Interventions for Congenital musculoskeletal and limb anomalies

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Age Cohort: Pregnancy and newborn

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	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	Recognition of Congenital musculoskeletal and limb anomalies signs and symptoms	Immediate transfer of congenital anomalies to a higher-level health care facility	Home based physiotherapy and occupational therapy	Psychological and social support to parents of babies with birth-related defects
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 Measles-rubella (MR) vaccine Screening and treatment of infections, especially rubella, varicella and syphilis	Recognition of Congenital musculoskeletal and limb anomalies signs and symptoms	Immediate transfer of suspected congenital anomalies to a higher-level health care facility	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects
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	Correction of some endocrine and metabolic abnormalities such as diabetes, hypothyroidism before conception Appropriate use of fortified foods Avoiding teratogenic medications during pregnancy	History Physical exam X-ray	Immediate transfer of congenital anomalies to a higher-level health care facility	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects
Referral Facility: Specialist
	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	History Physical examination Anthropometric measurements X-ray Ultrasonography (pre and post-natal) Chromosomal studies Computerized tomography (CT) Magnetic resonance imaging (MRI)	Antibiotics, Intravenous fluids Surgical repair Feeding support	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects

Age Cohort: < 5 years

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	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	Recognition of Congenital musculoskeletal and limb anomalies signs and symptoms	Immediate transfer of congenital anomalies to a higher-level health care facility	Home based physiotherapy and occupational therapy	Psychological and social support to parents of babies with birth-related defects
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 Measles-rubella (MR) vaccine Screening and treatment of infections, especially rubella, varicella and syphilis	Recognition of Congenital musculoskeletal and limb anomalies signs and symptoms	Immediate transfer of suspected congenital anomalies to a higher-level health care facility	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects
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	Correction of some endocrine and metabolic abnormalities such as diabetes, hypothyroidism before conception Appropriate use of fortified foods Avoiding teratogenic medications during pregnancy	History Physical exam X-ray	Immediate transfer of congenital anomalies to a higher-level health care facility	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects
Referral Facility: Specialist
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		History Physical examination Anthropometric measurements X-ray Ultrasonography (pre and post-natal) Chromosomal studies Computerized tomography (CT) scan Magnetic resonance imaging (MRI)	Antibiotics, Intravenous fluids Surgical repair Dental work Feeding support	Physiotherapy and occupational therapy Comprehensive and holistic care for the long-term management of problems associated with the congenital abnormality	Psychological and social support to parents of babies with birth-related defects