Steps
1) Take comprehensive history of the child and pregnant mother at first contact at clinic to assess risk status of the child such as their weight and eating habits. Based on findings refer to appropriate services. Similarly do the same for other population categories that are presenting with risk factors.
2) Agree and set up a schedule for home visits.
3) Review records, family history, cultural background prior to the visit to identify potential risks.
4) Upon arrival at the home set a conducive tone (warm introduction, thank family for time and participation, etc.) in order that conversation may more easily identify risk factors
5) During the home visits, you should follow up on all family members and confirm they have registered birth certificates because a child without a birth certificate is ‘at risk’
6) You should try and get an opportunity to individually talk to all the family members including children as some of the health risks may not be immediately obvious on a casual observation such as depression and addiction.
7) You should conduct screening for and responding to risk factors (for example, depression, family violence , and food insecurity ) as appropriate;
• Identify and address health care needs (for example, referral for postnatal and immunization services) Because a child who is not fully immunized is at risk;
• Assess the safety of the home environment (Because an unsafe home environment puts a child at risk) and advise parents on childproofing and proper nutrition of the children as per the local context.
• Do screening to all adult in the household for diabetes and hypertension, identifying of new cases should be referred to health clinic to attend the next NCD clinic.
• Share information on first 1000 days including: safe sleep, breast-feeding and complementary feeding, immunizations, basic care (swaddling, diapering, and bathing), and how to handle sleep deprivation and stress(This is the most critical stage for risks and doing these actions will help minimize or reduce the risk of disease);
8) Allow family input during discussions making sure to refer to reporting form and record pertinent information
9) Make appropriate referral to other service providers as necessary.
10) Agree on the date for follow-up at the clinic as necessary.
Remember
All PHC care providers should be sensitized on risk factors for children. These include:
- Being raised by a single parent or with a step-dad
- Instances of intimate partner violence
- Lack of food/ balanced diet in the household could lead to malnutrition
It is important to note that the home visits can act as deterrent to mistreatment of children