/sleep, regular meals, help the child to exercise Give adequate fluids especially if the child is vomiting Use of painkillers such as ibuprofen Monitor for any features of worsening of the condition of the child with migraine Referrer to a health facility for further management	Relaxation therapy e.g massage therapy to relive migraine	Counselling and education to parents/families on use and adherence to the medication for the child according to the prescription
Primary Care
Basic explanations information to parents/families on migraine headache, prevention measures and treatment. Health worker training on migraine, prevention , diagnosis and management	Advice to parents on lifestyle factors that the child need to avoid or the migraine triggers to reduce the frequency of attacks including, Irregular or skipped meals, Irregular or too little sleep, A stressful lifestyle, lack of exercise obesity Encourage parents of the under 5 patients to participate actively in their treatment and to employ management principles including; Monitoring the child to identify factors influencing migraine Managing migraine triggers effectively Pacing activity to avoid triggering or exacerbating migraine Ensure the child has a lifestyle that does not worsen migraine Ensure the child relaxes enough Ensure the child has good sleep hygiene Help the child to develop stress management skills Using acute and prophylactic medication on the child appropriately	Physical and neurologic examination to help in the diagnosis Identification of features of migraine in children including shorter-lasting headaches attacks, commonly bilateral and less usually pulsating headache; gastrointestinal disturbance Monitor for any features of migraine headaches due to underlying conditions such as headache with projectile vomiting that may be due to intracranial space-occupying lesion, new headache in a patient with a history of cancer, HIV infection or immunodeficiency Referral of the child to hospital for Management of any underlying conditions that may be causing migraine e.g. cancer, space occupying lesions Use of non-drug treatment (non- pharmacologic therapy for migraine in children through bed rest; relaxation therapy; adequate fluids (hydration) physiotherapy Use of drug therapy -analgesics (ibuprofen) in children with migraine, anti-emetics when vomiting is present	Relaxation therapy e.g massage therapy to relive migraine	Counselling and advice to parents on use and to ensure adherence to the medication for the child according to the prescription
Referral Facility: General
Basic explanations information to parents/families on migraine headache, prevention measures and treatment. Health worker training on migraine, prevention , diagnosis and management	Advice to parents on lifestyle factors that the child need to avoid or the migraine triggers to reduce the frequency of attacks including; irregular or skipped meals irregular or too little sleep a stressful lifestyle lack of exercise obesity Encourage parents of the under 5 patients to participate actively in their treatment and to employ management principles including; monitoring the child to identify factors influencing migraine managing migraine triggers effectively pacing activity to avoid triggering or exacerbating migraine ensure the child has a lifestyle that does not worsen migraine ensure the child relaxes enough ensure the child has good sleep hygiene help the child to develop stress management skills using acute and prophylactic medication on the child appropriately	Physical and neurologic examination to help in the diagnosis Identification of features of migraine in children including shorter-lasting headaches attacks, commonly bilateral and less usually pulsating headache, gastrointestinal disturbance Use of drug therapy -analgesics (ibuprofen) in children with migraine, anti-emetics when vomiting is present Use of non-drug treatment (non- pharmacologic therapy for migraine in children through bed rest, relaxation therapy, physiotherapy Management of any underlying conditions that may be causing migraine in under 5 e.g. . cancer, space occupying lesions Monitor for any features of migraine headaches due to underlying conditions such as; headache projectile vomiting that may be due to intracranial space-occupying lesion, new headache in a patient with a history of cancer, HIV infection or immunodeficiency Follow up to ensure optimum treatment is achieved	Physiotherapy services as a way of relieving migraine	Counselling and patient education on use and adherence to the medication according to the prescription
Referral Facility: Specialist
Basic explanations information to parents/families on migraine headache, prevention measures and treatment. Health worker training on migraine, prevention , diagnosis and management	Advice to parents on lifestyle factors that the child need to avoid or the migraine triggers to reduce the frequency of attacks including; irregular or skipped meals irregular or too little sleep a stressful lifestyle lack of exercise obesity Encourage parents of the under 5 patients to participate actively in their treatment and to employ management principles including; monitoring the child to identify factors influencing migraine managing migraine triggers effectively pacing activity to avoid triggering or exacerbating migraine ensure the child has a lifestyle that does not worsen migraine ensure the child relaxes enough ensure the child has good sleep hygiene help the child to develop stress management skills using acute and prophylactic medication on the child appropriately	Physical and neurologic examination to help in the diagnosis Identification of features of migraine in children including shorter-lasting headaches attacks, commonly bilateral and less usually pulsating headache, gastrointestinal disturbance Use of non-drug treatment (non- pharmacologic therapy for migraine in children through bed rest, relaxation therapy, physiotherapy Use of drug therapy -analgesics (ibuprofen) in children with migraine, anti-emetics when vomiting is present Management of any underlying conditions that may be causing migraine in under 5 e.g. . cancer, space occupying lesions Monitor for any features of migraine headaches due to underlying conditions such as ,headache projectile vomiting that may be due to intracranial space-occupying lesion, new headache in a patient with a history of cancer, HIV infection or immunodeficiency * Follow up to ensure optimum treatment is achieved	Physiotherapy services as a way of relieving migraine	Counselling and patient education on use and adherence to the medication according to the prescription

Condition: Hookworm disease

Health Promotion	Disease Prevention	Curative
Community Level
Community engagement on the importance of clean water and safe sanitation and waste disposal Education and social mobilization for the prevention and control of hook worm infection	Proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Avoidance of consuming or contact with soil that may be contaminated with human faecal matter Deworming and iron supplementation MDA with albendazole	Anthelmintic Antispasmodics Analgesics
Primary Care
Health education on risk factors for hook worm infection and preventive measures such as good sanitation and hygiene practice	Deworming and iron supplementation	Anthelmintic Antispasmodics Analgesics Iron supplementation
Referral Facility: General
Health education on risk factors for hook worm infection and preventive measures such as good sanitation and hygiene practice	Advice to parents/families on ensuring that the under 5s use safe Drinking water Advice to parents/families on Properly cleaning and cooking food for the under 5s Guidance to under 5s on proper handwashing/hand hygiene Guidance to parents/families on proper human waste disposal including the children waste
Referral Facility: Specialist
Health education on risk factors for hook worm infection and preventive measures such as good sanitation and hygiene practice	Advice to parents/families on ensuring that the under 5s use safe Drinking water Advice to parents/families on Properly cleaning and cooking food for the under 5s Guidance to under 5s on proper handwashing/hand hygiene Guidance to parents/families on proper human waste disposal including the children waste

Condition: Lower respiratory tract infections (LRTI)

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Create awareness on respiratory tract infections including prevention measures (hand feeding, bottle feeding) Distribution of IEC materials on lower respiratory tract infections i.e. danger signs like chest indrawing fast and difficult breathing. Advocacy for proper sanitation and good housing Community mobilisation for routine immunisation especially for the pneumococcal vaccine Create awareness on respiratory tract infections including prevention measures (hand feeding, bottle feeding) Distribution of IEC materials on lower respiratory tract infections i.e. danger signs like chest indrawing fast and difficult breathing. Advocacy for proper sanitation and good housing Community mobilisation for routine immunisation especially for the pneumococcal vaccine	Exclusive breastfeeding for the first 6 months of life and for up to two years Adequate nutrition for mothers and children Good hygiene practices including hand washing Avoidance of smoking within the household Avoidance of secondary exposure to smoke Avoidance of biomass combustion (particularly indoor cooking fires) and Avoidance of air pollutants Immunizations, e.g. Pneumococcal and pentavalent vaccinations Healthy nutrition including breastfeeding including exclusive breastfeeding for the first 6 months of life and for up to two years Good hygiene practices including hand washing and feeding utensils Avoidance of smoking within the household and secondary exposure to smoke to the under 5s Avoidance of biomass combustion (particularly indoor cooking fires) and other air pollutants that contribute to acute respiratory infections. Complete and timely immunizations, e.g., Pneumococcal and pentavalent vaccinations. Seek early treatment of respiratory infections for the children	Recognition of LRTI signs and symptoms	First-line antibiotic treatment Immediate transfer of unresponsive or sever cases to a higher-level health care facility
Primary Care
Health education on LRTI prevention measures and early treatment	Good hygiene practices including hand washing Avoidance of smoking and secondary exposure to smoke Avoidance of air pollutants Full immunizations, e.g. Pneumococcal and pentavalent vaccinations Healthy nutrition including breastfeeding including exclusive breastfeeding for the first 6 months of life and for up to two years Good hygiene practices including hand washing and feeding utensils Avoidance of smoking within the household and secondary exposure to smoke to the under 5s Avoidance of biomass combustion (particularly indoor cooking fires) and other air pollutants that contribute to acute respiratory infections. Complete and timely immunizations, e.g., Pneumococcal and pentavalent vaccinations. Seek early treatment of respiratory infections for the children	History Physical examination Pulse Oximetry	First-line antibiotic treatment Immediate transfer of unresponsive or sever cases to a higher-level health care facility Assess and classify for Cough or Difficult breathing using the IMNCI guideline Treat and refer according to the classification as per the guidelines Monitor progress and follow-up and refer giving urgent Referral treatment with oxygen, antibiotics, correction of hypoglycaemia, etc.) Advise mother when to return immediately Advise mother when to return if not improving
Referral Facility: General
Health education on LRTI prevention measures and early treatment	Good hygiene practices including hand washing Counselling and guidance on avoidance of smoking within the household and secondary exposure to smoke Full immunizations, e.g. Pneumococcal and pentavalent vaccinations	History Physical examination Pulse Oximetry Full blood count Chest radiography	Parenteral antibiotics Oxygen supplementation IV fluids
Referral Facility: Specialist
Health education on LRTI prevention measures and early treatment	Good hygiene practices including hand washing Counselling and guidance on avoidance of smoking within the household and secondary exposure to smoke Full immunizations, e.g. Pneumococcal and pentavalent vaccinations	History Physical examination Pulse Oximetry Full blood count Chest radiography	Parenteral antibiotics Oxygen supplementation IV fluids Intensive care for severe disease Physical and clinical examination Hospitalization based by severity ((low oxygen saturation, poor feeding, dehydration, apnea, respiratory distress) Oxygen therapy -Maintenance of oxygen saturation levels Management of dehydration through Intravenous fluids administration Monitoring using blood tests, culture, chest x-ray, GeneXpert Check for any underlying condition for those with persistent symptoms of lower respiratory tract infections Follow-up/regular review until all symptoms and signs resolve ICU services for those with severe disease

Condition: Non-migraine headache

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Education and awareness creation information to communities on headaches including prevention measures Community Health worker training on headaches prevention, recognition and management at the community level
Primary Care

Referral Facility: General
Provide information to on headaches their prevention measures and their treatment. Health workers training on the different types on non migraine head aches, their prevention and treatment measures
Referral Facility: Specialist
Provide information to on headaches their prevention measures and their treatment. Health workers training on the different types on non migraine head aches, their prevention and treatment measures

Condition: Dental Caries

Health Promotion	Disease Prevention	Curative
Community Level
Community awareness on dental caries and prevention measures Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions Multi-sectoral approach in ensuring access to clean safe water Community water fluoridation Community dental outreach services Training community health workers on dental caries including prevention measures	Oral hygiene through regular cleaning of teeth -tooth brushing and flossing Diet modification -use of low sugar diets Use of fluoridated tooth pastes Avoidance of tobacco use. Avoidance of alcohol use Screening for early detection of dental caries	Recognition of signs of dental caries including pain and difficulty with eating holes in teeth Pain relief with pain medications such as paracetamol and ibuprofen Recognition of symptoms of complications of dental caries including swelling of the tissue around the tooth, tooth loss and infection or abscess formation Referral to a health facility for management
Primary Care
Community awareness on dental caries and prevention measures Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions Multi-sectoral approach in ensuring access to clean safe water Community water fluoridation Community dental outreach services Training health workers on dental caries including prevention measures	Oral hygiene education Advice on oral hygiene -teeth brushing and flossing Advice on healthy diets -avoidance of sugars Tobacco and alcohol cessation programs Early screening for dental caries	Oral Hygiene instructions Relieve of pain with analgesics Monitor any complications of caries including development of abscesses Monitor and manage for any complication such as gum inflammations and dental abscesses Referral to a hospital for further management
Referral Facility: General
Community awareness on dental caries and prevention measures Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions Multi-sectoral approach in ensuring access to clean safe water Community water fluoridation Community dental outreach services Training health workers on dental caries including prevention measures	Oral hygiene education Advice on oral hygiene -teeth brushing and flossing Advice on healthy diets -avoidance of sugars Tobacco and alcohol cessation programs Application of topical fluorides/application of fluorides to prevent caries Application of sealants Early screening for dental caries	Investigations including dental x-rays Relieve of pain with analgesics Use of Local anesthetics, in some cases to relieve pain during or following treatment or to relieve anxiety during treatment. Use of topical fluoride to promote remineralization for small lesions Dental restorations -Dental fillings for carious lesions using amalgam or composite fillings Repair or replacement of fillings where necessary Dental extractions Endodontic therapy/Root canal treatment Use of Crown in extensive caries with little tooth structure left Monitor and manage any complication as a result of dental caries such as dental abscesses, gum inflammations Follow up
Referral Facility: Specialist
Community awareness on dental caries and prevention measures Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions Multi-sectoral approach in ensuring access to clean safe water Community water fluoridation Community dental outreach services Training health workers on dental caries including prevention measures	Oral hygiene education Advice on oral hygiene -teeth brushing and flossing Advice on healthy diets -avoidance of sugars Tobacco and alcohol cessation programs Application of topical fluorides/application of fluorides to prevent caries Application of sealants Early screening for dental caries	Investigations including dental x-rays Relieve of pain with analgesics Use of Local anesthetics, in some cases to relieve pain during or following treatment or to relieve anxiety during treatment. Use of topical fluoride to promote remineralization for small lesions Dental restorations -Dental fillings for carious lesions using amalgam or composite fillings Repair or replacement of fillings where necessary Dental extractions Endodontic therapy/Root canal treatment Use of Crown in extensive caries with little tooth structure left Monitor and manage any complication as a result of dental caries such as dental abscesses, gum inflammations Follow up

Condition: Rheumatic Heart Disease

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions Distribution of IEC materials on RHD Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living Advocacy for Improved access health services including to oral health care, access to life saving heart surgery Community health workers training on RHD	Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions Distribution of IEC materials on RHD Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living Advocacy for Improved access health services including to oral health care, access to life saving heart surgery Community health workers education on RHD	Recognition of symptoms indicative of RHD including fever, painful joints especially knees ankles, elbows and wrists pain that moves between different joints, fatigue, jerky uncontrollable body movements, nodules under the skin near joints and/or a non-itchy rash Relive of pain with pain killers Relieve of fever with ibuprofen or through tepid sponging Proper nutrition for child suspected to have RHD Ensure adherence to any prescribed medicines such as antibiotics Recognition of symptoms indicative of worsening of the condition such as complaints of chest pain, shortness of breath, swelling of the stomach, hands or feet Early Referral to a health facility	Psychosocial support and counselling to reduce stress associated with the prolonged treatment or admission Linkage with social and support services
Primary Care
Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions Distribution of IEC materials on RHD Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living Advocacy for Improved access health services including to oral health care, access to life saving heart surgery Community health workers training on RHD	Guidance to parents/families/children on healthy hygiene practice for the under 5s Advice to parents/families on the need for seeking treatment early for any child with sore throat or any signs of infection such as fever Promoting good nutrition for children Teaching/guidance on Good oral hygiene practices for the under 5s Advice to parents on the need to ensure Adherence to antibiotics medication for the under 5 Early identification and treatment of streptococcal infections with antibiotics such as penicillin to reduce the risk of Rheumatic fever and possible eventual progression to Rheumatic Heart disease	Complete Medical History and clinical examination Relive pain Relive fever Management of inflammation with anti-inflammatory medications such as aspirin Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G Recognition of any signs and symptoms indicating severe or complications of RHD eg severe chest pain, feet oedema Referral to a hospital	Psychosocial support and counselling for families/parents with an under 5 with RHD for any psychological trauma due to the long nature of treatment
Referral Facility: General
Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions Distribution of IEC materials on RHD Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living Advocacy for Improved access health services including to oral health care, access to life saving heart surgery Community health workers training on RHD	Guidance to parents/families/children on healthy hygiene practice for the under 5s Advice to parents/families on the need for seeking treatment early for any child with sore throat or any signs of infection such as fever Promoting good nutrition for children Teaching /guidance on Good oral hygiene practices for the under 5s Advice to parents on the need to ensure Adherence to antibiotics medication for the under 5 Early identification and treatment of streptococcal infections with antibiotics such as penicillin to reduce the risk of Rheumatic fever and possible eventual progression to Rheumatic Heart disease Early identification and treatment of Rheumatic fever to reduce the likelihood of Rheumatic Heart disease	Complete Physical and clinical examination Diagnostics -tests including; Throat swab culture for evidence of streptococcus infection Blood tests Echocardiogram (echo)-. check the heart's chambers and valves. Electrocardiogram (ECG)-.To test the strength and timing of the electrical activity of the heart. Chest x-rays Cardiac MRI Relive pain Relive fever Management of inflammation with anti-inflammatory medications such as aspirin or corticosteroids Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G Early identification and treatment of ARF, as well as interventions to prevent recurrences of ARF and therefore reduce the likelihood of RHD.-use of antibiotics, Management of heart failure or heart rhythm abnormalities heart failure e.g. with diuretics, beta blockers Prevention and management of clotting with blood thinners Anti-coagulants Surgical interventions including Cardiac catheterization to repair damaged valves or ICU services for severely ill patients e.g. post-surgery Follow up	Psychosocial support and counselling for families/parents with an under 5 with RHD for any psychological trauma due to the long nature of treatment
Referral Facility: Specialist
Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions Distribution of IEC materials on RHD Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living Advocacy for Improved access health services including to oral health care, access to life saving heart surgery Community health workers training on RHD	Guidance to parents/families/children on healthy hygiene practice for the under 5s Advice to parents/families on the need for seeking treatment early for any child with sore throat or any signs of infection such as fever Promoting good nutrition for children Teaching /guidance on Good oral hygiene practices for the under 5s Advice to parents on the need to ensure Adherence to antibiotics medication for the under 5 Early identification and treatment of streptococcal infections with antibiotics such as penicillin to reduce the risk of Rheumatic fever and possible eventual progression to Rheumatic Heart disease Early identification and treatment of Rheumatic fever to reduce the likelihood of Rheumatic Heart disease	Complete Physical and clinical examination Diagnostics -tests including; Throat swab culture for evidence of streptococcus infection Blood tests Echocardiogram (echo)-. check the heart's chambers and valves. Electrocardiogram (ECG)-.To test the strength and timing of the electrical activity of the heart. Chest x-rays Cardiac MRI Relive pain Relive fever Management of inflammation with anti-inflammatory medications such as aspirin or corticosteroids Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G Early identification and treatment of ARF, as well as interventions to prevent recurrences of ARF and therefore reduce the likelihood of RHD.-use of antibiotics, Management of heart failure or heart rhythm abnormalities heart failure e.g. with diuretics, beta blockers Prevention and management of clotting with blood thinners Anti-coagulants Surgical interventions including Cardiac catheterization to repair damaged valves or ICU services for severely ill patients e.g. post-surgery Follow up	Psychosocial support and counselling for families/parents with an under 5 with RHD for any psychological trauma due to the long nature of treatment

Condition: Upper Respiratory Tract Infections

Health Promotion	Disease Prevention	Curative
Community Level
Proper nutrition for the pregnant women Good Hand hygiene practices Smoking cessation/avoidance to exposure to secondary smoking Vitamin supplementation Seeking early treatment for any upper respiratory tract infection Adherence to medication including completion of antibiotic dosage	Proper nutrition for the pregnant women Good Hand hygiene practices Smoking cessation/avoidance to exposure to secondary smoking Vitamin supplementation Seeking early treatment for any upper respiratory tract infection Adherence to medication including completion of antibiotic dosage	Recognition of symptoms indicative of upper respiratory tract infections including fever, cough, nasal congestion, runny nose and sneezing, red waterly or sore eyes, Relieve of pain with pain killers such as paracetamol Relieve of fever Proper nutrition Plenty of fluids for the patient Plenty of rest Vitamins - such as Vitamin C Referral to a health facility for further management
Primary Care
Information on upper respiratory tract infections including prevention measures Distribution of IEC materials on URTI Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing Health workers training on URTI including prevention measures and its management	Promote Breast feeding Guidance on Proper nutrition for the child Guidance on good Hand hygiene practices for parents/caregivers and the children Advice on Avoidance of smoking in the household/exposure of children to secondary smoking Vitamin supplementation Vaccination for the children -influenza, pneumococcal vaccines . Early treatment of URTI in children	Hydration/fluids therapy Management of Nasal congestion/use of decongestants/e.g. pseudoephedrine Management of pain -Analgesics e.g. paracetamol and NSAIDs) Management of fever Management of allergies – use of antihistamines e.g. chlorpheniramine Antibiotics therapy e.g. co*amoxiclav Management of cough- use of mucolytics Vitamin C Zinc gluconate Follow up, prevention of complications such as otitis media, compromised airways Referral to hospital for further management or management of any complications
Referral Facility: General
Information on upper respiratory tract infections including prevention measures Distribution of IEC materials on URTI Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing Health workers training on URTI including prevention measures and its management	Promote Breast feeding Guidance on Proper nutrition for the child Guidance on good Hand hygiene practices for parents/caregivers and the children Advice on Avoidance of smoking in the household/exposure of children to secondary smoking Vitamin supplementation Vaccination for the children -influenza, pneumococcal vaccines . Early treatment of URTI in children	Diagnostic tests including culture and sensitivity, radiological examination (X-rays, CT scans) Hydration/fluids therapy Management of Nasal congestion/use of decongestants/e.g. pseudoephedrine Management of pain -Analgesics e.g. paracetamol and NSAIDs) Management of fever Management of allergies – use of antihistamines e.g. chlorpheniramine Antibiotics therapy e.g. co*amoxiclav Management of cough- use of mucolytics Vitamin C Zinc gluconate Humidified hot air Follow up, prevention and management of complications such as otitis media, compromised airways
Referral Facility: Specialist
Information on upper respiratory tract infections including prevention measures Distribution of IEC materials on URTI Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing Health workers training on URTI including prevention measures and its management	Guidance on Proper nutrition for the child Promote Breast feeding Guidance on good Hand hygiene practices for parents/caregivers and the children Advice on Avoidance of smoking in the household/exposure of children to secondary smoking Vitamin supplementation Vaccination for the children -influenza, pneumococcal vaccines . Early treatment of URTI in children	Diagnostic tests including culture and sensitivity, radiological examination (X-rays, CT scans) Hydration/fluids therapy Management of Nasal congestion/use of decongestants/e.g. pseudoephedrine Management of pain -Analgesics e.g. paracetamol and NSAIDs) Management of fever Management of allergies – use of antihistamines e.g. chlorpheniramine Antibiotics therapy e.g. co*amoxiclav Management of cough- use of mucolytics Vitamin C Zinc gluconate Humidified hot air Follow up, prevention and management of complications such as otitis media, compromised airways

Condition: Dietary iron deficiency

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Advice to mothers on ensuring breastfeeding including early initiation, exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and young child nutrition including micronutrient dietary diversification and dietary modification Community engagement on Infant and Young Child Nutrition IYCN * Counselling on micronutrient supplementation -Vit. A Supplementation, antihelminth * Counselling on when to seek medical help at facility level. * Counselling on feeding the sick child Promote exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and nutrition including micronutrient dietary diversification and dietary modification	Vitamin A Supplementation Deworming * Indoor residual spraying * Healthy nutrition for infant and young children Timely and appropriate complementary feeding especially dietary diversification and frequency of feeding children 6-59 months. Community based MUAC and bilateral edema screening for early identification * Mothers Support Groups (MSGs) to prepare local micronutrient rich diversified complementary foods Iron-fortified cereals or bread Foods rich in iron Breast feeding Timely and appropriate complementary feeding especially dietary diversification and frequency of feeding Deworming * Integrated vector control measures (use of bed nets and indoor residual spraying) Mothers Support Groups (MSGs) to prepare local micronutrient rich diversified complementary foods	Recognition of dietary iron deficiency signs and symptoms	Early identification of anaemia symptoms and referral for diagnostic work up Treatment with anti-helminths Treatment with anti-malaria for symptomatic children * Follow Up of patients in community Ensure compliance of feeding and or drug uptake
Primary Care
Advice to mothers on ensuring breastfeeding including early initiation, exclusive breastfeeding for the first 6 months of life and until the child is two years * Promote appropriate and timely complementary feeding and healthy infant and young child nutrition including micronutrient dietary diversification and dietary modification	• Routine prenatal supplementation of iron and folate • Multiple Micronutrient Supplements • Deworming • Perennial malaria chemoprevention (PMC) • Early detection and treatment of malaria	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Oral iron sulphate tablets Immediate transfer of severe anaemia to a higher-level health care facility
Referral Facility: General
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Stool exam Malaria RDT	Treat underlying cause Oral iron sulphate Blood transfusion for severe anaemia
Referral Facility: Specialist
Education on appropriate feeding and healthy nutrition including micronutrient dietary diversification and dietary modification	Routine prenatal supplementation of iron and folate Routine haemoglobin screening for early detection	History Physical examination Haemoglobin Haematocrit Complete blood count Serum ferritin level Bone marrow	Treat underlying cause Oral iron sulphate Parenteral iron Blood transfusion for severe anaemia

Condition: Neonatal Jaundice

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Health Education to pregnant women to create awareness on neonatal jaundice Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on Neonatal Jaundice	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	History and physical examination Basic laboratory test Blood film microscopy, Blood group and cross-match, Feeding or supplementation Light therapy (phototherapy) Intravenous immunoglobulin Exchange transfusion	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Primary Care
Health Education to pregnant women to create awareness on neonatal jaundice Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on Neonatal Jaundice	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	Refer neonates with confirmed jaundice to next level Kangaroo father care and/or Kangaroo mother care Breastfeeding/nutritional support Sunlight	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: General
Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	History and physical examination Basic laboratory test Blood film microscopy, Blood group and cross-match, Feeding or supplementation Light therapy (phototherapy) Intravenous immunoglobulin
Referral Facility: Specialist
Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices

Condition: Congenital anomalies

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate adolescent girls and mothers to have a healthy diet including adequate dietary intake of vegetables and fruit, vitamins and minerals particularly folic acid, and maintain a healthy weight Educating and counselling parents and community on addressing stigma attached with congenital abnormalities Information education and communication on harmful substances, particularly alcohol and tobacco, exposure of pregnant women to medications	Adequate dietary intake of vitamins and minerals, folic acid, variety of vegetables and fruit and maintain a healthy weight for adolescent’s girls and mothers Avoid harmful substances, particularly alcohol and tobacco during pregnancy Ensure avoidance of travel by pregnant women (and sometimes women of childbearing age) to regions experiencing outbreaks of infections known to be associated with birth defects, Reduce or eliminating environmental exposure to hazardous substances (such as heavy metals or pesticides) during pregnancy, Measles-rubella (MR) vaccine Screening and treatment of infections, especially rubella, varicella and syphilis	Recognition of congenital heart anomalies signs and symptoms	Immediate transfer of suspected congenital heart anomalies to a higher-level health care facility	Physical rehabilitation Family or caregiver educational training	Psychological and social support to patients and families of babies with birth-related complications
Primary Care
Raise awareness on the importance of birth defects as a cause of child morbidity and mortality Educate adolescent girls and mothers on healthy diet and consumption of foods rich in natural folates Information education and communication on harmful substances, particularly alcohol and tobacco Education to minimize exposure of pregnant women and workers in their workplace to risk factors for congenital anomalies (chemical, physical and biological Promote the use of iodized salt	Folic acid/multiple micronutrient supplementation in early pregnancy * Measles-rubella (MR) vaccine Avoiding teratogenic medications during pregnancy New born screening for congenital abnormalities	Clinician suspicion Pulse oximeter	Immediate transfer of suspected congenital heart anomalies to a higher-level health care facility	Physical rehabilitation Occupational therapy Family or caregiver educational training Provide assistive products	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: General
Raise awareness of health professionals on the importance of new born screening for early identification of infants born with congenital birth defects	Folic acid/multiple micronutrient supplementation during pregnancy Appropriate use of fortified foods Measles-rubella (MR) vaccine * Avoiding teratogenic medications during pregnancy Screening and treatment of syphilis in pregnant women Preconception care; hypothyroidism management, obesity control, chronic diseases e.g. diabetes, epilepsy control, hepatitis B vaccination and glycaemic control	Clinical suspicion Pulse oximeter Chest radiograph Ultrasonography (pre and post-natal) Electrocardiogram (ECG) Echocardiography	Antihypertensive Diuretics Anti-arrhythmia Early screening for early correction Immediate transfer of suspected congenital heart anomalies to a higher-level health care facility	Long term rehabilitation support including physical therapy, speech therapy, occupational therapy Family or caregiver educational training Provide assistive products	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: Specialist
Raise awareness of health professionals on the importance of new born screening for early identification of infants born with congenital birth defects	Correction of some endocrine and metabolic abnormalities such as diabetes, hypothyroidism before conception Avoiding teratogenic medications during pregnancy Genetic testing and counselling for families at risk	Clinical suspicion Pulse oximeter Chest radiograph Ultrasonography (pre and post-natal) Electrocardiogram (ECG or EKG) Echocardiography Cardiac catheterization Heart magnetic resonance imaging (MRI) Chromosomal studies Genomic microarray	Corrective/plastic surgery with good follow up care (e.g.congenital heart defects, NTD, congenital talipes, cleft lip, cleft palate etc) Screening of newborn for certain metabolic, hematologic and endocrine disorders Management of newborns for certain metabolic, hematologic and endocrine disorders	Long term rehabilitation support including physical therapy, speech therapy, occupational therapy Family or caregiver educational training Provide assistive products	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones

Condition: Ear Infections

Health Promotion	Disease Prevention	Curative
Community Level
Distribution of IEC materials on lower respiratory tract infections Sensitization on personal hygiene, proper sanitation and good housing Community health workers training on ear infections Community mobilisation for routine immunisation sensitization on IPC	Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib)	Counselling on oral hydration Clinical assessment for early recognition of need for referral
Primary Care
Counselling about handwashing with soap and water/sanitizer Counselling about household and indoor air pollution	Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib)	History and physical examination for ENT infections Otoscopy Cerumen removal Dry wicking Saline irrigation Nasal decongestants Oral antihistamines Oral antimicrobials for ENT infections Oral analgesics for ENT infections Intramuscular antimicrobials for ENT infections Referral of complications
Referral Facility: General
sensitization on IPC Sensitization on household and indoor air pollution	Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib)	History and physical examination for ENT infections and complications Dry wicking Saline irrigation Nasal decongestants Oral antihistamines Oral antimicrobials for ENT infections Oral analgesics for ENT infections Intramuscular antimicrobials for ENT infections Intranasal corticosteroids for ENT infections Intravenous analgesics for ENT infections Intravenous antipyretics for ENT infections Intravenous antimicrobials for ENT infections Referral
Referral Facility: Specialist
sensitization on IPC Sensitization on household and indoor air pollution	Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib	History and physical examination for ENT infections and complications Saline irrigation Nasal decongestants Oral antihistamines Oral antimicrobials for ENT infections Oral analgesics for ENT infections Intramuscular/intravenous antimicrobials for ENT infections Intranasal corticosteroids Intravenous analgesics Intravenous antipyretics Adenoidectomy Needle aspiration Tympanocentesis Tympanoplasty

Condition: Vaccine Preventable Diseases

Health Promotion	Disease Prevention	Curative
Community Level
Strengthen community health workers knowledge on vaccine preventable diseases (VPDs) Strengthen families and community-based awareness on VPDs including transmission and prevention measures * Information and health education to parents, families and Communities on immunization including vaccination schedule for young children * Community education on proper nutrition for young children	Routine on schedule vaccination for infants and children Strengthen community reporting systems on VPD symptoms Guidance on good hygiene practices including hand hygiene and stay at home if any symptoms of VPDs Avoiding close contact with people with VPDs	Recognition of VPDs symptoms Referrals to a health facility if symptoms worsen * Supportive care (e.g., fever reduction, hydration, feeding, etc.) Immediate Referral of infants to hospitals
Primary Care
Strengthen families and community- based awareness on VPDs including transmission and prevention measures/awareness raising campaigns Create awareness among family members and communities on importance of vaccination and the vaccination schedule Guidance on hygiene during childhood Sensitization/education on appropriate nutrition for children Knowledge on the importance of timely uptake of vaccine dose Appropriate storage and delivery of vaccines on optimal temperature	Routine vaccination on schedule by infants and children * Vitamin A supplementation Strengthen community reporting systems on VPD symptoms Guidance on good hygiene practices including hand hygiene and stay at home if any symptoms of VPDs Avoiding close contact with people with VPDs	Recognition of danger signs of vaccine preventable diseases Antimicrobial therapy when indicated Monitor and manage complications such as apnoea, cyanosis, pneumonia, encephalopathy Report and refer immediately suspected cases of VPDs
Referral Facility: General
Awareness to parents on VPDs and prevention measures Guidance on hygiene practices for children including hand hygiene, cough etiquette Guidance on good nutrition/diet for the children	Routine childhood vaccinations, timely and complete	Recognition of signs and symptoms (features) of VPDs in infants and in children * Report and refer immediately suspected cases of VPDs Emergency care to stabilize VPDs before referral If urgent transfer is not possible: * Oral antibiotics if indicated Supportive therapy Antipyretics for fever and analgesics for aches/pains Nutritional support and supplementation years of age with VPD Hydration /fluids administration for the under 5 with VPD
Referral Facility: Specialist
Awareness to parents on VPDs and prevention measures Guidance on hygiene practices for children including hand hygiene; cough etiquette Guidance on good nutrition/diet for the children	Routine childhood vaccinations, timely and complete	Physical and Clinical examination Hospitalisation of severely ill Oral antibiotics for complications IV antibiotics for complications *Monitoring /special attention to prevent and manage any complications e.g., apnea and pneumonia Oral Vitamin A IV fluid for rehydration ICU services for severely ill Laboratory tests (serology, culture, etc...) Close follow up

Condition: Surgical Emergencies

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement [community sensitization on symptoms of surgical emergencies when to seek care]			Early recognition and referral
Primary Care
Sensitization on symptoms of surgical emergencies when to seek care			History and physical examination Early recognition of need for referral
Referral Facility: General
			History and physical examination for gastrointestinal diseases Point of care testing Basic laboratory tests Ultrasound Intravenous analgesics for appendicitis Intravenous antiemetics Intravenous antimicrobials for appendicitis Intravenous fluids Open appendectomy
Referral Facility: Specialist
			History and physical examination Point of care testing Basic laboratory tests Advanced laboratory tests Computed tomography (CT) scan Ultrasound Intravenous analgesics Intravenous antimicrobials Intravenous fluids Surgical intervention

Condition: Idiopathic epilepsy

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Provide information and Awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures Education to prevent misunderstanding, discrimination and social stigma. multi-sectoral approach to reduce incidences of trauma e.g. falls, burns and promote access to education Community Health workers education on seizures disorders including epilepsy on signs and symptoms, preventive measures and it management at community level	ANC attendance for adequate care and promoting health facilities deliveries to reduce possibility of new cases of seizures disorders including epilepsy caused by birth injury. Prevention and seeking treatment early for febrile infections such as malaria and other viral/bacterial infections and head trauma Education on prevention of infections Prevention of falls, drownings, burns * Vaccination of children to prevent diseases	Early recognition of signs of seizures disorders Relieve of any pain due to physical injuries as a result of seizures through use of pain medications First aid on any other complication due to seizures e.g. burns Referral to a health facility for management	Promote access to occupational opportunities/education
Primary Care
Provide information and Awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures Education to prevent misunderstanding, discrimination and social stigma. Multi-sectoral approach to reduce incidences of trauma e.g. falls, burns and promote access to education Health workers education on seizures disorders including epilepsy on signs and symptoms, preventive measures and it management	ANC attendance for adequate care and promoting health facilities deliveries to reduce possibility of new cases of seizures disorders including epilepsy caused by birth injury. Prevention and seeking treatment early for febrile infections such as malaria and other viral infections Education on prevention of infections Prevention of falls, drownings, burns * Vaccination of children to prevent diseases"	History and physical examination for epilepsy Point of care testing Oral glucose Condition specific nutrition assessment and counselling Oral antiepileptics for epilepsy Oral antipyretics for seizures
Referral Facility: General
Provide information and Awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures Education to prevent misunderstanding, discrimination and social stigma. Multi-sectoral approach to reduce incidences of trauma e.g. falls, burns and promote access to education Health workers education on seizures disorders including epilepsy on signs and symptoms, preventive measures and it management	ANC attendance for adequate care and promoting health facilities deliveries to reduce possibility of new cases of seizures disorders including epilepsy caused by birth injury. Prevention and seeking treatment early for febrile infections such as malaria and other viral infections Education on prevention of infections Prevention of falls, drownings, burns * Vaccination of children to prevent diseases	History and physical examination for epilepsy Point of care testing Basic laboratory tests Lumbar puncture Condition specific nutrition assessment and counselling Oral glucose Intramuscular benzodiazepines for seizures Oral antiepileptics for epilepsy Oral antipyretics for seizures Intravenous benzodiazepines for seizures Intravenous glucose for seizures Laboratory test to monitor therapeutic drug level	Psychoeducation and psychosocial support (including for patient’s carers)
Referral Facility: Specialist
Provide information and Awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures Education to prevent misunderstanding, discrimination and social stigma. Multi-sectoral approach to reduce incidences of trauma e.g. falls, burns and promote access to education Health workers education on seizures disorders including epilepsy on signs and symptoms, preventive measures and it management	ANC attendance for adequate care and promoting health facilities deliveries to reduce possibility of new cases of seizures disorders including epilepsy caused by birth injury. Prevention and seeking treatment early for febrile infections such as malaria and other viral infections Education on prevention of infections Prevention of falls, drownings, burns * Vaccination of children to prevent diseases	History and physical examination for epilepsy Point of care testing Basic laboratory tests Lumbar puncture Condition specific nutrition assessment and counselling Oral glucose Intramuscular benzodiazepines for seizures Oral antiepileptics for epilepsy Oral antipyretics for seizures Intravenous benzodiazepines for seizures Intravenous glucose for seizures Laboratory test to monitor therapeutic drug level	History and physical examination for epilepsy Point of care testing Basic laboratory tests Electrocardiogram (ECG) Magnetic resonance imaging (MRI) Computed tomography (CT) scan Lumbar puncture Electroencephalography (EEG) Condition specific nutrition assessment and counselling Psychoeducation and psychosocial support (including for patient’s carers) Oral glucose Intramuscular benzodiazepines for seizures Oral antiepileptics for epilepsy Oral antipyretics for seizures Intravenous benzodiazepines for seizures Intravenous glucose for seizures Epilepsy surgery Laboratory test to monitor therapeutic drug level

Condition: Malnutrition and Micronutrient Deficiency

Health Promotion	Disease Prevention	Curative
Community Level
Advice to mothers on ensuring breastfeeding including early initiation, exclusive breastfeeding for the first 6 months of life and for at least till the child is two years * Counselling on appropriate and timely complementary feeding and healthy infant and young child nutrition Counselling on good hygiene practices including hand hygiene and quitting smoking Community based MUAC and bilateral edema screening for early identification * Community engagement on Infant and Young Child Nutrition IYCN * Counselling on micronutrient supplementation -Vit. A Supplementation, albendazole Counselling on use of therapeutic and supplementary foods with malnourished children * Education on use of safe water and good compound practices Counselling on when to seek medical help at facility level. * Counselling on use of family MUAC. Self-screening of children 6-59 months by mothers	Exclusive breastfeeding, early initiation of breastfeeding and complementary feeding, * Vitamin A supplementation * Hygiene, sanitation and deworming for preschool children * Follow up/home visits to ensure nutrition products for malnourished children are given to patients Examine/assess children during home/school visits for signs of acute malnutrition using MUAC and Edema to identify and refer identified	Refer children identified with MUAC<12.5cm to next level Follow up cases of moderate and severe acute malnutrition treated at facility Ensure compliance with treatment and advice
Primary Care
Same as Community Level plus * Group and focused counselling of mothers and carers at facility level on MIYCN - Early initiation of breastfeeding, EBF, Appropriate and timely complementary feeding, food demonstrations. Counselling on feeding of the sick child. * Feeding on good hygiene practices. * Growth monitoring and promotion	Breast breastfeeding and complementary feeding; * Routine and outreach of vitamin A and deworming administration * Hygiene, sanitation promotion * Community based growth monitoring * Nutrition products for malnourished children. * Examine children during home visits for signs of acute malnutrition and advise parents accordingly	Management of Severe Acute Malnutrition (SAM) without Complications Educate mothers on feeding of children through provision of practical examples using local foods Provide treatment to correct other specific deficiencies Treat moderate cases with balanced local oral diet Provide children with multivitamin supplement * Conduct food demonstrations on local food preparation
Referral Facility: General
Advice to mothers on ensuring breastfeeding including exclusive breastfeeding for the first 6 months of life and for at least till the child is two years Counselling on Healthy nutrition for the under 5s Counselling on Good hygiene practices including hand hygiene Growth monitoring	Early initiation and exclusive breastfeeding and complementary feeding * Vitamin A administration and deworming * Counselling on hygiene, sanitation practices * Facility based growth monitoring * Use of Local foods for complementary feeding and nutrition products for malnourished children. Examine children during home visits for signs of acute malnutrition and advise parents accordingly	Management of Severe Acute Malnutrition (SAM) with Complications Provision of therapeutic meals for clinical management of patients Educate mothers on feeding of children through provision of practical examples using local foods Treat moderate cases with balanced oral diet, correct fluid and electrolyte imbalances Provide macronutrients for severe cases by appropriate means (orally, feeding tube, nasogastric tube) Provide children with multivitamin supplement Provide treatment to correct other specific deficiencies
Referral Facility: Specialist
Counselling of mothers/caregivers on Breastfeeding- including early initiation and exclusive breastfeeding for the first 6 months of life and for at least till the child is two years Counselling on Healthy IYCN for the under 5s Counselling on Good hygiene practices including hand hygiene Growth monitoring and promotion -screening for malnutrition BFHI promotion	Early initiation and exclusive breastfeeding and complementary feeding * Vitamin A administration and deworming * Counselling on hygiene, sanitation practices Facility based growth monitoring * Use of Local foods for complementary feeding and nutrition products for malnourished children. Examine children during home visits for signs of acute malnutrition and advise parents accordingly	Management of Severe Acute Malnutrition (SAM) with Complications by the national IMAM Protocol * Management of SAM without complications and Management of MAM as per National IMAM protocol. Therapeutic meals for clinical management of under-fives Nutrition counselling Educate mothers on feeding of children through provision of practical examples using local foods Treat existing infections in severe cases Oral macronutrients for severe cases Feeding by feeding tube, nasogastric tube, gastrostomy tube) Multivitamin supplement as appropriate Counsel caregivers on feeding the sick child. Lactose free liquid oral food supplements

Condition: Road traffic Injuries

Health Promotion	Disease Prevention	Curative
Community Level
Mass media campaigns on road safety for children Community awareness on the prevention of fire, heat, falls and drowning of children Educate kindergarten students on safety	Enforcement of traffic regulations including seatbelt use * Use a car safety seat every time your child rides in the car. Installation of speed bumps at high risk intersections(e.g. schools, playground areas) Requirement and enforcement of helmets Breath testing for alcohol * Keeping children under close supervision * Reduce the risk of injuries by making a few practical changes to your home.	First aid Early recognition of danger signs for the need for referral
Primary Care
Promote the use of safety belt * Public awareness campaigns on road safety for children * Education and public awareness of the risks of injuries to children	Counselling on fall prevention Counselling on safety and injury prevention Counselling on vehicular child restraint and road safety behaviours Strength and balance training for fall prevention	History and physical examination for serious injury Early recognition of danger signs and referral
Referral Facility: General
Making parents aware of common injuries and ways to prevent them	Enforcement of traffic regulations including seatbelt use Installation of speed bumps at high risk intersections (e.g. schools, playground areas) * Make sure children are in constant visual eye contact and within arm’s reach of an adult at all times when in and around water. * Keep children away from fires, flames, hot surfaces and hot liquids * Create a clear area for play by removing tripping hazards from the floor, such as toys, rugs and electrical cords * Keep all medicines and household products out of the reach and out of sight of children. * Creating an environment that is safe and not risky such as: -Locking windows and using barriers and stair gates -Using a car seat for infants and toddlers and booster seats for older children -Installing a fence around a swimming pool -Installing a smoke alarm -Using child resistant packages for all medications and discarding unused medications	History and physical examination for serious injury Basic laboratory tests Advanced laboratory tests Basic imaging (x-ray, ultrasound) Advanced imaging (Computed tomography (CT) scan, MRI) Perform temperature management including non-invasive cooling and warming Supplemental oxygen Intramuscular analgesia for serious injury Oral volume resuscitation Oral antimicrobials for serious injury Intramuscular anxiolysis for serious injury Intranasal analgesia for serious injury Intranasal anxiolysis for serious injury Oral analgesia for serious injury Topical analgesia for serious injury Intravenous analgesics for serious injury Intravenous antimicrobials for serious injury Intravenous anxiolytics for serious injury Intravenous fluids Intravenous vasopressor infusion for serious injury Intravenous antifibrinolytics for haemorrhage control Intravenous sedatives for serious injury Intravenous osmotic medications to reduce intracranial pressure Burr hole Craniotomy Blood and blood product transfusion Mechanical ventilation (invasive) Mechanical ventilation (non-invasive) Wound care Continuous vital sign monitoring Transurethral catheter placement Intramuscular tetanus toxoid for serious injury and wounds Spine immobilization Surgical spinal decompression Surgical spinal fixation Pelvic binding Suture repair of lacerations Surgical wound debridement Laparotomy Needle thoracostomy Pericardiocentesis Three sided chest dressing for sucking chest wound Thoracostomy tube Wound care Thoracotomy Bronchoscopy
Referral Facility: Specialist

Condition: Renal Injury (acute renal failure)

Health Promotion	Disease Prevention	Curative
Community Level
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Avoid nephrotoxic medicines and traditional herbs Early treatment seeking for malaria and other infections Keep drugs and harmful substances away from the reach of children Safe environment for children to play	Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early Early treatment of malaria and other infections * Avoid nephrotoxic medicines and traditional herbs
Primary Care
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play	Early recognition of kidney disease symptoms Early treatment of acute febrile illnesses such as malaria * Advice on adequate hydration
Referral Facility: General
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play	Laboratory investigations such as urine, blood to diagnose the underlying diseases * Treat early treatable urinary tract infections and other febrile illnesses * Adequate hydration, In case of kidney trauma, toxicity and overdose of medicines stabilize and refer to the next level
Referral Facility: Specialist
Educate children to avoid wild kicking, falling when playing Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Implement measures such as adequate hydration, Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play	Laboratory investigations such as urine analysis, renal function tests Basic Imaging modalities (x-ray, contrast x-ray, ultrasound Advance imaging modalities( CT scan, MRI) Treat renal diseases according the diagnosis * Renal dialysis for acute and chronic renal failures * Surgical management for trauma to the kidneys

Condition: Childhood Cancers

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Educate community to identify childhood cancer symptoms such as unusual swelling, early bruising or bleeding, unexplained weight loss and fever, persisting headache and vomiting, sudden eye problem	Keeping children away from second-hand smoke Reducing exposure to traffic-related air pollution Avoiding exposure to chemicals that can cause cancer.	Early identification of cancer symptoms and referral
Primary Care
Educate community to identify childhood cancer symptoms such as unusual swelling, early bruising or bleeding, unexplained weight loss and fever, persisting headache and vomiting, sudden eye problem	Keeping children away from second-hand smoke *Reducing exposure to traffic-related air pollution Avoiding exposure to chemicals that can cause cancer	Early identification of cancer symptoms and referral
Referral Facility: General
Educate community to identify childhood cancer symptoms such as unusual swelling, early bruising or bleeding, unexplained weight loss and fever, persisting headache and vomiting, sudden eye problem	Keeping children away from second-hand smoke Reducing exposure to traffic-related air pollution Avoiding exposure to chemicals that can cause cancer	Early identification of cancer symptoms and referral
Referral Facility: Specialist
Educate community to identify childhood cancer symptoms such as unusual swelling, early bruising or bleeding, unexplained weight loss and fever, persisting headache and vomiting, sudden eye problem	Keeping children away from second-hand smoke Reducing exposure to traffic-related air pollution Avoiding exposure to chemicals that can cause cancer	Counselling on nutrition, food safety, and healthy diet Histopathology Staging Advanced imaging Intravenous chemotherapy Intravenous targeted therapy Intravenous immunotherapy Bone marrow transplantation Radiotherapy application Management of toxicities Monitoring for new cancers Monitoring for toxicities Monitor for cardiac function Monitor for neurocognitive function Monitor for groth and development	Provide palliative and supportive care Psychological support with counselling Physical therapy and occupational therapy (peripheral neuropathy, after severe illnesses)

Condition: Burns

Health Promotion	Disease Prevention	Curative
Community Level
Mass media campaigns on preventing burns in children * Community awareness on the prevention of fire, heat, burn Educate KG students on safety measures	Counselling on burn prevention Keep children away from fires, flames, hot surfaces and hot liquids Create a safe and not risky environment at home and school	Decontamination Home wound care Oral fluids Early recognition of the need for referral of thermal and chemical injuries
Primary Care
Mass media campaigns on preventing burns in children Community awareness on the prevention of fire, heat, burn Educate KG students on safety measures	Counselling on burn prevention Keep children away from fires, flames, hot surfaces and hot liquids * Create a safe and not risky environment at home and school	Decontamination Outpatient wound care Oral analgesics for thermal and chemical injuries Intravenous fluids Clinical assessment for early recognition of the need for referral
Referral Facility: General
Mass media campaigns on preventing burns in children Community awareness on the prevention of fire, heat, burn Educate KG students on safety measures	Counselling on burn prevention Keep children away from fires, flames, hot surfaces and hot liquids Create a safe and not risky environment at home and school	Accurate Total Body Surface Area (TBSA) estimation Adequate analgesia to facilitate assessment and patient comfort IV fluid resuscitation Check peripheral perfusion and need for escharotomy Prevention of hypothermia Dressings depending on the type of burn Burn wound management depending on the type of burn Intramuscular tetanus toxoid for burns Blood and blood product transfusion Nutritional support including therapeutic feeding for thermal and chemical injuries Surgical interventions: trauma management, debridement, basic skin grafting, escharotomy fasciotomy-myectomy
Referral Facility: Specialist
Mass media campaigns on preventing burns in children Community awareness on the prevention of fire, heat, burn Educate KG students on safety measures.	Counselling on burn prevention Keep children away from fires, flames, hot surfaces and hot liquids * Create a safe and not risky environment at home and school	Accurate Total Body Surface Area (TBSA) estimation Adequate analgesia to facilitate assessment and patient comfort IV fluid resuscitation Check peripheral perfusion and need for escharotomy Prevention of hypothermia Dressings depending on the type of burn Burn wound management depending on the type of burn Intramuscular tetanus toxoid for burns Blood and blood product transfusion Nutritional support including therapeutic feeding for thermal and chemical injuries Surgical interventions: trauma management, debridement, basic skin grafting, escharotomy fasciotomy-myectomy

Condition: Bites and Envenomation

Health Promotion	Disease Prevention	Curative
Community Level
Increasing awareness of rabies, snake bite and scorpion sting prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, immediate care measures after a bite	Wear high, thick rubber boots when walking through snake-prone areas Counselling on prevention of bite and envenoming injuries Eliminating rabies in dogs- through Vaccinating dogs. Pre-exposure immunization for high-risk occupations	Early recognition of the need for referral of bites and envenoming injuries Wound care
Primary Care
	Wear high, thick rubber boots when walking through snake-prone areas Counselling on prevention of bite and envenoming injuries Eliminating rabies in dogs- through Vaccinating dogs. Pre-exposure immunization for high-risk occupations	History and examination for bites and envenoming injuries Wound care Oral analgesics Early recognition of the need for referral of bites and envenoming injuries
Referral Facility: General
Increasing awareness of rabies, snake bite and scorpion sting prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, immediate care measures after a bite	Wear high, thick rubber boots when walking through snake-prone areas Counselling on prevention of bite and envenoming injuries Eliminating rabies in dogs- through Vaccinating dogs. Pre-exposure immunization for high-risk occupations	History and examination for bites and envenoming injuries Adequate analgesics Adequate hydration Immunoglobulin for bites and envenoming injuries Vaccine for bites and envenoming injuries Intravenous antivenin for bites and envenoming injuries Surgical exploration and debridement for bites and envenoming injuries
Referral Facility: Specialist
Increasing awareness of rabies, snake bite and scorpion sting prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, immediate care measures after a bite.	Wear high, thick rubber boots when walking through snake-prone areas Counselling on prevention of bite and envenoming injuries Eliminating rabies in dogs- through Vaccinating dogs. Pre-exposure immunization for high-risk occupations	History and examination for bites and envenoming injuries Adequate analgesics Adequate hydration Immunoglobulin for bites and envenoming injuries Vaccine for bites and envenoming injuries Antivenin for bites and envenoming injuries Surgical exploration and debridement for bites and envenoming injuries

Condition: Sickle cell anemia/disorder

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community education and awareness on sickle cell disease * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs Sensitize and use local governance structures to establish community-based intervention program	Genetic counselling for carriers of haemoglobin disorders, including premarital counselling Prophylaxis for infection, pneumococcal vaccines, oral penicillin, Insecticide treated bed nets, Prophylaxis for Malaria Folate supplementation with folic acid	Recognition of Sickle cell disease signs and symptoms	Immediate transfer of severe anaemia to a higher-level health care facility	Physiotherapy: exercise, breathing exercises and massages	Non-opioid analgesia for effective control of mild to moderate- pain Symptomatic non-pharmacological treatment Emotional, social, spiritual support for parents
Primary Care
Community education and awareness on sickle cell disease * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs Sensitize and use local governance structures to establish community-based intervention program	Genetic counselling for carriers of haemoglobin disorders, including premarital counselling Prophylaxis for infection, pneumococcal vaccines, oral penicillin Insecticide treated bed nets Prophylaxis for Malaria Folate supplementation with folic acid	Prenatal screening using rapid point of care test	Management of pain Referral to the next higher level Folic acid	Physiotherapy, exercise, breathing exercises and massages	Non-opioid analgesia for effective control of mild to moderate- pain Symptomatic non-pharmacological treatment Emotional, social, spiritual support for parents
Referral Facility: General
Parent/care takers education and awareness on sickle cell disease, physical activity and need of being mobile, breathing techniques	Genetic counselling for carriers of haemoglobin disorders, including premarital counselling Prophylaxis for infection, pneumococcal vaccines, oral penicillin,	History Physical examination Pre-natal Screening Neonatal screening X-ray, Ultrasound Electrocardiogram (ECG)	Chemoprophylaxis IV fluids Supplemental oxygen IM analgesics IM/IV antibiotics Blood and blood product transfusion Referral to the next higher level	Physiotherapy: exercise, breathing exercises and massages	Opioid analgesia for effective control of moderate- to severe pain Symptomatic non-pharmacological treatment Emotional, social, spiritual support for parents
Referral Facility: Specialist
Parent/care takers education and awareness on sickle cell disease, physical activity and need of being mobile, breathing techniques	Genetic counselling for carriers of haemoglobin disorders, including premarital counselling Prophylaxis for infection, pneumococcal vaccines, oral penicillin,	History Physical examination Pre-natal screening Neonatal screening Incentive spirometry X-ray, Ultrasound, Computed tomography (CT) Electrocardiogram (ECG)	Chemoprophylaxis Oral hydroxyurea IV fluids Supplemental oxygen IV/IM analgesics IV/IM antibiotics Blood and blood product transfusion Splenectomy Red cell exchange transfusion	Physiotherapy: exercise, breathing exercises and massages	Opioid analgesia for effective control of moderate- to severe pain Symptomatic non-pharmacological treatment Emotional, social, spiritual support for parents

Condition: Road traffic Injuries

Health Promotion	Disease Prevention	Curative
Community Level
Mass media campaigns on road safety for children Educate kindergarten students on safety	Enforcement of traffic regulations Using appropriate child restraints and seatbelts Requiring children to sit in the rear passenger seat Use a car safety seat every time a child rides in the car Installation of speed bumps at high-risk intersections (e.g schools, playground areas) Breath testing for alcohol	First aid Early recognition of danger signs for the need for referral
Primary Care
Public awareness campaigns on road safety for children	Counselling on vehicular child restraint and road safety behaviours	First aid Early recognition of danger signs and referral
Referral Facility: General
Health education on road safety to children and their parents		Paediatric Advanced Life Support (PALS) Advanced Trauma Life Support (ATLS) management IV fluids Blood and blood product transfusion Acute trauma management, Transfer to higher centres for complicated cases
Referral Facility: Specialist
Health education on road safety to children and their parents		Paediatric Advanced Life Support (PALS) Advanced Trauma Life Support (ATLS) management Blood and blood product transfusion Major surgery Re-constructive surgery

Condition: Invasive non-typhoid Salmonella (iNTS)

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Community and mass media-based awareness campaign	Breastfeeding Good sanitation and hygiene practices Safe water supply Insecticide treated bed net Indoor residual spray	Recognition of Invasive Non-typhoidal Salmonella (iNTS) signs and symptoms	Oral rehydration Antipyretics Immediate transfer to a higher-level health care facility
Primary Care
Health education on good sanitation and hygiene practices including hand washing	Good sanitation and hygiene practices Perennial malaria chemoprevention (PMC) Seasonal malaria chemoprevention (SMC) RTS, S Malaria vaccine	History Physical examination	Oral rehydration Antipyretics Immediate transfer to a higher-level health care facility
Referral Facility: General
Health education on prevention and treatment of Invasive Non-typhoid salmonella	Access to safe drinking water Use of improved sanitation Hand washing with soap Malaria prevention	History Physical examination Anthropometric measurement Complete blood count Malaria test HIV test Serologic tests	Oral rehydration salts (ORS) solution Antibiotics IV fluids Anti-malaria treatment Nutritional support
Referral Facility: Specialist
Health education on prevention and treatment of Invasive Non-typhoid salmonella	Access to safe drinking water Use of improved sanitation Hand washing with soap Malaria prevention	Blood culture Bone marrow culture Stool culture Lumbar puncture CSF analysis	Antibiotics Anti-malaria treatment IV fluid Nutritional support

Condition: Neural Tubal Defect

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate adolescent girls and mothers to have a healthy diet including adequate dietary intake of vegetables and fruit; vitamins and minerals particularly folic acid, and maintain a healthy weight Community awareness on addressing stigma attached with congenital abnormalities Information education and communication on harmful substances, particularly alcohol and tobacco, exposure of pregnant women to medications	Adequate dietary intake of vitamins and minerals, folic acid, variety of vegetables and fruit, and maintain a healthy weight for adolescent’s girls and mothers Avoid harmful substances, particularly alcohol and tobacco during pregnancy Reduce or eliminating environmental exposure to hazardous substances (such as heavy metals or pesticides) during pregnancy;	Recognition of neural tubal defect signs and symptoms	Immediate transfer of suspected NTD to a higher-level health care facility	Physical rehabilitation Family or caregiver educational training	Psychological and social support to patients and families of babies with birth-related complications
Primary Care
Educate adolescent girls and mothers to have a healthy diet including adequate dietary intake of vegetables and fruit, vitamins and minerals particularly folic acid, and maintain a healthy weight Educating and counselling parents and community on addressing stigma attached with congenital abnormalities Information education and communication on harmful substances, particularly alcohol and tobacco, exposure of pregnant women to medications or medical radiation	Folic acid/multiple micronutrient supplementation in early pregnancy * Avoiding teratogenic medications during pregnancy Preconception care: glycaemic control	Recognition of neural tubal defect signs and symptoms	Immediate transfer of correctable NTD to a higher-level health care facility	Long term rehabilitation support including physical therapy, speech therapy, occupational therapy Family or caregiver educational training Provide assistive products	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: General
Health education on prevention and early identification of congenital defects	Folic acid/multiple micronutrient supplementation in early pregnancy * Avoiding teratogenic medications during pregnancy Preconception care: glycaemic control	History Physical examination Alpha fetoprotein (AFP) Ultrasound	Counselling for NTD identified prenatally Immediate transfer of correctable NTD to a higher-level health care facility	Long term rehabilitation support including physical therapy, speech therapy, occupational therapy	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: Specialist
Health education on prevention and early identification of congenital defects	Folic acid/multiple micronutrient supplementation in early pregnancy * Avoiding teratogenic medications during pregnancy Preconception care: glycaemic control	History Physical examination Serum Alpha fetoprotein (AFP) Amniotic Alpha fetoprotein (AFP) Ultrasound	Neonatal surgical repair	Long term rehabilitation support including physical therapy, speech therapy, occupational therapy Family or caregiver educational training Provide assistive products	Psychological and social support to patients and families of babies with birth-related complications Assess to detect and manage any signs of neurologic dysfunction such as delayed developmental milestones

Condition: Syphilis

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Social and behavioural change communication for parents Community awareness on the risks and prevention of sexual abuse of children	Primary prevention of syphilis in adolescents and women of child bearing ages Safe sexual practice including condom use	Recognition of syphilis signs and symptoms Syphilis RDT	Referral to the next higher level		Emotional, social, spiritual support for parents
Primary Care
	Safe blood transfusion Early syphilis screening and treatment of women	History Physical examination Treponemal test Non-treponemal rapid plasma reagin (RPR) test Syphilis testing of mother	Antibiotics Referral to the next higher level	Physiotherapy, speech therapy services Training on use of assisting devices	Emotional, social, spiritual support for parents
Referral Facility: General
	Safe blood transfusion Screening pregnant women for syphilis Treatment of syphilis in pregnant women	History Physical examination Treponemal test Non-treponemal rapid plasma reagin (RPR) test Syphilis testing of mother 8 X-ray	Antibiotics Referral to the next higher level for corrective surgery	Physiotherapy, speech therapy services Training on use of assisting devices	Emotional, social, spiritual support for parents
Referral Facility: Specialist
	Safe blood transfusion Screening pregnant women for syphilis Treatment of syphilis in pregnant women	History Physical examination Treponemal test Non-treponemal rapid plasma reagin (RPR) test Lumbar puncture for CSF analysis X-ray Histological examination of the placenta and cord	Antibiotics Surgical repair of deformity	Physiotherapy, speech therapy services Training on use of assisting devices	Emotional, social, spiritual support for parents

Condition: Digestive congenital anomalies (Oesophageal Atresia/Tracheo-Oesophageal Fistula)

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate adolescent girls and mothers to have a healthy diet including adequate dietary intake of vegetables and fruit, vitamins and minerals particularly folic acid; and maintain a healthy weight Educating and counselling parents and community on addressing stigma attached with congenital abnormalities Information education and communication on harmful substances, particularly alcohol and tobacco, exposure of pregnant women to medications	Adequate dietary intake of vitamins and minerals, folic acid, variety of vegetables and fruit, and maintain a healthy weight for adolescent’s girls and mothers Avoid harmful substances, particularly alcohol and tobacco during pregnancy Reduce or eliminating environmental exposure to hazardous substances (such as heavy metals or pesticides) during pregnancy.	Recognition of digestive congenital anomalies signs and symptoms	Immediate transfer of suspected congenital digestive system anomalies to a higher-level health care facility	Physiotherapy, speech therapy services Comprehensive and holistic care for the long-term management of problems associated with post-operative care	Psychological support to parents of babies with birth-related complications
Primary Care
Raise awareness on the importance of birth defects as a cause of child morbidity and mortality Educate adolescent girls and mothers on healthy diet and consumption of foods rich in natural folates Information education and communication on harmful substances, particularly alcohol and tobacco Education to minimize exposure of pregnant women and workers in their workplace to risk factors for congenital anomalies (chemical, physical and biological	Avoiding teratogenic medications during pregnancy	Recognition of digestive congenital anomalies signs and symptoms	Immediate transfer of suspected digestive congenital anomalies to a higher-level health care facility	Physiotherapy, speech therapy services Comprehensive and holistic care for the long-term management of problems associated with post-operative care	Assess to detect and treat any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: General
Raise awareness of health professionals on the importance of new born screening for early identification of infants born with congenital birth defects	Appropriate use of fortified foods Avoiding teratogenic medications during pregnancy	Clinical suspicion Chest radiograph	Immediate transfer of suspected digestive anomalies to a higher-level health care facility	Physiotherapy, speech therapy services Comprehensive and holistic care for the long-term management of problems associated with post-operative care	Assess to detect and treat any signs of neurologic dysfunction such as delayed developmental milestones
Referral Facility: Specialist
Raise awareness of health professionals on the importance of new born screening for early identification of infants born with congenital birth defects	Correction of some endocrine and metabolic abnormalities such as diabetes, hypothyroidism before conception Avoiding teratogenic medications during pregnancy Genetic testing and counselling for families at risk	Clinical suspicion Chest radiograph Ultrasonography (pre and post-natal) Chromosomal studies	Antibiotics, Intravenous fluids Nothing by mouth (NPO) Total parenteral nutrition (TPN) Surgical repair 8 Postoperative neonatal intensive care	Physiotherapy, speech therapy services Comprehensive and holistic care for the long-term management of problems associated with post-operative care	Psychological support to parents of babies with birth-related complications Assess to detect and treat any signs of neurologic dysfunction such as delayed developmental milestones

Condition: Sudden infant death syndrome

Health Promotion	Disease Prevention	Diagnostic	Palliative
Community Level
Education on safe sleeping practices	Avoid use of alcohol or illicit drugs during pregnancy Place infant on the back to sleep Allow infant to sleep in his or her own crib in the same room as caregivers Firm and flat surface for sleeping Avoid soft bedding or objects such as blankets, pillows or toys in sleeping area Avoid covering infant's head Avoid overheating Avoid second-hand smoke Do not prop bottles in the baby's mouth Breastfeeding Immunizations		Emotional support for caretakers
Primary Care
Education to parents on safe sleeping practices Establish and implement institutional policies on safe sleeping practices for infants	Safe sleeping practice for infants	Recognition of malaria signs and symptoms	Emotional support for caretakers
Referral Facility: General
Education to parents on safe sleeping practices	Safe sleeping practice for infants	Recognition of malaria signs and symptoms	Emotional support for caretakers
Referral Facility: Specialist
Education to parents on safe sleeping practices	Safe sleeping practice for infants	Recognition of malaria signs and symptoms	Emotional support for caretakers

Condition: Drowning

Health Promotion	Disease Prevention	Diagnostic	Curative
Community Level
Community awareness about the risks and prevention of childhood drowning	Safe places away from water for pre-school children Close and constant supervision during swimming Physical barriers to stop children coming into contact with open water sources Use of playpens, doorway barriers, pool fencing, and cistern, tank or well covering	Recognition of drowning signs and symptoms	First aid (ABC) Immediate transfer to a higher-level health care facility
Primary Care
Health education about the risks and prevention of childhood drowning		History Physical examination Pulse oximetry Chest radiography	First aid: artificial respiration Adequate oxygenation, Prevent aspiration Stabilise body temperature Immediate transfer to a higher-level health care facility
Referral Facility: General
Health education about the risks and prevention of childhood drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management Grade II & III drowning Prevention of hypothermia Oxygen supply Mechanical ventilation
Referral Facility: Specialist
Health education about the risks and prevention of childhood drowning		History Physical examination Basic metabolic panel Pulse oximetry Chest radiography ECG	Continuous vital sign monitoring Management of Grade IV & V drowning Warmed IV Fluids Humidified oxygen delivery Mechanical ventilation

Condition: Neonatal Preterm Birth

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
	Regular ANC attendance Delivery by a skilled attendance Timely access to obstetric care Smoking cessation Maintain healthy body weight Avoidance of heavy workload	Recognition of Neonatal Preterm birth signs and symptoms	Immediate Kangaroo mother care (KMC) Immediate transfer to a higher-level health care facility	Physical therapy for children with neurological complications	Psychological support to parents of babies with birth-related complications
Primary Care
Promote family involvement in the routine care of preterm or low-birth-weight infants in health-care facilities	Identify high risk women Antibiotics for PROM Timely referral	History Physical examination Pelvic examination	Immediate Kangaroo mother care (KMC) Expressed mother’s own milk feeding by cups, nasogastric tubes Immediate transfer to a higher-level health care facility	Physical therapy for children with neurological complications	Psychological support to parents of babies with birth-related complications
Referral Facility: General

Referral Facility: Specialist