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IMCI ADAPTATION GUIDE - World Health Organization

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1. 6 4 Translate the video if necessary uoce erdt D ox iro ta etn 6 5 Translate the answer sheets in the Facilitator Guide for Modules and if necessary all of the facilitator guides and the Course Director CUCA EA 6 6 Print out the translated modules and translated parts of the guides Then check them carefully against the adapted modules in ENB lt a Prepare the camera ready adapted and translated chart booklet and als aia 7 1 Prepare the car a das hee mo e iO d Prepare the A IE 7 3 Produce high quality copies of each box in the chart booklet for taping into the final modules vinci tt dio li Print out the final modules and recording forms adapted and translated and proof carefully sss Tape and write in necessary items to complete the modules facilitator guides and other materials esee Copy the answer sheets from the Facilitator Guide for Modules Print the course materials seecae ruiserior ietie AERA Section B Annexes Annex B 1 Annex B 2 Annex B 3 Annex B 4 Annex B 5 Annex B 6 Annex B 7 Specifications of printers for producing the modules and other documents in WordPerfect 19 Managing the computer files eset oreet ree tas e rera ud 21 WordPerfect settings and features used in the files for the modules and recording forms sssssssseeee 26 L
2. B Procedures for Adapting the Charts and Modules Ear infection Ear pain Ear problem Early implementation phase 2 Early use countries Empirical treatment Energy rich foods Engorgement breast Episode of illness Erythromycin Essential drugs Essential services Evaluation Exclusive breastfeeding Exclusively breastfed Expanded Programme on Immunization EPI Expansion phase 3 Expressed breastmilk Eye ointment Facilitator Guide for Modules Facilitator Guide for Outpatient Clinical Practice Facility supports Family and community practices Family foods Family planning Fast breathing Febrile disease Feeding assessment Feeding counselling Feeding problem or low weight Feeding problems Feeding questions Feeding recommendations Fever Fever malaria unlikely Infection de l oreille Douleur l oreille Probl me d oreille affection de l oreille Phase initiale de la mise en uvre Pays premiers utilisateurs pays qui les premiers ont utilis la PCIME Traitement empirique Aliments nerg tiques Engorgement Episode de maladie Erythromycine f M dicaments essentiels Services essentiels Evaluation Allaitement au sein exclusif Exclusivement allait au sein Programme largi de Vaccinations PEV Extension phase 3 Lait maternel exprim Pommade ophtalmique Guide de l Animateur pour l Enseignement des Modules Guide de l Animateur pour l Activit Clin
3. Shortages of drugs and large case loads make difficult working conditions and discourage health workers so supervisors should try to change them The reference to Them is not clear What needs changing the shortages and case loads or the health workers To help the less able reader follow relationships include relative pronouns rather than deleting them to help keep the relationships clear gt This is the same parasite that is found in young children who come to this health centre rather than This is the same parasite found in young children coming to this health centre Organizing sentences and paragraphs 76 18 19 Organize information in sentences and paragraphs according to a logical order such as sequence or time Use clear transitions to help the reader follow what should happen first second etc gt First ask the mother to describe how she feeds her child Next ask her how often she feeds her child is better than Before asking the mother how often she feeds her child ask her to describe how she feeds her child Pay attention to the organization of the page Take any opportunity to break up the monotony of a solid page of text For example can any information be placed in a list Would an illustration help Can longer paragraphs be broken into shorter paragraphs B Procedures for Adapting the Charts and Modules References Savage F and Godwin P 1981 Controlling your langu
4. MEASLES WITH EYE OR MOUTH COMPLICATIONS mebendazole medical assistant melena meningitis micronutrient supplementation monitoring morbidity mortality mosquito bite blanche movement normal nalidixic acid nasal discharge ict rique l thargique l thargie infection bact rienne locale infection locale infection localis e appellations locales sympt mes principaux principales maladies paludisme neuropaludisme risque de paludisme lev faible 7 risque palustre paludisme peu probable malnutrition prise en charge de l enfant malade prise en charge de l enfant ayant une infection s v re on une malnutrition s v re prise en charge du nourrisson malade g de 1 semaine 2 mois mastoidite mat riels documents tissus etc sant maternelle rougeole rougeole s v re compliqu e ruption rougeoleuse rougeole avec complications aux yeux ou la bouche complications oculaires et buccales m bendazole assistant m dical m l na ou m laena m ningite compl ment 7 suppl mentation en micronutriments Suivi surveillance morbidit mortalit piq re de moustique dans Cours du Directeur mouvement normal acide nalidixique coulement nasal B Procedures for Adapting the Charts and Modules nasal flaring nasogastric NG therapy nasogastric tube needle NO ANAEMIA AND NOT VERY LOW WEIGHT NO DEHYDRATION NO EAR INFECTIO
5. 100 0 cm bottom Or 000 26 B Procedures for Adapting the Charts and Modules Line Justification Justify Left Widow Orphan On Text Box In Options menu for text box select single for border style Select anchor to para and set positions as needed Recording form settings Note Due to the special requirements of the Recording Form the margins are less than what is recommended for page margins in all of the other files The form was created with a base font and font size that is different from the recommended base font for the modules and facilitator guides The Recording Form files for both the Sick Child and Young Infant Recording forms have the following initial settings Page Paper Size Definition 2 cm x 29 7 cm 8 27 x 11 69 for A4 paper size Margins for Top 1 02cm or 0 4 A4 Paper Size Bottom 1 47cm or 0 58 Left 1 27cm or 0 5 Right 1 27cm or 0 5 If you change to Letter size paper 21 59 cm x 27 94 cm or 8 5 x 11 reset the bottom margin as follows The form will also adjust itself to some extent to maintain almost the same appearance Bottom 1 02cm or 0 4 Base Font Univers 8 point Note When a printer defaults to Arial or Helvetica 8 point as the closest san serif font check to see if the font has affected the spacing of the form You may need to do considerable reformatting Extra Large and Large are selected from the Font Size menu to increase font size for the title of the form a
6. 300 dots per inch dpi and True Type fonts preferably a laser printer The files 1 The software Microsoft Publisher version 2 0 costs approximately US 80 It can be requested from the World Health Organization Department of Child and Adolescent Health and Development for use in adapting materials 3 B Procedures for Adapting the Charts and Modules have been successfully printed on Hewlett Packard Laser Jet II III and IV printers and on a QMS printer s Depending on the amount of adaptation needed and the approach to be taken to produce the chart booklet and wall charts see step 7 0 below One sided black and white copy of generic chart booklet Black and white copy of generic wall charts STEPS TO CHANGE THE CHARTS AND MODULES The steps to make changes in the charts and modules are described below Additional details such as about managing the computer files are in the annexes to this section 1 Red pencil all changes into the chart booklet and recording forms When you start the actual physical adaptation of the chart booklet charts modules and other materials all the decisions about the adaptations in the chart booklet should have been made The final draft adapted chart booklet is the result of the work done to decide appropriate adaptations set clinical policies and guidelines and adapt the feeding recommendations as described in the previous sections of the JMCT Adaptation Guide When pencillin
7. Anaemia Anaemia or very low weight Antibiotic Antihelminthic treatment Antimalarial Areola Assess Assess and classify the sick child age 2 months up to 5 years Assessment Attachment breastfeeding Bcg Becomes sicker Bednets insecticide impregnated Benzylpenicillin Blood sugar low Boils Breast infection Poursuivre l alimentation ne pas arr ter l alimentation Aigu f Infection aigu de l oreille Infection aigu des voies respiratoires inf rieures 7 infection aigu des voies respiratoires basses Infections respiratoires aigu s IRA Infection aigu des voies respiratoires sup rieures 7 infection aigu des voies respiratoires hautes Adaptation Guide pour l adaptation Donner des conseils conseiller Algorithme directives Amoxicilline f An mie An mie ou poids tr s faible Antibiotique Traitement vermifuge traitement anthelminthique Antipalud en antipaludique Ar ole Evaluer Evaluer et classer l enfant malade g de 2 mois 5 ans Evaluation Prise du sein Bcg Devient plus malade Moustiquaires impr gn es Benzylp nicilline f Sucre dans le sang glyc mie basse Furoncles Infection du sein B Procedures for Adapting the Charts and Modules Breastfeed Allaiter au sein Breastfeeding assessment counselling Allaitement au sein valuation conseil Breastmilk Lait maternel Breastmilk substitute Substitut du
8. Staff required Equipment and supplies required Steps to Change the Charts and Modules 1 2 B Procedures for Adapting the Charts and Modules Red pencil all changes into the chart booklet and recording forms Make a list of all changes needed in the charts and list any other changes needed in the modules which do not appear on the charts Adapt the recording forms using the computer files Mark all adaptations in the modules and answer sheets in the Facilitator Guide for Modules and mark any other changes Iti facilitator pudes nani isla 4 1 Follow the instructions in section H if any of the adaptations that you need to make are described there For other adaptations read through the modules and mark changes needed errante 4 2 Check all the changes for accuracy consistency and compl ai Change the computer TES cai 5 1 Enter all changes in the computer files esee 5 2 Print out and check all the computer changes in the modules and facilitator a Translate the training materials nc nn 6 1 Give the translator the list of key words to translate first Then check them ociera nennen 7 vi 10 11 6 2 Translate the chart booklet and recording forms consistently using the agreed translations of the key words including thel c l terms ssl a 6 3 Translate the adapted modules being consistent with the chart booklet vocabulary and agreed translations of the key words
9. Supplies may be assembled as Adaptation kit 1 roll invisible tape in dispenser does not show on photocopying 3 refill rolls of invisible tape 1 T square for making items straight on the page before taping 3 pencils 2 red pencils 2 red felt tip pens 1 eraser 1 small pencil sharpener 1 bottle white out fluid 1 box correction tape 1 scissors 1 writing pad 1 highlighter pen 1 box of diskettes for back up of adapted modules Photocopy machine which makes clear copies ability to reduce is helpful e Supply of good quality paper size A4 and some A3 gt To adapt the generic chart booklet the following are needed Diskette from WHO with the computer files for the generic chart booklet in Microsoft Publisher version 2 0 The chart booklet is saved in two files Eng lnd pub contains the chart pages in A4 Landscape mode page size 29 7cm x 21cm or 11 69 x 8 27 Eng prt pub contains the patient recording forms in A4 Portrait mode page size 21cm x 29 7cm or 8 27 x 11 69 Personal computer system requirements Microprocessor Pentium computer recommended or 80386DX minimum Memory 16 MB recommended or 6 MB minimum Hard disk space 10 MB minimum available Disk drive 3 5 inch 1 4 MB capacity Operating system Windows 3 1 or Windows for Workgroups 3 11 Software Microsoft Publisher version 2 0 for Windows 3 1 or 3 11 Printer Any Windows supported printer capable of printing a minimum of
10. back up as you adapt the files and when you have finished When you are making changes always use the files on the hard drive Save your work to the hard drive frequently Then periodically such when you finish for the day or finish working on a particular module copy back up the files you have changed to the set of diskettes If you always work on the files on the hard drive and then back up each file when you have finished with it you will not be confused about finding the most recent revisions If you have a computer problem you will have a back up copy of the most recent version on your diskettes 21 B Procedures for Adapting the Charts and Modules File names 22 The following file names are used on the generic diskettes It is highly recommended that you use them also but with your own extension When they are all copied into a new subdirectory on the hard disk they will arrange in a logical order This will help you find the files you need more easily File Names of the Modules 1 INTRO GEN 2 ASS1 GEN 2 ASS2 GEN 3 ID GEN 4 TRE1 GEN 4 TRE2 GEN 4 TREB1 GEN 4 TREB2 GEN 5 COUN1 GEN 5 COUN2 GEN 6 INF GEN 7 FUP GEN Introduction Assess and Classify the Sick Child Age 2 Months up to 5 Years Identify Treatment Treat the Child two tables in Treat the Child Counsel the Mother Management of the Sick Young Infant Age 1 Week up to 2 Months Follow Up Facilitator Guide for Modules Noti
11. box Correct any printing problems such as a few lines on an otherwise blank page or boxes with instructions to the participant which should be at the bottom of the page ending up on the next page This may require a bit of manipulating such as inserting a hard page break before a heading so that it will print with the text that follows on the next page 13 B Procedures for Adapting the Charts and Modules If there have been page numbering changes correct the page numbers in the Table of Contents Ifa module is in two or more computer files remember to change the page number which begins the second file or any subsequent file so that the page numbers will print correctly To do this put your cursor at the beginning of the file Then go to Page Numbering New page number and enter the page number that you want to print on the first page in that file Reprint corrected pages as needed Insert blank pages as needed so that double sided photocopying will work out correctly refer to the original bound modules Tape and write in necessary items to complete the modules facilitator guides and other materials If the Sick Child Recording Form was changed make clear copies for taping into the modules and answer sheets You may need up to 75 copies depending on how the form was changed If the Young Infant Recording Form was changed make 20 copies for taping into the module and answer sheets Make high quality copies of the char
12. infections ALRI Infecciones agudas de las v as respiratorias inferiores IAVRI Acute respiratory infections ARI linfecciones respiratorias agudas IRA Acute upper respiratory infections Infecciones agudas de las v as respiratorias superiores IAVRSY Adaptation Adaptaci n Adaptation guide Gu a de adaptaci n Advise Orientar aconsejar asesorar Algorithm use guidelines do not use algorithm Algoritmo usar normas no usar algoritmo Amoxycillin Amoxicilina Anemia Anemia Anemia or very low weight Antibiotic Anemia o peso muy bajo Antibi tico Antihelminthic treatment Tratamiento antihelm ntico Antimalarial Antimal rico antipal dico Areola Ar ola del pez n Assess Evaluar Assess and Classify the Sick Child Age 2 Months up to 5 Years Evaluar y Clasificar al Ni o Enfermo de 2 Meses a 5 A os de Edad Assessment Evaluaci n Attachment breastfeeding Acoplamiento amamantamiento Bcg Vacuna BCG Becomes sicker El ni o empeora Bednets insecticide impregnated Mosquiteros impregnados con insecticida Benzylpenicillin Bencilpenicilina Blood sugar low Az car sangu neo bajo Breast infection Infecci n de la mama o del pecho Breastfeeding assessment counseling Amamantamiento lactancia materna lactancia natural asesoramiento orientaci n consejos sobre 49 B Procedures for Adapting the Charts and Modules Breastmilk substitute Breathing rate Breaths Bulgi
13. is because there must be consistency between the words used on the chart signs symptoms classifications drugs counselling steps and feeding information and words the participant will read in the materials The agreed upon translations should be used consistently throughout the materials by all translators Itis assumed that translators will adhere to similar guidelines for writing simplified text as were used to develop the original materials Note See Annex B 6 Guidelines for writing simpler English page For the translation of common words and terms in the IMCI guidelines please request a copy from WHO Word lists exist for English French Spanish and Russian Note The following list is organized so that the key words are listed in alphabetical order in the first column The second column lists words that are related to those key words and that are needed to describe information in the modules Any particular point about how the word should be understood and used is with the agreed upon word Words or phrases to avoid are shown with a strikeout line through them Translators should write the agreed translations of key words and related words in the space near each word for easy reference B Procedures for Adapting the Charts and Modules Key word Related words for consistent use Anaemia Anaemia chronic anaemia Simplify text such as anaemia that lasts for a long time and anaemia due to malaria mala
14. lait maternel Breathing rate Rythme respiratoire fr quence respiratoire Breaths Respirations Bulging fontanelle Fontanelle bomb e Calm Calme Capacity building Renforcement des comp tences Careseeking Recours aux soins Caretaker carer Personne qui s occupe de l enfant 7 gardien de l enfant en Afrique Case management Prise en charge des cas Chart booklet Fascicule de tableaux Check understanding V rifier la compr hension Chest indrawing Tirage sous costal Childhood illness Maladie de l enfant Chloramphenicol Chloramph nicol m Chloroquine Chloroquine Cholera Chol ra m Chronic Chronique Chronic ear infection Infection chronique de l oreille Classification Classification quelques fois consid r e comme un diagnostic approximatif Classify Classer Clinic Dispensaire aussi parfois consultation Clinical guidelines Directives cliniques Clouding of the cornea Opacit de la corn e Cold Rhume Cold chain Chaine du froid Combined treatment Traitement associ Communication skills Aptitude communiquer Community health care provider Agent de soins de sant communautaire Community health worker Agent de sant communautaire Complementary feeding Alimentation compl mentaire Complementary foods Aliments compl mentaires aliments de compl ment Compliance with treatment Observance du traitement 37 B Procedures for Adapting the Charts and Modules Complications Condition Control of
15. print the page Working with graphics requires a larger amount of computer memory and printer memory than working with files that are only text Graphics also require suitable software The graphic files for the five images seen in the generic materials are provided on diskette for those who have the equipment and skill to use them hand holding a pencil for written exercises group scene for discussions video player for video exercises masks for role plays pencil for short answer exercises 15 B Procedures for Adapting the Charts and Modules 3 Course Director s Guide bound or put in a binder 3 sets of Case Management Wall Chart with colours 5000 Sick Child Recording Form 2 sided single sheets 1000 Young Infant Recording Form 2 sided single sheets 1000 or more Mother s Card 60 sets of Answer Sheets sets stapled in corner 8 sets of Facilitator Aids 8 plasticized enlarged size A3 paper Sick Child Recording Form 8 plasticized enlarged size A3 paper Young Infant Recording Form 60 photo books Request from WHO Geneva VV VV VV ON ON ON ON Notice that the wall charts are produced only for use during training Copies are not printed and distributed to participants to display in health facilities as was the case for CDD and ARI charts Plasticized enlarged Recording Forms are used in the clinical sessions in the Inpatient Ward and can be erased and reused day after day If it is not possible to plasticize t
16. still some pages in the Facilitator Guide for Modules that must be translated The answer sheets must be translated because they will be distributed to participants You may also decide to translate the drills and demonstrations so that the facilitators can be better prepared for these oral teaching activities Print out the translated modules and translated parts of the guides Then check them carefully against the adapted modules in English The materials are a large translation job It is impossible to do it without making mistakes Checking is very important if tedious It will take at least a week full time to check the translation often more Also check that the formatting of the modules is consistent with the original When corrections are made check them 11 B Procedures for Adapting the Charts and Modules 7 Prepare the camera ready adapted and translated chart booklet and wall charts Begin this step anytime after Step 1 above The chart booklet must be finished camera ready before the final modules can be completed Step 8 below Decide whether a fully computerized or partially computerized approach will be used WHO headquarters may be able to provide support for preparation of camera ready chart copy if adequate computer facilities are not available in country 7 1 7 2 Prepare the chart booklet Using Microsoft Publisher Prepare the revised chart booklet using Microsoft Publisher before starting o
17. 1 Checklist for Monitoring Outpatient Sessions Sick Young Infant GESCOUT2 WK1 Checklist for Monitoring Outpatient Sessions Sick Child GESUMDIR WK1 Course Director Summary The 5 forms listed above in one file for group discussion exercises for written exercises for role play exercises for short answer exercises for video exercises Note These graphics are also available from WHO as stickers to use in preparing for the camera ready copy for printing 23 B Procedures for Adapting the Charts and Modules Some files are provided to help implement common adaptations If implementing Use Use the Adaptation described Adapted Recording Form file Major Text Additions in Section E in this file 2 0 G2chg 97 3 0 G3chg 97 5 0 Gbform 97 G5chg 97 6 1 G61chg 97 6 2 G62chg 97 7 0 G7form 97 8 0 G8form 97 G8chg 97 9 2 G92chg 97 9 4 G94chg 97 10 0 G10chg 97 11 0 G11chg 97 12 1 G122form 97 G121chg 97 12 2 G122chg 97 13 0 G13chg 97 24 B Procedures for Adapting the Charts and Modules Annex B 3 WordPerfect settings and features used in the files for the modules and recording forms Introduction The instructional materials were written with WordPerfect 5 2 for Windows The diskette files are compatible with WordPerfect 5 1 for DOS WordPerfect 5 1 for Windows WordPerfect 5 2 for Windows You will need to use an IBM type computer with a 80286X proces
18. INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS IMCI INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESS IMCI ADAPTATION GUIDE A guide to identifying necessary adaptations of clinical policies and guidelines and to adapting the charts and modules for the WHO UNICEF course PART 1 B Procedures for Adapting the Charts and Modules June 2002 a P LES CEL amp DEPARTMENT OF CHILD AND ADOLESCENT HEALTH AND DEVELOPMENT WORLD HEALTH ORGANIZATION unicef For further information please contact Department of Child and Adolescent Health and Development World Health Organization 20 Avenue Appia 1211 Geneva 27 Switzerland Tel 41 22 791 32 88 Fax 41 22 791 48 53 Email cah Qwho int Website http www who int child adolescent health The 2002 working draft of the IMCI Adaptation Guide consists of the following sections Section A Section B Section C Section D Section E Section F Section H The Adaptation Process Procedures for Adapting the Charts and Modules Technical Basis for Adapting the Clinical Guidelines Feeding Recommendations and Local Terms Protocol for Adapting the Feeding Recommendations Protocol for Identifying and Validating Local Terms Protocol for Designing and Pretesting an Adapted Mother s Card Modifying the Generic Chart Booklet Using Microsoft Publisher Please provide comments and further input to WHO CAH Geneva Switzerland Contents
19. If you changed the Sick Child Recording Form make 75 copies If you changed the Young Infant Recording Form make 20 copies If the recording forms will be translated you may also begin that step now B Procedures for Adapting the Charts and Modules 4 Mark all adaptations in the modules and answer sheets in the Facilitator Guide for Modules and mark any other changes in facilitator guides 4 1 Follow the instructions in E Changes in materials required for specific adaptations if any of the adaptations that you need to make are described there For other adaptations read through the modules and mark changes needed Check E Changes in materials required for specific adaptations to determine whether any of the adaptations that you need to make are described there If so follow those instructions to locate the places to change On a bound copy of the modules write all the changes in red pencil It is essential that the changes be made in an obvious way so that they can be checked by another person It is impossible for one person to make all the necessary changes without errors or omissions After all changes are written on one copy and double checked by a second person that copy may be given to the individual who will enter the changes on the WordPerfect disks For any additional changes that are not described in section E you will need to read very carefully through all the modules and other materials to identify where to ma
20. N NO FEEDING PROBLEM NO PNEUMONIA COUGH OR COLD normal saline solution NOT ABLE TO FEED POSSIBLE SERIOUS BACTERIAL INFECTION nutrient rich foods nutrition nutritional counselling nutritional status oedema OPV oral rehydration salts ORS oral rehydration therapy ORT outpatient outpatient treatment palmor pallor paracetamol paramedical health workers patient recording form perinatal PERSISTENT DIARRHOEA petechiae on skin pharmacist pharmacy Photographs plan A plan B plan C diarrhoea treatment planning planning and programme management guidelines PNEUMONIA battement des ailes du nez traitement par voie nasogastrique NG sonde nasogastrique aiguille pas d an mie et pas de poids tr s faible pas de d shydratation pas d infection de l oreille pas de probl me d alimentation pas de pneumonie toux ou rhume s rum physiologique incapable de se nourrir possibilit d infection bact rienne grave aliments riches en nutriments nutrition conseil nutritionnel tat nutritionnel ced me vaccin antipoliomy litique buccal VPO sels de r hydratation orale SRO traitement par r hydratation orale TRO patient ambulatoire traitement ambulatoire p leur palmaire parac tamol personnel param dical fiche de prise en charge du patient p rinatal diarrh e persistante p t chies pharmacien pharmacie photographies Plan A plan B plan C traitement de l
21. Practice in Outpatient Clinic Clinical Practice in Inpatient Ward D O Additional Steps 79 Make set of answer sheets for printing Prepare video if translation needed Prepare all modules for printing Make facilitator aids for printing Prepare instructions for printers B Procedures for Adapting the Charts and Modules Los t rminos que pueden ser de g nero masculino o femenino se mencionan solamente en la forma masculina Creemos que esta debe ser la traducci n y no otitis media aguda que es un t rmino m s restrictivo Adem s si este fuese el sentido en ingl s se habr a escrito acute otitis media Semejantes argumentos pueden darse en el caso de chronic ear infection Esta equivalencia IAVRI es com n en espa ol y es la que usamos corrientemente Sin embargo para preservar el paralelismo con infecciones respiratorias agudas IRA tal vez fuese oportuno cambiar a infecciones respiratorias agudas bajas que se abreviar a IRA B V ase la siguiente nota AVRS es tambi n com n y la que usamos Si se acepta el cambio sugerido en la nota anterior ser a infecciones respiratorias agudas altas y se abreviar a IRA A La raz n del gui n ser a simplemente evitar que a simple vista se confundiesen IRA e IRA A En el caso de IRA B no hay posibilidad de confusi n pero el gui n se a adir a para conservar el paralelismo con IRA A 5 Todos los medicamentos mencionados en el glosario son denomin
22. Prepare the wall charts Using a computerized service The chart booklet will be converted to create the large wall charts so it is most efficient if all the chart booklet revisions are completed first The graphics service may convert the files to their particular software or retype the charts to make them compatible for production on their equipment Ifthe service is retyping the charts careful proofreading of every word is required Frequent typing mistakes and omissions are common Preparing partially computerized plus cut and paste wall charts If the graphics service does not have the capacity to print out on large paper use the same cut and paste method described above to produce the camera ready B Procedures for Adapting the Charts and Modules wall charts Revise the boxes or produce new boxes on computer and print out individual boxes on regular size paper Then carefully tape these over the existing boxes on the generic wall charts Since the Treat and Counsel charts are only black and white new boxes could be pasted onto the printed charts which could then be reproduced hopefully without problems with the grey background For the colour charts Assess and Classify and Young Infant you may obtain a black and white version of the charts direct contact print from WHO which can be used in the same way A local printer could then prepare the colour separations If the in country printer does not have a press that can produc
23. R VERY LOW WEIGHT antibiotic antihelminthic treatment antimalarial areola assess Assess and classify the sick child age 2 months up to 5 years assessment attachment breastfeeding BCG becomes sicker bednets insecticide impregnated benzylpenicillin blood sugar low boils breast infection breastfeed breastfeeding assessment counselling breastmilk agantayna Pyxkoeodcmeo no Adanyuu CoBeToBaTb OObACHATb anrop amoxicilline f an mie an mie ou poids tr s faible antibiotique traitement vermifuge traitement anthelminthique antipalud en antipaludique ar ole valuer valuer et classer l enfant malade ag de 2 mois 5 ans valuation prise du sein BCG devient plus malade moustiquaires impr gn es benzylp nicilline f sucre dans le sang glyc mie basse furoncles infection du sein allaiter au sein allaitement au sein valuation conseil lait maternel 61 B Procedures for Adapting the Charts and Modules breastmilk substitute breathing rate breaths bulging fontanelle calm capacity building careseeking caretaker carer case management chart booklet check understanding chest indrawing childhood illness chloramphenicol chloroquine cholera chronic CHRONIC EAR INFECTION classification classify clinic clinical guidelines clouding of the cornea cold cold chain combined treatment communicatio
24. Sick children also need treatment is easier than Adults who are sick need treatment as do sick children gt Pesto has no fever and no rash is easier than Pesto does not have fever nor rash 12 Use simple comparatives Avoid complicated comparatives The child is better is easier than The child is relatively better gt Fever in a young infant is a sign of serious bacterial infection is easier than If fever is present in a young infant it more often means a serious bacterial infection than in an older infant or young child Using verbs 13 Use imperative and you forms Avoid passive verb construction gt Advise the mother to return immediately is better than The mother should be advised to return immediately gt Keep the infant at the health centre is better than The infant may be kept at the health centre 14 Use simpler tenses Use the present tense whenever possible gt The child with cough and fast breathing has pneumonia is easier than The child with cough and fast breathing will have pneumonia 15 B Procedures for Adapting the Charts and Modules Using pronouns 15 16 17 Use a minimum number of pronouns within a sentence to avoid confusion about what is being referred to gt Tell the mother to feed her child nutritious foods five times per day is easier than Tell her to feed it to him five times per day Keep pronoun references clear
25. a diarrh e planification directives pour la planification et la gestion du programme pneumonie parfois pneumopathie B Procedures for Adapting the Charts and Modules policy positioning breastfeeding POSSIBLE SERIOUS BACTERIAL INFECTION praise the mother pre referral treatment pre service training premature infant prevention preventive interventions problems other common local feeding pulse radial pus draining from the eye ear or umbilicus pustules skin quality of care quinine rapid breathing rational use of drugs red eyes refer urgently referral care referral level referral level facilities rehydrate rehydrated rehydration reinforce skills relactation to relieve restless return immediately Ringer s lactate solution runny nose rural medical aide safe motherhood politique position allaitement possibilit d infection bact rienne grave complimenter f liciter la m re traitement pr transfert formation initiale pr matur pr vention interventions pr ventives 7 interventions de pr vention probl mes autres habituels alimentation locale pouls radial coulement de pus de l oeil de l oreille ou de l ombilic pustules peau qualit des soins quinine respiration rapide utilisation rationnelle des m dicaments yeux rouges transf rer d urgence soins plus sp cialis s donn s dans un tabl
26. abajador sanitario de la comunidad Alimentaci n complementaria Alimentos complementarios Cumplimiento del tratamiento observancia del tratamiento Complications Complicaciones 50 B Procedures for Adapting the Charts and Modules Condition Afecci n enfermedad trastorno padecimiento situaci n Orientar aconsejar asesorar Counsel the Mother Aconsejar a la Madre Course Director s Guide Gu a del Director del Curso Cut off breathing rate Valor l mite punto de corte de la frecuencia respiratoria Developing countries Pa ses en desarrollo Difficult breathing Respiraci n dif cil dificultad para respirar dificultad respiratoria Disabilities Discapacidades Discharge from the ear or the umbilicus Flujo secreci n exudado del o do o del ombligo supuraci n si es pus Disease classification Clasificaci n de la enfermedad Division of Child Health and Divisi n de Salud y Desarrollo del Ni o CHD Development CHD WHO OMS Dosage table Cuadro de dosificaci n cuadro de posolog a Drinks eagerly Bebe con ansiedad bebe con muchas ganas bebe con mucha sed Drinks poorly Bebe mal casi no bebe Drug supply management DSM Gesti n del abastecimiento de medicamentos Drugs Medicamentos f rmacos medicinas remedios drogas psicoactivas 51 B Procedures for Adapting the Charts and Modules Ear infection Ear pain Ear problem Early implementation phase 2 Early use countrie
27. aciones comunes internacionales y por tanto deben ir con min scula tanto en ingl s como en espa ol Esta palabra puede llevar acento o no llevarlo Se recomienda acentuarla para evitar la confusi n con aureola error com n 7 Hemos venido traduciendo assess por evaluar si en ingl s hay diferencias entre assess y evaluate en el contexto de la AIEPI habr a que traducir assess como valorar y evaluate como evaluar Desde luego esto es v lido tambi n para los sustantivos evaluation y assessment Conviene evitar traducir clinic como cl nica pues en espa ol un establecimiento con este nombre suele tener camas para internar enfermos En ingl s sin embargo suele designar un servicio ambulatorio Ev tese asistencia domiciliaria pues domiciliario es lo que se hace a domicilio Por ejemplo un hospital puede mandar a sus enfermeras u otro personal a hacer visitas domiciliarias o a prestar asistencia domiciliaria lo cual es diferente de la atenci n o asistencia que el paciente recibe de sus familiares en casa 1 Immunization se usa a menudo para referirse a la vacunaci n es decir la inmunizaci n pasiva Es claro que el esquema de vacunaci n y la cartilla o carn de vacunaci n se llaman as en espa ol Como ha dicho el Dr Ciro de Quadros vacunaci n no es igual a inmunizaci n lo contrario tambi n es verdad inmunizaci n no es necesariamente igual a vacunaci n Aunque implementaci n ya fig
28. age making English clear Transactions of the Royal Society of Tropical Medicine and Hygiene 75 No 4 Fry E 1989 Reading formulas maligned but valid Journal of Reading January 1989 Strunk W Jr and White E B 1972 The Elements of Style New York NY McMillan Publishing Co Inc 77 B Procedures for Adapting the Charts and Modules Annex B 7 Checklist for producing adapted materials CHARTS AND RECORDING FORMS Se npouuJ 10 sexoq Jo seidoo axe eu diesen We le Chart Booklet Assess amp Classify Treat Chart Counsel Chart Infant Chart Sick Child Recording Form Infant Recording Form 78 B Procedures for Adapting the Charts and Modules MODULES AND FACILITATOR GUIDES S UBLUNDOP e J0J SJ9A09 eJedaJd SJU8 U09 JO qE 199 109 9 J0014 SU0I 981109 BUI sabed e jo 499y9 euly uoneuuoJul BJM 9 suo Bulpiose1 ui ade soiydes6 suoneujsnji sexoq yeyo ul ade K njeJeo J0014 suo BUIP10981 9 sejnpouJ eu no JUL JEUIBUO U IM 3uejsisuoo jeuuo u JUBLUNDOP peje sueJ eJedejg SUOI E SULL 129 402 SUOne SUEJ YOOYD mojaq ajou 99S 9 4 pue sejnpouu ajejues loued jsuieBe seBueuo 9819 saBueya no yud sa Jeyndujoo ui sefueyo Jejuy saBueyo jroued 29u5 seBueyo e loued pay Introduction EXER ES se ETE IEA IT Luc Treatment FO Answersoot TC Crus CTI couse FS E amv shoots oro ment young fan FG amp Asse Follow Up FG amp Answer sheets Clinical
29. and have two narrators practice reading it in time with the video When they are sufficiently familiar with the narration work your way through the video deleting the existing voice track and replacing it with your own narrators voices If the health workers do not know the language of the video at all and therefore would be distracted by the subtitles for the assessment and the chart excerpts it will be necessary to make arrangements for these sections to be re created This is expensive because the producer of the video will need to make a special re edited version of the master Translations would have to be provided for all captions and charts which appear on the screen In some cases depending on the language concerned these may need to be in the form of camera ready artwork When requesting a video sub master please ensure that you ask for the format suitable for use in the country concerned and on the equipment which is available If no specification is given sub masters will be supplied in the PAL format on Betacam tape Translate the answer sheets in the IMCI Facilitator Guide for Modules and if necessary all of the facilitator guides and the IMCI Course Director s Guide In some places participants need materials translated into the local language but the course director and facilitators are comfortable using materials that are not translated Even if all the facilitator materials will not be translated however there are
30. apes du traitement ulc rations bouche profondes et tendues ombilic inconscient urgent prise en charge urgente vaccin m lutte antivectorielle maladie tr s grave maladie f brile tr s grave vomir vomissures qui vomit vomissements tableau mural amaigri 7 maci amaigrissement visible et s v re maciation aliments de sevrage poids pour l ge faible B Procedures for Adapting the Charts and Modules poids ge poids par rapport l ge weight for age chart growth chart courbe poids pour l ge fiche de croissance courbe poids ge well child visit visite d un enfant bien portant wheezing sifflement respiratoire respiration sifflante sibilance whipworm trichoc phale white patches in the mouth muguet wicking to dry the ear placer une m che pour ass cher l oreille worsen Empirer s aggraver se d t riorer se d grader young infant nourrisson de moins de 2 mois 72 B Procedures for Adapting the Charts and Modules Annex B 6 Guidelines for writing simpler English Writing sentences 1 Write short sentences Short sentences are easier for readers to understand Some will be shorter others longer but on the average each sentence should contain no more than 20 words 2 Avoid complex embedded sentences and difficult constructions Write simpler sentences which have only one or two clauses Only on
31. at each feed active feeding actively feed non breastmilk feeds feeding assessment feeding counselling feeding problem feeding questions feeding recommendations feeding regimen teedi ie no other signs of feeding problem food based fluids fluid fluids foods appropriate food and fluids weaning foods family foods semisolid complementary foods semisolid foods breastmilk substitute complementary feeding supplementary feeding therapeutic feeding 30 B Procedures for Adapting the Charts and Modules Key word Related words for consistent use follow up follow up follow up box follow up note follow up visit return visit well child visits scheduled follow up visit further care When related to need for immediate return health facility clinic Use clinic throughout the materials to describe the variety of places where sick children are managed such as an outpatient facility health centre clinic etc hospital Use to describe referral site first level health facility facility health centre outpatient clinic inpatient ward ua ty faciliti Note Use outpatient and inpatient when describing instructional activities for clinical practice such as outpatient clinical practice and clinical practice in the inpatient ward local local bacterial infections local infections Use local in its medical meaning one site or place in or on the body Wheneve
32. ato Irritable Comez n prurito Ict rico Aletargado let rgico Letargo letargia Infecci n bacteriana local Infecci n local T rminos locales S ntomas principales Enfermedades principales MALARIA malaria malaria cerebral Riesgo bajo alto de malaria Malaria unlikely Malaria poco probable Malnutrition Management of sick children Management of the child with a serious infection or severe malnutrition Management of the sick young infant age 1 week up to 2 months Mastoiditis Materials Maternal health Measles Malnutrici n Manejo de ni os enfermos manejo del ni o enfermo Manejo de nifios con infecci n seria o desnutrici n grave Manejo del lactante menor enfermo de 1 semana a 2 meses de edad Mastoiditis Materiales Salud materna Sarampi n Measles severe complicated Sarampi n grave con complicaciones Measles rash Measles with eye or mouth complications Mebendazole Medical assistant Meningitis Micronutrient supplementation Monitoring Morbidity Mortality Movement normal Nalidixic acid Erupci n sarampionosa exantema del sarampi n Sarampi n con complicaciones de los ojos o la boca Mebendazol Asistente m dico Meningitis Administraci n de suplementos de micronutrientes Monitoreo Morbilidad Mortalidad Movimiento normal cido nalid xico B Procedures for Adapting the Charts and Modules Terapia por sonda nasog
33. body temperature feels cool feels hot history of fever low body temperature low temperature temperature 37 5 C or above 33 B Procedures for Adapting the Charts and Modules Key word Related words for consistent use Treatment treat treatment treatment procedures problems to be treated s herbaHreatments Simplify text such as if the child is treated with herbs or other traditional medicines Urgent referral refer urgently refer to hospital refer urgently to hospital referral urgent attention urgent pre referral treatment urgent referral 34 B Procedures for Adapting the Charts and Modules Words for which there may be a local term If a local term has been found for any word below use the local term rather than another possible translation See Protocol for Identifying and Validating local Terms Local terminology Key word fill in based on study results Convulsions Difficult breathing Fast breathing Diarrhoea Blood in stool mae o 35 B Procedures for Adapting the Charts and Modules Annex B 5 Translation of IMCI terms French Spanish and Russian Active feeding Acute Acute ear infection Acute lower respiratory infection Acute respiratory infections ARI Acute upper respiratory infection Adaptation Adaptation guide To advise Algorithm guidelines Amoxicillin
34. ce the file name begins with FG and the next letter is the section letter found in the page number FGA GEN FGB INT GEN FGC ASS1 GEN FGC ASS2 GEN FGD ID GEN FGE TRE1 GEN FGE TRE2 GEN FGF COUN GEN FGG INF GEN FGH FUP GEN FGI GEN Introduction to this Facilitator Guide Guidelines for Introduction Guidelines for Assess and Classify the Sick Child Guidelines for Identify Treatment Guidelines for Treat the Child Guidelines for Counsel the Mother Guidelines for Management of the Sick Young Infant Guidelines for Follow Up Guidelines for All Modules B Procedures for Adapting the Charts and Modules FGJ GEN Other materials CDG1 GEN CDG2 GEN CDG3 GEN CPINP GEN CPOUT GEN FORM SC GEN FORM YI GEN List of Photographs Course Director s Guide Guide for Clinical Practice in the Inpatient Ward Facilitator Guide for Outpatient Clinical Practice Sick Child Recording Form Young Infant Recording Form Monitoring forms are in Excel and Lotus shown in the Course Director s Guide The same monitoring forms are provided in three different software formats In Excel 3 GESCIN1 XLS GESCIN2 XLS GESCOUT1 XLS GESCOUT2 XLS GESUMDIR XLS In Excel 5 GENSC XLS Graphics files GROUP PCX HAND TIF MASKS PCX PENCIL PCX VIDEO PCX In Lotus 123 GESCIN1 WK1 Checklist for Monitoring Inpatient Sessions Sick Young Infant GESCIN2 WK1 Checklist for Monitoring Inpatient Sessions Sick Child GESCOUT1 WK
35. consciousness Inconsciencia p rdida del conocimiento Urgent Urgente Urgent attention Atenci n urgente Vaccine Vacuna Vector control Lucha antivectorial control de vectores Very severe disease Enfermedad muy grave Very severe febrile disease Enfermedad febril muy grave Vomit V mito Vomiting Vomitar vomitando Wall chart Cartel Wasted Emaciado consumido Wasting visible severe Emaciaci n consunci n visible grave Weaning foods Alimentos para destete Weight for age low Peso bajo para la edad Weight for age chart growth chart Gr fico de peso para la edad gr fico de crecimiento Well child visit Visita de ni o sano control del ni o sano B Procedures for Adapting the Charts and Modules Whipworm Tricoc falo la enfermedad es tricuriasis tricocefalosis o tricocefaliasis White patches Placas blancas Wicking to dry the ear Mecha para secar el o do 60 B Procedures for Adapting the Charts and Modules ENGLISH RUSSIAN active feeding AkTMBHOe KoOpMneHuye acute Ocrpbil aa oe ACUTE EAR INFECTION acute lower respiratory infection Ocrpas uHpekuna yxa Ocrpbie uHpekU un HAXKHUX ABIXaTenbHbIXx nyTeh ONHAN acute respiratory infections ARI OcTpbie pecnupatopbie HHekuiuu OPN acute upper respiratory infection OcTpbie uHcpekuua BEPXHUX DIBIXaTeribHbIX nyTe adaptation Adaptation guide to advise algorithm guidelines amoxicillin anaemia ANAEMIA O
36. d alimentation ou poids faible probl mes d alimentation questions sur l alimentation recommandations alimentaires fi vre Fi vre paludisme peu probable tablissement de sant de premier niveau personnel de sant de premier niveau m dicament de premi re intention solut pour perfusion B Procedures for Adapting the Charts and Modules fluid intake and output fluid overload IV fluids follow up verb Follow Up noun follow up care follow up visit food safety food security food based fluids frequency furazolidone further care when related to immediate return general condition general danger signs generic version gentamicin gentian violet burden of disease global burden of disease in a country global burden of disease in the world growth grunting Guide for clinical practice in the inpatient ward guidelines not algorithm Guidelines for follow up after training hands on clinical practice health assistant health care provider health centre health facility health management information system HMIS health system health system management health system reform apports et pertes de liquides hydriques surcharge hydrique surhydratation solut pour administration v solut v suivre suivi soins de suivi visite de suivi salubrit des aliments s curit alimentaire pr paration liquide base d aliments fr quence furazolidone s
37. diarrhoeal diseases CDD Convulsions Cotrimoxazole Cough Counsel Counsel the mother Counselling Course director s guide Cut off breathing rate Danger signs Decentralization of management Dehydration Dengue haemoragic fever Department of Child and Adolescent Health and Development CAH Developing countries Development Diagnosis Diarrhoea Difficult breathing Disability Discharge from the ear or the umbilicus Disease Disease classification Disease prevention Division of Child Health and Development CHD Dosage table Dose Dpt Drinks eagerly Drinks poorly Drug supply management DSM Drugs Dysentery Complications Affection Lutte contre les maladies diarrh iques LMD Convulsions Cotrimoxazole m Toux Conseil Conseiller la M re Conseil Guide du directeur de cours Seuil rythme respiratoire Signes de danger D centralisation de la gestion D shydratation Dengue h morragique D partement Sant et d veloppement de l enfant et de l adolescent CAH Pays en d veloppement D veloppement Diagnostic Diarrh e Respiration difficile Incapacit Ecoulement de l oreille ou de l ombilic Maladie Classification des maladies Pr vention de la maladie Division Sant et d veloppement de l enfant CHD Table de posologie Dose Dtc Boit avec avidit Boit difficilement Gestion de l approvisionnement en m dicaments M dicaments Dysenterie
38. die tr s grave gravit dysenterie Shigella signes de maladie pli cutan signes vidents de d shydratation calmer soulager le mal de gorge mamelons douloureux st rile st rilisation nuque raide selles sanglantes molles strat gie stridor succion eau sucr e sulfadoxine pyrim thamine yeux enfonc s supervision syst me de surveillance durabilit parfois viabilit sympt mes seringue B Procedures for Adapting the Charts and Modules syrup tablet drug target telangectasia temperature axillary rectal tender swelling behind the ear tetanus toxoid tetracycline thirsty threshold throat thrush timing device traditional healer training modules to treat Treat the child treatment treatment procedures treatment steps ulcers mouth deep and extensive umbilicus unconsciousness urgent urgent attention vaccine vector control very severe disease VERY SEVERE FEBRILE DISEASE to vomit vomit noun vomiting wall chart wasted wasting visible severe weaning foods weight for age low sirop comprim cible t langiectasie temp rature axillaire rectale gonflement douloureux anatoxine t tanique t tracycline f assoiff seuil gorge muguet chronom tre parfois minuterie gu risseur traditionnel tradipraticien modules de formation traiter traiter l enfant traitement conduite th rapeutique t
39. e pus de l il de l oreille ou de l ombilic Pustules peau Qualit des soins Quinine Respiration rapide Utilisation rationnelle des m dicaments Yeux rouges Transf rer d urgence Soins plus sp cialis s donn s dans un tablissement de niveau sup rieur capable d assurer la prise en charge Niveau de recours Etablissements de transfert plus sp cialis R hydrater R hydrat R hydratation Renforcer le savoir faire Reprise de l allaitement Soulager traiter les sympt mes Agit B Procedures for Adapting the Charts and Modules Return immediately Revenir imm diatement Ringer s lactate solution Solution de Ringer lactate Runny nose Nez qui coule Rural medical aide Aide m dicale rurale Safe motherhood Maternit sans risque Safe remedy Rem de inoffensif sans danger Second line drug M dicament de seconde intention Semisolid foods Aliments semi liquides Sepsis Septic mie Serious Grave s v re Serious bacterial infection Infection bact rienne grave Severe classification Classification grave Severe complicated measles Rougeole avec complications graves Severe dehydration D shydratation s v re Severe disease Maladie grave Severe malnutrition or severe anaemia Malnutrition s v re ou an mie s v re Severe persistent diarrhoea Diarrh e persistante s v re Severe pneumonia or very severe disease Pneumonie grave on maladie tr s grave Severity Gravit Shigella dy
40. e single idea should be in one simple sentence Here are two examples of complex construction taken from an earlier version of the course The infant may also have other classifications that require treatment but these treatments should not be given before referral because they are not urgently needed and would delay referral All young infants in this classification need home care and need to return to the health worker in 14 days so that the health worker can be sure that the feeding is improving and give additional guidance as needed 3 Write sentences using the active voice gt Health workers assess and treat sick children is better than Sick children are assessed and treated by health workers 4 Write statements in a positive form gt Rehydrate the child before referral is easier than Do not refer the child before she is rehydrated Choosing words 5 Use simpler more familiar words They are easier for the reader to understand gt Try is easier than endeavor or attempt Give is easier than administer Injectable antibiotics is easier than parenteral antibiotics 73 B Procedures for Adapting the Charts and Modules 74 6 10 Omit unnecessary words gt I m hungry is better than There is no doubt that I am hungry gt Try to help the family care for the child is better than Do whatever is possible to help the family care for the child Use consis
41. e the full size wall charts the wall charts can be printed on a smaller press in two or four pieces and then pasted or taped together IMPORTANT Chart booklets and wall charts must be proofread after making any adaptation change or correcting any typographical or other error Proofread after every set of changes until the very end Also try to not reduce the font size substantially in the chart booklet or on the charts Many people cannot read small text 7 3 Produce high quality copies of each box in the chart booklet for taping into the final modules Measure the size of the boxes in the chart booklet and make sure that there is enough blank space on each page of a module where a box will be taped If not modify the file to make additional space on the page It may be necessary to reduce some chart boxes for insertion in the modules but they must be readable Print out the final modules and recording forms adapted and translated and proofread carefully Keep everything very clean and unwrinkled from now on Use good quality paper especially if the modules will be duplicated by photocopying Check that there is enough blank space on any page where you will tape a chart box illustration graphic or recording form Check that page breaks are logical that is a heading does not occur at the bottom of one page and the text on the next page Exercises should always start on a new page Do not have a page break in the middle of a
42. eral regional Mother s Cards do not include the card in the Annex to the Counsel the Mother module In the Counsel module use the country wide adapted food box and problem list as it appears on the chart Then direct the health worker to look at the mother s counselling card developed for his region Check all the changes for accuracy consistency and completeness Check all the changes that have been written in This is essential It is very difficult to carry out the adaptation exercise on a single pass through the materials without making errors usually of omission It is essential that a second person checks everything and if possible a third It is essential to check not only those changes that have been made but also to read through the modules to check for additional places where there should be changes B Procedures for Adapting the Charts and Modules S Change the computer files Note Before using any of the generic diskettes read and follow the instructions in Annex B 2 which describe how to manage the computer files If another person will be making the changes in the computer files give that individual a copy of the instructions Check periodically that they are following the instructions Using the recommended procedures can prevent many problems 5 1 Enter all changes in the computer files The WordPerfect files of the modules have been created in a way that should make them easier to use with a variety of computer
43. erious infection or severe malnutrition Management of the Sick Young Infant Age 1 Week up to 2 Months Mastoiditis Materials Maternal health Measles Measles severe complicated Measles rash Measles with eye or mouth complications Mebendazole Medical assistant Melena Meningitis Micronutrient supplementation Monitoring Morbidity Administration de fer traitement martial Fer folates Irritable Qui d mange d mangeaison prurit Jaunisse ict re Ict rique L thargique L thargie Infection bact rienne locale Infection locale infection localis e Appellations locales Sympt mes principaux Principales maladies Paludisme neuropaludisme Risque de paludisme lev faible risque palustre Paludisme peu probable Malnutrition Prise en charge de l enfant malade Prise en charge de l enfant ayant une infection s v re on une malnutrition s v re Prise en Charge du Nourrisson Malade Ag de 1 Semaine 2 Mois Mastoidite Mat riels documents tissus etc Sant maternelle Rougeole Rougeole s v re compliqu e Eruption rougeoleuse Rougeole avec complications aux yeux ou la bouche complications oculaires et buccales M bendazole Assistant m dical M l na ou m laena M ningite Compl ment suppl mentation en micronutriments Suivi surveillance Morbidit B Procedures for Adapting the Charts and Modules Mortality Mo
44. es PostScript Printers QMS Apple LaserWriter NEC TI HP Laserjet 5MP etc PostScript printers have proportional fonts built in These printers will print the files as they appear on diskette without any additional accessories if the computer has the appropriate printer driver Helvetica and Times Roman fonts are normally built into PostScript printers 19 B Procedures for Adapting the Charts and Modules Dot Matrix Bubble Jet and Other Printers Epson FX Canon BJ etc 20 It is not recommended to use dot matrix or bubble jet printers to print the modules These printers have limited capabilities and do not have the required proportional fonts Helvetica and Times Roman If there are no laser printers available these printers may be used However much attention must be given to editing tables and figures as well as correcting other formatting changes that may occur Some modern dot matrix and bubble jet printers that have good resolution capability minimum 150 dots per inch and scalable proportional fonts Helvetica and Times Roman can be used to print the modules B Procedures for Adapting the Charts and Modules Annex B 2 Managing the computer files Setting up the IMCI directory It is common to have problems such as confusing generic files with adapted files making changes on a file and later not being able to find them or confusing an old file with a more recently changed one These problems cause fru
45. es as you move through a document When you use the mouse or arrow keys to position the cursor in the document the Reveal Codes insertion point moves to the corresponding location The generic files were kept somewhat small not over 150 000 bytes This was done so that most computers can handle the files without too much difficulty If the files are combined in larger files they can be extremely slow to use heavy A computer hangs when there is a convergence of factors that ends up in unpredictable results The computer stops working because the software stops working WordPerfect seems more likely to hang as a document is more complex Any use of a feature that contributes to the complexity of the document will increase the probability of hanging such as large file size graphics tables and changes in margins fonts or paper orientation In theory therefore one can minimize the chances of a computer hanging by keeping the document size small not using many graphics and tables not changing margins etc 8 B Procedures for Adapting the Charts and Modules 5 2 with codes and difficult to edit and print Therefore combining files is not recommended If the materials will not be translated and if you have a clean single sided copy of the original you can try to use some of the original generic pages to save you some work If changes are small try to avoid changes in page numbering by a bit of squeezing and other w
46. g the changes into the chart booklet and recording forms use a red pen or pencil that shows up well Identify changes needed in the recording form to make it reflect adaptations in the chart booklet However any changes in the recording forms will result in much substitution in the preparation of modules and the answer sheets so keep changes in recording forms to a minimum Check the chart and recording form changes to be sure all planned adaptations are addressed Have another person who is very familiar with the charts check that changes are made in every place they are needed in the chart booklet and recording forms For example if a sign is added in the assess column it must also be inserted in a classification box and on the recording form Note If the chart booklet will be translated you may begin that process see Step 6 below so that translation of the charts is proceeding while you adapt the modules If the charts will not be translated you should soon begin working with a graphics expert to produce the adapted chart booklet in a finished form See Step 7 below 2 Make a list of all changes needed in the charts and list any other changes needed in the modules which do not appear on the charts Use the results of technical discussions any studies of local terms and foods and the results of the final adaptation meeting to make this list Make a list summarizing all the chart booklet changes to refer to as you go through the module
47. heck the translation of the list of key words These are words that occur repeatedly in the charts and modules Make sure that the adapted local terms are properly inserted and used in place of the translator s own translation of a term Two or more people should check and agree on the translation of the key words A clinical person should check the translation of WordPerfect has a feature called Master Document which can handle several smaller files as if they were one big file such as for automatically numbering pages consecutively The generic files do not use this feature If you know how to use this feature and think it will help you you may try it B Procedures for Adapting the Charts and Modules 6 2 6 3 6 4 clinical words If ARI or CDD materials have been translated compare how key words were translated in those materials Annex B 5 provides translations of common IMCI terms into French Spanish and Russian A blank list is included for use in translating into other languages Translate the chart booklet and recording forms consistently using the agreed translations of the key words including the local terms Have a clinical person check the translation Circulate to key persons for comments if necessary Translate the adapted modules being consistent with the chart booklet vocabulary and agreed translations of the key words After the chart wording is agreed on make sure that the translators know to consisten
48. hese forms about 100 copies of the enlarged Sick Child Recording Form and 25 copies of the Young Infant Recording Form are needed for the inpatient sessions 16 B Procedures for Adapting the Charts and Modules Annex B 1 Annex B 2 Annex B 3 Annex B 4 Annex B 5 Annex B 6 Annex B 7 Section B ANNEXES Specifications of printers for producing the modules and other documents in WordPerfect Managing the computer files WordPerfect settings and features used in the files for the modules and recording forms List of key words and related words for consistent use Translation of IMCI terms French Spanish and Russian Guidelines for writing simpler English Checklist for producing the adapted materials 17 B Procedures for Adapting the Charts and Modules B Procedures for Adapting the Charts and Modules Annex B 1 Specifications of printers for producing the modules and other documents in WordPerfect The generic modules are formatted to print on a Hewlett Packard Laserjet Series IV Use a laser printer capable of printing 300 dots per inch dpi and proportional fonts Points to consider when choosing a printer on which to print the modules and other materials are listed below Hewlett Packard Laserjet Series II The HP Laserjet Series II printer does not have built in Helvetica and Times Roman fonts In order to print the modules as prepared on the diskettes an HP Laserjet Series II printer m
49. ial infection Use to describe an infection in a sick young infant which may require urgent referral or other urgent treatment severe disease Use generically to describe disease which may require urgent referral or other urgent treatment 32 B Procedures for Adapting the Charts and Modules Key word Related words for consistent use Serious severe cont severe classification Use generically to describe any classification which requires urgent referral or other urgent treatment severe problem Use generically to describe a presenting symptom which when assessed and classified will need urgent referral or other urgent treatment severe infection Do not use generically Use when referring to a specific severe disease or classification signs Note All words relating to signs and symptoms should be consistent with how they appear on the case management charts signs abnormal signs normal signs dd Signs eae RS signs Avoid these terms and use instead sign is present or sign is not present general signs Use to describe non specific signs in a sick young infant related signs sign and symptoms general danger signs skin pinch skin pinch skin pinch flattens returns goes back immediately skin pinch flattens eturas goes back slowly skin pinch flattens returns goes back very slowly tenting Use if the skin stays up for even a brief time temperature
50. ique au Dispensaire Soutien aux tablissements Pratiques familiales et communautaires Alimentation familiale Planification familiale Respiration rapide Maladie f brile Evaluation de l alimentation Conseil alimentaire Probl me d alimentation ou poids faible Probl mes d alimentation Questions sur l alimentation Recommandations alimentaires Fi vre Fi vre paludisme peu probable 39 B Procedures for Adapting the Charts and Modules First level health facility First level health workers First line drug Fluid for infusion Fluid intake and output Fluid overload IV fluids Follow up verb Follow Up noun Follow up care Follow up visit Food safety Food security Food based fluids Frequency Furazolidone Further care when related to immediate return General condition General danger signs Generic version Gentamicin Gentian violet Burden of disease Global burden of disease in a country Global burden of disease in the world Growth Grunting Guide for clinical practice in the inpatient ward Guidelines not algorithm Guidelines for follow up after training Hands on clinical practice Health assistant Health care provider Health centre Health facility Etablissement de sant de premier niveau Personnel de sant de premier niveau M dicament de premi re intention Solut pour perfusion Apports et pertes de liquides hydriques Surcharge hydrique surhyd
51. issement de niveau sup rieur capable d assurer la prise en charge niveau de recours tablissements de transfert plus sp cialis r hydrater r hydrat r hydratation renforcer le savoir faire reprise de l allaitement soulager traiter les sympt mes agit revenir imm diatement solution de Ringer lactate nez qui coule aide m dicale rurale maternit sans risque B Procedures for Adapting the Charts and Modules safe remedy second line drug semisolid foods sepsis serious serious bacterial infection severe classification SEVERE COMPLICATED MEASLES SEVERE DEHYDRATION severe disease SEVERE MALNUTRITION OR SEVERE ANAEMIA SEVERE PERSISTENT DIARRHOEA SEVERE PNEUMONIA OR VERY SEVERE DISEASE severity Shigella dysentery signs of illness skin pinch SOME DEHYDRATION soothe soothe throat sore nipples sterile sterilization stiff neck stool bloody loose strategy stridor suckling sugar water sulfadoxine pyrimethamine sunken eyes supervision surveillance system sustainability symptoms syringe rem de inoffensif sans danger m dicament de seconde intention aliments semi liquides septic mie grave s v re infection bact rienne grave classification grave rougeole avec complications graves d shydratation s v re maladie grave malnutrition s v re ou an mie s v re diarrh e persistante s v re pneumonie grave on mala
52. ist of key words and related words for consistent use 30 Guidelines for writing simpler English 36 Checklist for producing the adapted materials Checklist for producing the adapted materials vii B Procedures for Adapting the Charts and Modules B Procedures for Adapting the Charts and Modules Adapting the charts and modules is a demanding task that must be planned thoughtfully and executed with thorough attention to detail Selection of suitable staff to supervise and carry out the adaptation is essential Better computer equipment will greatly facilitate the computer revisions Using good quality supplies such as paper and tape and working on clean uncrowded surfaces will make the process easier and will result in a better product STAFF REQUIRED To make the actual changes in the charts and modules requires four people with certain characteristics A secretary very skilled on computers sometimes called a word processing or document expert to work on the modules who is thoroughly skilled in WordPerfect 5 x for Windows including working with tables The secretary should also be able to spend uninterrupted blocks of time making the changes in the computer files for the modules be available for the whole period of adapting the modules be responsible for keeping track of the files on the hard disk and back up diskettes and be patient attentive to detail and compulsive about completeness and thoroughnes
53. ke changes and decide how to change the text Although some changes can be located with a computer search function this will not find all of the necessary changes As you read think about the changes in the charts and look for sections of the modules that explain those parts of the chart Refer to the lists of chart changes the drugs list and the list of explanations needed from Step 2 Also look for exercises that teach or use those parts of the charts Note Some persons have tried to make changes on the diskette right away using the strike out add feature so that the changes can be proofed later skipping the step of writing them all on a copy of the modules However this has been unsatisfactory because it is much more difficult to work with and proof including finding any changes that were omitted Therefore it is NOT recommended If a recording form has changed you will have to find every page on which it appears Transfer all the patient information from the generic version to the adapted recording form by hand and add or change patient information related to items you have changed on the form Then tape the revised recording form into the module over the one that will be replaced B Procedures for Adapting the Charts and Modules 4 2 The adapted feeding recommendations food box on the Counsel chart must be incorporated in the Counsel the Mother module The adapted food box and a list of local feeding problems were devel
54. n skills community health care provider community health worker complementary feeding complementary foods compliance with treatment complications condition control of diarrhoeal diseases CDD substitut du lait maternel rythme respiratoire 7 fr quence respiratoire respirations fontanelle bomb e calme renforcement des comp tences recours aux soins personne qui s occupe de l enfant 7 gardien de l enfant en Afrique prise en charge des cas fascicule de tableaux v rifier la compr hension tirage sous costal maladie de l enfant chloramph nicol m chloroquine chol ra m chronique infection chronique de l oreille classification quelques fois consid r e comme un diagnostic approximatif classer dispensaire aussi parfois consultation directives cliniques opacit de la corn e rhume chaine du froid traitement associ aptitude communiquer agent de soins de sant communautaire agent de sant communautaire alimentation compl mentaire aliments compl mentaires aliments de compl ment observance du traitement complications affection lutte contre les maladies diarrh iques LMD B Procedures for Adapting the Charts and Modules convulsions cotrimoxazole cough counsel Counsel the mother counselling Course director s guide cut off breathing rate danger signs decentralization of management dehydration dengue haemoragic fever Depa
55. n the wall charts Although it is useful to have pencilled in changes at the early stages of discussing adaptations it is also good to begin to revise the chart booklet on the computer early in the process rather than waiting until the end This allows for making changes in various pages as adaptations are decided proofreading making corrections and proofreading again which requires time and careful work See section H Modifying the generic Chart Booklet Using Microsoft Publisher for instructions on how to make changes Clean copies of the chart booklet are useful at various steps in the review process as well as when they are needed for making physical changes in the modules With the equipment and software listed above it should be possible to make clean copies without going to a commercial service It is very important to proofread all changes Because the files are complex sometimes when a box is changed some text in it or another box may move or be hidden Therefore check both the format and the text very carefully Preparing a partially computerized plus cut and paste chart booklet If it is difficult to print out the entire booklet from the file a cut and paste method may be used to produce the camera ready chart booklet Revise or produce new boxes on computer and print them out Then carefully tape the adapted box over the previous box on a black and white version of the chart booklet obtained from WHO headquarters
56. nd the headings Layout Center Page has been selected from Layout Page menu Table size 2 columns 9 rows Column width 14 28 cm 5 62 and 4 18 cm 1 65 Select Multi line from Row 27 B Procedures for Adapting the Charts and Modules Annex B 4 List of key words and related words for consistent use A step in the adaptation of the charts and materials for the Integrated Management of Childhood Illness course is to translate the text into the language participants will use in the training Using the list of key words 28 This annex contains a list of key words and words related to them that are used in the participant materials The list is intended to assist those who will translate the course material to ensure consistent word use and maintain an appropriate and consistent level of readability throughout the materials Before beginning the translation translators review this list of key and related words and agree on the translations to be used for each of them When a local term for a key word was determined by the study described in section E Protocol for Identifying and Validating Local Terms translators should use that local term rather than another translation of the word Translators then translate the case management charts and recording forms using the agreed translations of the key words Finally translators translate the rest of the participant materials modules and answer sheets This
57. ng fontanel Calm Capacity building Careseeking Caretaker Case management Chart booklet Check understanding Chest indrawing Childhood illness Chloramphenicol Chloroquine Cholera Chronic Chronic ear infection Classification Classify Clinic Clinical guidelines Clouding of the cornea Cold Cold chain Combined treatment Communication skills Community health care provider Community health worker Complementary feeding Complementary foods Compliance with treatment Suced neo de la leche materna Frecuencia respiratoria o de la respiraci n Respiraciones Abombamiento o abultamiento de la fontanela Tranquilo Creaci n de capacidad fortalecimiento de la capacidad B squeda de asistencia atenci n o consulta Cuidador persona que cuida al nifio encargado de cuidar al ni o Manejo de casos Folleto del gr fico Comprobar que se haya entendido Tiraje tor cico Enfermedades prevalentes de la infancia Cloranfenicol Cloroquina C lera Cr nico Infecci n cr nica del o do Clasificaci n Clasificar Consultorio dispensario ambulatorio Pautas cl nicas Opacamiento de la c rnea Resfr o o resfriado com n catarro com n Cadena de fr o Tratamiento combinado terapia de combinaci n Aptitudes de comunicaci n habilidades de comunicaci n Proveedor de asistencia sanitaria de la comunidad proveedor de atenci n de salud de la comunidad Agente sanitario de la comunidad tr
58. noun Seguimiento Follow up care Asistencia de seguimiento Follow up visit Visita de seguimiento visita de control Food security Seguridad alimentaria Food based fluids L quidos a base de alimentos bebidas a base de alimentos Frequency Frecuencia Furazolidone Furazolidona Further care when related to immediate Asistencia adicional o complementaria la return relacionada con el regreso inmediato del paciente General condition Estado general situaci n general condiciones generales General danger signs Signos generales de peligro Generic version Versi n gen rica versi n general Gentamicin Gentamicina Gentian violet Violeta de genciana Global burden of disease Carga global de la morbilidad Growth Crecimiento Grunting Quejido espiratorio Guide for clinical practice in the inpatient Gu a del facilitador para la pr ctica cl nica con ward pacientes internos o encamados Guidelines not algorithm Normas pautas directrices Guidelines for follow up after training Gu a para el seguimiento posterior a la capacitaci n o al adiestramiento Hands on clinical practice Pr ctica cl nica Health assistant Asistente de salud o sanitario Health care provider Proveedor de atenci n de salud o asistencia sanitaria Health center Centro de salud Health facility Establecimiento de salud o sanitario Health management information system Sistemas de informaci n para la gesti n sanitaria HMIS Health system Sistema de
59. oins compl mentaires tat g n ral parfois affection g n ralis e signes g n raux de danger version g n rique gentamicine f violet de gentiane charge de morbidit charge globale totale de morbidit charge de morbidit mondiale croissance geignement expiratoire guide pour la pratique clinique au service d hospitalisation directives directives pour le suivi de la formation pratique clinique assistant sanitaire personnel soignant centre de sant tablissement de sant centre de sant tablissement de sant syst me d information pour la gestion sanitaire syst me de sant gestion des syst mes de sant r forme du syst me de sant 65 B Procedures for Adapting the Charts and Modules health worker home care home fluids hookworm hospital hydration status Identify treatment illness immunization immunization schedule immunization status implementation improving noun child is improving in service training indicator individual feedback indoor air pollution infection initial visit injection inpatient care inpatient ward integrated approach integrated management of childhood illness IMCI integrated strategy intervention intramuscular intravenous IV fluid intravenous therapy Introduction introduction phase 1 iron treatment iron folate irritable itching jaundice personnel de sant agent de san
60. onom tre parfois minuterie Gu risseur traditionnel 7 tradipraticien Modules de formation Traiter Traiter l Enfant Traitement Conduite th rapeutique Etapes du traitement Ulc rations bouche profondes et tendues Ombilic Inconscient Urgent Prise en charge urgente Vaccin m Lutte antivectorielle Maladie tr s grave Maladie f brile tr s grave Vomir Vomissures Qui vomit vomissements Tableau mural B Procedures for Adapting the Charts and Modules Wasted Amaigri maci Wasting visible severe Amaigrissement visible et s v re maciation Weaning foods Aliments de sevrage Weight for age low Poids pour l ge faible poids ge poids par rapport l ge Weight for age chart growth chart Courbe poids pour l ge fiche de croissance courbe poids ge Well child visit Visite d un enfant bien portant Wheezing Sifflement respiratoire 7 respiration sifflante sibilance Whipworm Trichoc phale White patches in the mouth Muguet Wicking to dry the ear Placer une m che pour ass cher l oreille Worsen Empirer 7 s aggraver se d t riorer se d grader Young infant Nourrisson de moins de 2 mois 47 B Procedures for Adapting the Charts and Modules 48 B Procedures for Adapting the Charts and Modules Alimentaci n activa Agudo Active feeding Acute Acute ear infection Infecci n aguda del o do Acute lower respiratory
61. oped as described in section D Protocol for Adapting the Feeding Recommendations Substitute the adapted food box and add description of the local foods appropriate for each age group Also add any local feeding problems and corresponding recommendations Refer to section E Changes in Materials required for specific adaptations for pages to change When you change any exercise mark corresponding changes on the answer sheet Also make any additions or changes in the facilitator guidelines for teaching the module and if needed in the guidelines for clinical practice with inpatients or outpatients for example to add teaching the management of acute convulsions If you choose to substitute common children s names in your country for some of the names used in the exercises in the generic materials you will have to change each name in the exercise and in the answer sheet See section E Changes in materials required for specific adaptations for a list of names and where they appear If there will be an adapted Mother s Card which is appropriate for the whole country and it will be ready by the time of printing the modules put it in the Annex to the Counsel the Mother module If there will be several different regional cards or the national card will not be ready in time for printing the modules do not include one in the module Instead plan to distribute the appropriate card for the health workers at each course If there will be sev
62. ord processing tricks to fit the changes onto the page This will allow you to only replace pages where there is new text or adapted chart boxes saving the work of reprinting and taping illustrations on all pages If text changes require that a page be added but the pages after this are unchanged you can avoid reprinting and repasting the unchanged pages Instead use the generic pages with illustrations and chart boxes already pasted or printed in and change their page numbers using white out or correction tape Print out and check all the computer changes in the modules and facilitator guides The person who enters the changes should check that all the changes written on the modules and answer sheets have been made and none missed Then a second person should check all the changes Translate the training materials if needed If translation is required follow this order first translate the list of key words then the adapted chart and the adapted recording forms and then the adapted modules 6 1 Give the translator the list of key words to translate first Then check them It is important to use a limited number of technical words and to keep the translation as simple as possible It is also important to be consistent in the translation use the same words and sentences consistently on the charts and throughout the modules The list of key words will help with this process see Annex B 4 page 28 First translate and c
63. paper in North and South America Base Font Times New Roman 12 point or Times Roman or CG Times depending on the fonts available on your printer Base font for recording forms only is Univers 8 or Helvetica or Arial depending on the fonts available on your printer 25 B Procedures for Adapting the Charts and Modules Preferences Print settings Set the preferences for relative font size as follows Fine 60 Small 180 Large 120 Very large 150 Extra large 200 Super Subscript 60 Page Number Style Bottom center New Page Number Start numbering with page 1 on Introduction page If a module is in 2 or more computer files the New page number which begins the second file or any subsequent file is set at the beginning of the file at Page Numbering Margins for A4 Paper Size Top 3 18cm or 1 25 Bottom 3 18cm or 1 25 Left 3 18cm or 1 25 Right 3 18cm or 1 25 If you change to Letter size paper 21 59 cm x 27 94 cm or 8 5 x 11 reset the margins as follows to maintain the same amount of text on each page Top 3 18cm or 1 25 Bottom 1 4 cm or 0 55 Left 3 48 cm or 1 37 Right 3 43cm or 1 35 Table Options Do not exceed 14 65 cm or 5 77 line length when you make a table This is the normal line width of text when margins are set as recommended above Set Position in options menu as Full to keep within 14 65 cm line length Cell margins 0 21 cm left or 083 0 21 cm right or 083 0 25 cm top or
64. r possible avoid using local in its geographic meaning as in common local problems Exception Use local feeding problems to describe feeding problems specific to an area the clinic serves loca adaptations local problems in your area local problems in the community common loca problems Simplify text such as common problems of women in your area local feeding problems 31 B Procedures for Adapting the Charts and Modules Key word Related words for consistent use malaria malaria malaria infection Simplify text such as The child with malaria or malaria that is resistant to or use classification name lari linical pre referral pre referral forral situati pre referral treatment urgent pre referral treatment Respiratory infection respiratory infection infecti less serious respiratory infection upper respiratory infection acute lower respiratory infection respiratory symptoms pi hi respiratory distress Use difficult breathing to describe mother s report of these symptoms or health worker s observation of them Runny nose runny nose nasal discharge Use when describing post nasal drip that may cause cough Serious severe serious illness Use generically to describe an illness that requires treatment serious problem Use to describe a presenting symptom or problem which when assessed and classified will need treatment serious bacter
65. ratation Solut pour administration i v solut i v Suivre Suivi Soins de suivi Visite de suivi Salubrit des aliments S curit alimentaire Pr paration liquide base d aliments Fr quence Furazolidone Soins compl mentaires Etat g n ral parfois affection g n ralis e Signes g n raux de danger Version g n rique Gentamicine f Violet de gentiane Charge de morbidit Charge globale totale de morbidit Charge de morbidit mondiale Croissance Geignement expiratoire Guide pour la pratique clinique au service d hospitalisation Directives Directives pour le suivi de la formation Pratique clinique Assistant sanitaire Personnel soignant Centre de sant tablissement de sant Centre de sant tablissement de sant B Procedures for Adapting the Charts and Modules Health management information system HMIS Health system Health system management Health system reform Health worker Home care Home fluids Hookworm Hospital Hydration status Identify treatment Illness Immunization Immunization schedule Immunization status Implementation Improving noun child is improving In service training Indicator Individual feedback Indoor air pollution Infection Initial visit Injection Inpatient care Inpatient ward Integrated approach Integrated management of childhood illness IMCI Integrated strategy Intervention Intram
66. ready facilitator aids that will be printed Modify the generic cover design as needed or prepare new covers for each module and guide Copy the answer sheets from the Facilitator Guide for Modules After the Facilitator Guide for Modules is adapted make a copy of each final answer sheet and white out the Facilitator Guide page number Assemble the copies in the order that the modules and exercises occur in the course This will be the camera ready copy for the set of answer sheets to give to participants Print the course materials Determine how many copies are needed for the first round of courses and calculate how many copies of modules and other materials should be printed Many countries make corrections after the first few courses For this reason limit the number of sets to be printed until materials can be finalized Below are typical numbers of the different materials needed to conduct the course two times These estimates assume that in each course there will be 20 participants 8 facilitators one inpatient ward instructor and one course director Number of Copies Needed for two courses and allowing for a few extra copies gt 70 of each of the seven modules bound gt 70 chart booklets colour printing bound gt 10 Facilitator Guide for Modules and 10 for outpatient practice bound gt 5 Inpatient Instructor Guide bound Some countries have the capability to insert a graphic file in a WordPerfect file and
67. rencia o remisi n 57 B Procedures for Adapting the Charts and Modules Second line drug Medicamento de segunda l nea Semisolid foods Alimentos semis lidos Sepsis Septicemia Serious Serio v ase severe Serious bacterial infection Infecci n bacteria seria Severe Grave v ase serious Severe classification Clasificaci n de grave clasificado como grave Severe complicated measles Sarampi n grave con complicaciones Severe dehydration Deshidrataci n grave Severe malnutrition or severe anemia Desnutrici n grave o anemia grave Severe persistent diarrhea Diarrea persistente grave Shigella dysentery Shigelosis disenteria 58 B Procedures for Adapting the Charts and Modules Tablet drug Comprimido tableta medicamento Temperature axillary rectal Temperatura axilar rectal Tender swelling behind the ear Tumefacci n dolorosa al tacto detr s de la oreja Tetanus toxoid Toxoide tet nico anatoxina tet nica Tetracycline Tetraciclina Thirsty Sediento tiene sed Thresholds Umbrales Throat Garganta Thrush Candidiasis bucal Timing device Cron metro Traditional healer Curanderos Training modules M dulos de capacitaci n Treat Tratar Treat the child Tratar al ni o Treatment Tratamiento Treatment procedures Procedimientos de tratamiento Treatment steps Pasos del tratamiento Ulcers mouth deep and extensive lceras bucales profundas y extensas Umbilicus Ombligo Un
68. ria anaemia Assessment Assessment assessmentapproach assessment findings results assessment steps case management process integrated case management appreach process do a complete full assessment Breastfeeding Breastfeeding breastfeeding assessment breastfeeding counselling breastfeed exclusively exclusive breastfeeding exclusively breastfed exclusively breastfeeding breathing rate breathing rate cut off rate Use cut off when describing how to determine fast breathing respiratory rate respiratory rate threshold fast breathing rapid breathing case of E infecti acquiring malaria Simplify text such as child can have other infections or a child develops malaria attackof measles Use a case of measles episode of diarrhoea classification tables classification tables classification pink row severe classification yellow row eat green row ficati 29 B Procedures for Adapting the Charts and Modules Key word Related words for consistent use dehydration Dehydration dehydration status hydration status But only use when describing Plan C Use it very little elsewhere rehydrate rehydrated rehydration fully rehydrated no signs of dehydration feeding terms feeds Used as a verb Also used to describe meals eaten by a breastfed or bottle fed infant such as a bottle feed or breastfeed long enough
69. ries the health education or communications department may have a media section with the necessary skills and equipment The chart booklet is produced in Microsoft Publisher The graphics service will need to convert the chart booklet files to create the large wall charts To do this they may convert the files to their particular software or retype the charts to make them compatible for production on their equipment EQUIPMENT AND SUPPLIES REQUIRED gt To adapt the generic modules recording forms and facilitator guides you will need Set of diskettes from WHO with computer files for the generic Integrated Management of Childhood Illness course in WordPerfect 5 1 5 2 Personal computer system requirements Microprocessor Pentium computer recommended or a 80286X processor minimum Memory 640 KB Hard disk space 8 MB minimum available for use with WordPerfect 5 2 for Windows Disk drive 3 5 inch 1 4 MB capacity Software WordPerfect 5 1 or 5 2 for Windows with Windows 3 1 or later version Printer Any laser printer capable of printing 300 dots per inch dpi and proportional fonts see Annex B 1 page 19 Printed and bound generic version of the modules B Procedures for Adapting the Charts and Modules Optional useful if the materials will not be translated single sided copy of the generic modules and guides Notebook titled section E ustrations and Paste Ups for the Course Modules
70. rtment of Child and Adolescent Health and Development CAH developing countries development diagnosis diarrhoea difficult breathing disability discharge from the ear or the umbilicus disease disease classification disease prevention Division of Child Health and Development CHD dosage table dose DPT drinks eagerly drinks poorly drug supply management DSM drugs DYSENTERY ear infection ear pain ear problem early implementation phase 2 convulsions cotrimoxazole m toux conseil conseiller la m re conseil Guide du directeur de cours seuil rythme respiratoire signes de danger d centralisation de la gestion d shydratation dengue h morragique D partement Sant et d veloppement de l enfant et de l adolescent CAH pays en d veloppement d veloppement diagnostic diarrh e respiration difficile incapacit coulement de l oreille ou de l ombilic maladie classification des maladies pr vention de la maladie Division Sant et d veloppement de l enfant CHD table de posologie dose DTC boit avec avidit boit difficilement gestion de l approvisionnement en m dicaments m dicaments dysenterie infection de l oreille douleur l oreille probl me d oreille affection de l oreille phase initiale de la mise en oeuvre B Procedures for Adapting the Charts and Modules early use countries empirical treatment energ
71. s To make changes in the chart booklet the secretary should also be familiar with advanced features of word processing or desktop publishing including working with graphics and text boxes These skills are needed in using the Microsoft Publisher program to make changes in the chart booklet In some cases the national focal person or adaptation consultant will have received training to use Microsoft Publisher and will be able to assist in making these changes in the chart booklet Booking the time of such a person in advance is very important The adaptation expert the coordinator of the adaptation subgroup and or a local consultant trained in adaptation who has thorough familiarity with the course has been trained in how to do adaptation and is patient attentive to detail and compulsive about completeness and thoroughness Another clinician or trainer to assist the adaptation expert to check the changes help oversee the graphics work proof final copy interact with the printer etc who B Procedures for Adapting the Charts and Modules has thorough familiarity with the course is patient attentive to detail and compulsive about completeness and thoroughness and is available for the whole period of adapting the modules A graphics expert with the appropriate equipment to produce the wall charts This expert will usually be located at a graphics service or company However in some minist
72. s Empirical treatment Exclusively breastfed Expanded Program on Immunization EPI Expansion phase 3 Expressed breastmilk Eye ointment Facilitator guide for modules Facilitator guide for outpatient clinical practice Facility supports Family and community practices Family foods Family planning Fast breathing Febrile disease Feeding assessment Feeding counseling Feeding problem or low weight Feeding problems Feeding questions Feeding recommendations Fever Fever malaria unlikely 52 Infecci n del o do Dolor de o do otalgia Problema de o do Pa ses que han empezado a usar o aplicar la estrategia Ejecuci n temprana segunda fase Tratamiento emp rico Amamantado al pecho materno en forma exclusiva Programa Ampliado de Inmunizaci n PAI Leche materna extra da Gu a del facilitador para la pr ctica cl nica con pacientes ambulatorios Medios de apoyo del establecimiento Pr cticas familiares y comunitarias Alimentos de la familia Planificaci n de la familia planificaci n familiar Fiebre por malaria poco probable B Procedures for Adapting the Charts and Modul es First level health facility Establecimiento de salud o sanitario de primer nivel First level health workers Agentes de salud o sanitarios de primer nivel First line drug Medicamento de primera l nea Fluids L quidos Follow up verb Seguir hacer el seguimiento verbo Follow up
73. s As part of B Procedures for Adapting the Charts and Modules planning for IMCI in the country you have also generated a list of the sick child drugs including their formulations When you were making technical adaptation decisions you may have thought of explanations that should be added to or changed in the modules Also make a list of these Adapt the recording forms using the computer files Note Before using any of the generic diskettes read and follow the instructions in Annex B 2 page 21 which describe how to manage the computer files If another person will be making the changes in the computer files give that individual a copy of the instructions Check periodically that they are following the instructions Using the recommended procedures can prevent many problems The Sick Child Recording Form and the Young Infant Recording Form are each a separate computer file These two files use different base fonts and margins than the modules See Annex B 3 page 25 for a description of the WordPerfect settings used in the recording form files The recording forms are complex tables Only someone who is experienced making tables in WordPerfect should attempt to revise these files Be careful with spacing so that all items for assessment and classification will fit on one sheet Proof the changes and formatting carefully Print out the adapted recording forms and make copies to use in planning the changes in the modules Step 4
74. s and printers A description of the word processing settings and features used is in Annex B 3 Enter in the computer files all the changes that have been written on the modules answer sheets and facilitator guides Ifthere are new chart boxes which have been added or enlarged make sure that adequate blank space is inserted on each page where the new boxes will be placed Generally when a document is heavy with codes you may have more difficulty working with the file Your computer may frequently lock up or hang or your printer may not print at all When editing files try not to add too many codes for example by changing the margins to fit more information on a page and then returning to the normal margins If you change a font style size bold or italic you can use Reveal Codes to find and delete any old codes Tip for using the Reveal Codes feature When you change the formatting of a document WordPerfect inserts codes Reveal Codes lets you see these codes If you are having difficulty with formatting use Reveal Codes to see the codes that are in the file If you have added new codes but the old codes remain in the file the file may behave in ways that seem irrational Delete any old or unnecessary code by highlighting it and then using the Delete key To turn Reveal Codes on to see the codes choose Reveal Codes from the View menu or press Alt F3 Turn Reveal Codes off in the same way Move in Reveal Cod
75. salud sistema sanitario Health system management Gesti n de sistemas de salud 53 B Procedures for Adapting the Charts and Modules Health system reform Reforma del sistema de salud reforma sanitaria Health worker Personal de salud personal sanitario Home care Asistencia en casa Hookworm Uncinaria anquilostoma la enfermedad es uncinariasis anquilostomiasis o necatoriasis Improvements in family and community Mejoras de las pr cticas de la familia y la practices comunidad Improvements in health systems Mejoras de los sistemas de salud Improvements in the case management Mejoras de las aptitudes de manejo de casos del skills of health staff personal de salud 12 child is improving Mejorando gerundio el ni o est mejorando Improving noun In service training Adiestramiento o capacitaci n en servicio Indicators Indicadores Retroalimentaci n individual Indoor air pollution Contaminaci n del aire en locales cerrados hospitalizados o encamados Integrated management of childhood Atenci n integrada de las enfermedades illness IMCI prevalentes de la infancia AIEPI 54 B Procedures for Adapting the Charts and Modules Iron treatment Iron folate Irritable Itching Jaundiced Lethargic Lethargy Local bacterial infection Local infection Local terms Main symptoms Major illnesses MALARIA cerebral malaria Malaria risk low high Tratamiento con hiero Hierro fol
76. sentery Dysenterie Shigella Signs of illness Signes de maladie Skin pinch Pli cutan Some dehydration Signes vidents de d shydratation Soothe Calmer Soothe throat Soulager le mal de gorge Sore nipples Mamelons douloureux Sterile St rile Sterilization St rilisation Stiff neck Nuque raide Stool bloody loose Selles sanglantes molles Strategy Strat gie Stridor Stridor Suckling Succion Sugar water Eau sucr e Sulfadoxine pyrimethamine Sulfadoxine pyrim thamine Sunken eyes Yeux enfonc s Supervision Supervision 45 B Procedures for Adapting the Charts and Modules Surveillance system Sustainability Symptoms Syringe Syrup Tablet drug Target Telangectasia Temperature axillary rectal Tender swelling behind the ear Tetanus toxoid Tetracycline Thirsty Threshold Throat Thrush Timing device Traditional healer Training modules To treat Treat the child Treatment Treatment procedures Treatment steps Ulcers mouth deep and extensive Umbilicus Unconsciousness Urgent Urgent attention Vaccine Vector control Very severe disease Very severe febrile disease To vomit Vomit noun Vomiting Wall chart Syst me de surveillance Durabilit parfois viabilit Sympt mes Seringue Sirop Comprim Cible T langiectasie Temp rature axillaire rectale Gonflement douloureux Anatoxine t tanique T tracycline f Assoiff Seuil Gorge Muguet Chr
77. sor the work will be easier with a faster computer but a 286 will work The computer must have a hard disk with at least 8MB of available hard disk space and WordPerfect 5 2 Use Windows 3 1 or later version If the computer that will be used throughout the process of adapting and producing the course materials has WordPerfect 6 0 for Windows or higher or Microsoft WORD for Windows it will be necessary to convert the files WordPerfect 6 0 and Microsoft WORD will convert the files automatically At least one country has successfully converted files to WORD and completed the adaptations However once converted to a later version of WordPerfect files do not convert well back to 5 2 Therefore do not convert the files unless there is equipment and a skilled operator that can complete the entire job using the alternative software or later version Converted files may have problems with incompatible font size page size tables figures and page numbering and may require some reworking The files are not compatible with WordPerfect versions 5 0 4 2 or other earlier versions The module diskette files have not been converted for use on an Apple Macintosh Initial settings definitions for the modules and guides Page Paper Size Definition 2 cm x 29 7 cm 8 27 x 11 69 for A4 paper size Note The generic files for modules are set for A4 paper size If another paper size is required select 21 59 cm x 27 94 cm or 8 5 x 11 for Letter
78. squito bite blanche Movement normal Nalidixic acid Nasal discharge Nasal flaring Nasogastric NG therapy Nasogastric tube Needle No anaemia and not very low weight No dehydration No ear infection No feeding problem No pneumonia cough or cold Normal saline solution Not able to feed possible serious bacterial infection Nutrient rich foods Nutrition Nutritional counselling Nutritional status Oedema Opv Oral rehydration salts ORS Oral rehydration therapy ORT Outpatient Outpatient treatment Palmor pallor Paracetamol Paramedical health workers Patient recording form Perinatal Persistent diarrhoea Petechiae on skin Pharmacist Pharmacy Photographs Mortalit Piq re de moustique dans Cours du Directeur Mouvement normal Acide nalidixique Ecoulement nasal Battement des ailes du nez Traitement par voie nasogastrique NG Sonde nasogastrique Aiguille Pas d an mie et pas de poids tr s faible Pas de d shydratation Pas d infection de l oreille Pas de probl me d alimentation Pas de pneumonie toux ou rhume S rum physiologique Incapable de se nourrir possibilit d infection bact rienne grave Aliments riches en nutriments Nutrition Conseil nutritionnel Etat nutritionnel d me Vaccin antipoliomy litique buccal VPO Sels de r hydratation orale SRO Traitement par r hydratation orale TRO Patient ambulatoire Traitement ambulatoire P le
79. sten en ingl s en espa ol se proponen las siguientes equivalencias follow up seguimiento 80 B Procedures for Adapting the Charts and Modules monitoring monitoreo surveillance vigilancia Aunque monitoreo no ha sido admitido todav a por la Real Academia es un neologismo necesario y sancionado por el uso T pesar de las tentativas por normalizar las denominaciones comunes internacionales de la OMS en varios pa ses el nombre utilizado es acetaminof n a veces en alternancia con paracetamol Tambi n es algo que tal vez quieran considerar en sus adaptaciones 19 Esta entrada se agreg pues hace falta seg n lo se alado en la nota 16 2 En ingl s las enfermedades se designan a veces simplemente por el nombre del agente causal como en este caso En espa ol ello no es aceptable y resulta confuso V anse tambi n los art culos hookworm y whipworm 81
80. stration and require considerable time to figure out or fix However you can prevent problems and headaches by following the simple procedures below Then you will always be able to find the most recent revision and prevent redoing a lot of work if you have a disk or computer failure l Create a subdirectory on your hard drive named IMCI for Integrated Management of Childhood Illness or another short name which has not been used already The computer files for the generic materials have all been given names that end with the extension gen See the list below Select a 2 or 3 character extension such as an abbreviation for the name of your country to substitute as the extension on files that you adapt Copy all the generic files from the diskettes into the IMCI subdirectory on your hard drive usually C changing the extension on each file as you copy it For example in Uganda if using UG as the extension copy A 1 INT GEN to C AIMCI 1 INT UG A 2 ASS1 GEN to CAIMCN2 ASS1 UG A 2 ASS2 GEN to CAIMCN2 ASS2 UG etc Then put the generic disks aside in a safe place Do not make any changes on them They will be there if you ever need to copy a generic file again Take a new set of diskettes and copy all the files from the IMCI subdirectory onto them This will require 3 High Density 1 44 MB diskettes or 6 Double Density 720 KB diskettes Label these diskettes with all the file names and keep them safe They will be your
81. strica terapia NG Not able to feed possible serious No logra alimentarse posible infecci n bacteriana bacterial infection seria Nutrient rich foods Alimentos ricos en nutrientes alimentos muy nutritivos Nutrition Nutrici n Nutritional status Estado de nutrici n estado nutricional VOP vacuna oral contra la poliomielitis Oral rehydration salts ORS Sales de rehidrataci n oral SRO Oral rehydration therapy ORT Terapia de rehidrataci n oral TRO Outpatient Paciente ambulatorio paciente externo Outpatient treatment Tratamiento ambulatorio tratamiento de pacientes externos Palmar pallor Palidez palmar Paracetamol Paracetamol acetaminof n sanitarios param dicos Planning and program management Pautas para la planificaci n y gesti n de guidelines programas 56 B Procedures for Adapting the Charts and Modules Positioning breastfeeding Colocaci n en posici n adecuada amamantamiento Possible serious bacterial infection Posible infecci n bacteriana seria Pus draining from the eye ear or umbilicus Quality of care Calidad de la atenci n o asistencia Rapid breathing Respiraci n r pida Rational use of drugs Uso racional de medicamentos Red eyes Ojos enrojecidos ojos encarnados Refer urgently Referir o remitir urgentemente Asistencia de referencia o remisi n Referral level Nivel de referencia o remisi n Referral level facilities Establecimientos del nivel de refe
82. t soins domicile liquides pr par s la maison ankylostome h pital degr d hydratation identifier le traitement maladies vaccination parfois immunisation ex immunisation passive calendrier vaccinal tat vaccinal mise en ceuvre am lioration formation en cours d emploi continue indicateur r troinformation pollution domiciliaire au domicile infection premi re visite injection piq re soins l h pital service d hospitalisation en hospitalisation approche int gr e prise en charge int gr e des maladies de l enfant PCIME strat gie int gr e intervention intramusculaire solut pour administration intraveineuse solut i v traitement par voie intraveineuse introduction introduction phase 1 administration de fer traitement martial fer folates irritable qui d mange d mangeaison prurit jaunisse ict re B Procedures for Adapting the Charts and Modules jaundiced lethargic lethargy LOCAL BACTERIAL INFECTION local infection local terms main symptoms major illnesses MALARIA cerebral malaria malaria risk low high malaria unlikely malnutrition management of sick children Management of the child with a serious infection or severe malnutrition Management of the sick young infant age 1 week up to 2 months MASTOIDITIS materials maternal health MEASLES measles severe complicated measles rash
83. t boxes illustrations graphics and recording forms that will appear on the pages of the modules and answer sheets Correctly sized copies of these items can be found in the ustrations and Paste Ups for the Course Modules If the materials have been translated only the illustrations and graphics will be used in your modules You must substitute any adapted or translated chart boxes or recording forms for those in the ustrations notebook but you may refer to the notebook to determine the size needed Tape the chart boxes illustrations and recording forms into the materials Use a ruler or T square to be certain that you place each item straight on the page Use invisible tape which will not show up on photocopying This is preferred to glue which can cause rippling B Procedures for Adapting the Charts and Modules 10 11 Before each exercise cut out and tape on the appropriate graphic to indicate the type of exercise or use a peel and stick graphic if available Refer to the generic modules as needed Handwrite the entries on all recording forms in the modules and answer sheets Proofread the entries carefully It is a very common error to miss some entries when copying Also have a second person check each page Review the package of generic Facilitator Aids Identify all aids that must be changed either because the materials were translated or because a chart box was adapted Produce enlarged copies to be the camera
84. tent wording Choose the word with the most direct and clear meaning and use the same word every time rather than a related word or synonym Refer to the List of key words gt Always use The skin pinch goes back slowly to use wording consistent with the chart rather than The skin pinch returns slowly or The skin pinch flattens slowly Use precise words and avoid idiomatic expressions Instead of get use obtain find bring pick up receive catch locate etc Instead of Have the mother bring the child back in 2 days gt use Ask the mother to bring the child back in 2 days The first time essential words unfamiliar to the reader appear define them gt Stridor is a harsh noise that is made when the child breathes in Stridor happens when Repeat the same word to help to keep the meaning clear gt Sick child drugs include cotrimoxazole chloroquine and iron These drugs are listed on the chart is easier than Sick child drugs include cotrimoxazole chloroquine and iron These medications are listed on the chart B Procedures for Adapting the Charts and Modules 11 Use simpler conjunctions or adverbs to clarify what is being referred to For example avoid so not as like in this way etc These relationships may be difficult for a less able reader to understand Instead use and rather than nor use because rather than as etc Adults who are sick need treatment
85. tly use the words on the charts and key word list and to keep the language as simple as possible The English is currently at a 7 to 8th grade level The language level should match the reading abilities of the less educated first level health facility workers who will be using the course See Annex B 5 page 37 for some guidelines on writing simpler English Some translators try to vary how something is expressed in order to make the text more lively Ask them not to do this Even when the text is translated into the local language reading this quantity of text and exercises can be demanding for health workers who do not usually read much Limiting the vocabulary will make the materials easier to read Check several early sections of the translation Do not let the translator do all the modules before checking them If there is a problem you may need to substantially redo a large job Translate the video if necessary English French and Spanish versions of the videos are available from WHO Portuguese and Russian versions of the video are in process and will be available from WHO in the future B Procedures for Adapting the Charts and Modules 6 5 6 6 If translation to another language is needed request from WHO a copy of the video script and a sub master of the video with an unmixed soundtrack In an unmixed soundtrack the narrators voices and the background effects are on separate soundtracks Translate the script
86. ur palmaire Parac tamol Personnel param dical Fiche de prise en charge du patient P rinatal Diarrh e persistante P t chies Pharmacien Pharmacie Photographies 43 B Procedures for Adapting the Charts and Modules Plan A plan B plan C diarrhoea treatment Planning Planning and programme management guidelines Pneumonia Policy Positioning breastfeeding Possible serious bacterial infection Praise the mother Pre referral treatment Pre service training Premature infant Prevention Preventive interventions Problems other common local feeding Pulse radial Pus draining from the eye ear or umbilicus Pustules skin Quality of care Quinine Rapid breathing Rational use of drugs Red eyes Refer urgently Referral care Referral level Referral level facilities Rehydrate Rehydrated Rehydration Reinforce skills Relactation To relieve Restless Plan A plan B plan C traitement de la diarrh e Planification Directives pour la planification et la gestion du programme Pneumonie parfois pneumopathie Politique Position allaitement Possibilit d infection bact rienne grave Complimenter f liciter la m re Traitement pr transfert Formation initiale Pr matur Pr vention Interventions pr ventives 7 interventions de pr vention Probl mes autres habituels alimentation locale Pouls radial Ecoulement d
87. ura en el Diccionario de la Lengua Espa ola de la Real Academia su uso se limita al campo de la inform tica Por lo tanto en un sentido general es mejor evitar este anglicismo innecesario 12 Este no es un sustantivo noun sino una forma verbal el gerundio gerund El sustantivo ser a improvement 1 En los documentos de AIEPI se encuentran las dos formas atenci n integrada a las enfermedades y atenci n integrada de las enfermedades La forma correcta es la segunda atenci n de Ahora que se est preparando el glosario ser a un buen momento para adoptar la forma correcta y uniformar la documentaci n en lo sucesivo hd Aunque malaria es la forma usual en la OPS cabe se alar que se trata de un anglicismo frecuente en el medio de la asistencia sanitaria donde se ha dejado sentir m s la influencia del ingl s Sin embargo en los pa ses de habla hispana el com n de la gente sigue prefiriendo el t rmino original paludismo y sus derivados antipal dico pal dico etc Tal vez quieran ustedes considerar este aspecto al adaptar sus materiales 15 Debe ser as no desnutrici n como dec a originalmente Este t rmino es traducci n de undernutrition 18 En los materiales del AIEPI hemos visto que serious indica un grado de gravedad menor que severe Por consiguiente las traducciones correspondientes deben ser serio y grave V ase la nota 19 17 Para mantener las distinciones de sentido que exi
88. uscular Intravenous IV fluid Intravenous therapy Introduction Introduction phase 1 Syst me d information pour la gestion sanitaire Syst me de sant Gestion des syst mes de sant R forme du syst me de sant Personnel de sant agent de sant Soins domicile Liquides pr par s la maison Ankylostome H pital Degr d hydratation Identifier le Traitement Maladies Vaccination parfois immunisation ex Immunisation passive Calendrier vaccinal Etat vaccinal Mise en oeuvre Am lioration Formation en cours d emploi continue Indicateur R troinformation Pollution domiciliaire au domicile Infection Premi re visite Injection pig re Soins l h pital Service d hospitalisation en hospitalisation Approche int gr e Prise en charge int gr e des maladies de l enfant PCIME Strat gie int gr e Intervention Intramusculaire Solut pour administration intraveineuse solut i v Traitement par voie intraveineuse Introduction Introduction phase 1 41 B Procedures for Adapting the Charts and Modules Iron treatment Iron folate Irritable Itching Jaundice Jaundiced Lethargic Lethargy Local bacterial infection Local infection Local terms Main symptoms Major illnesses MALARIA cerebral malaria Malaria risk low high Malaria unlikely Malnutrition Management of sick children Management of the child with a s
89. ust be equipped with a supplementary accessory such as a Helvetica Times Roman font cartridge Otherwise soft fonts must be downloaded Accessories are available from Hewlett Packard and other commercial providers Please consult the HP Laserjet Series II User Manual for details When using downloadable soft fonts the memory RAM of the HP Laserjet Series II may need to be increased to 2MB Hewlett Packard Laserjet Series II and WordPerfect for Windows 3 1 An HP Laserjet Series II printer can print the modules as prepared on the generic diskettes without additional accessories provided that WordPerfect for Windows running under Windows 3 1 or later version is being used and that Windows has been installed with True Type fonts The True Type equivalent of Helvetica is called Arial and the equivalent for Times Roman is Times New Roman When printing in WordPerfect for Windows select the Windows Printer Driver instead of the WordPerfect Printer Driver Do this by clicking on File then Select Printer gt then Printer Driver Windows gt Hewlett Packard Laserjet Series III Series IV and later models The HP Laserjet Series III and later models have proportional fonts built in These printers will print the modules as they appear on diskette without any additional accessories The Helvetica font does not exist on the HP Laserjet Series III However it has a sans serif equivalent called Univers The serif equivalent for Times Roman is CG Tim
90. y rich foods engorgement breast episode of illness erythromycin essential drugs essential services evaluation exclusive breastfeeding exclusively breastfed Expanded Programme on Immunization EPI expansion phase 3 expressed breastmilk eye ointment Facilitator guide for modules Facilitator guide for outpatient clinical practice facility supports family and community practices family foods family planning fast breathing febrile disease feeding assessment feeding counselling FEEDING PROBLEM OR LOW WEIGHT feeding problems feeding questions feeding recommendations fever FEVER MALARIA UNLIKELY first level health facility first level health workers first line drug fluid for infusion pays premiers utilisateurs pays qui les premiers ont utilis la PCIME traitement empirique aliments nerg tiques engorgement pisode de maladie rythromycine f m dicaments essentiels services essentiels valuation allaitement au sein exclusif exclusivement allait au sein Programme largi de Vaccinations PEV extension phase 3 lait maternel exprim pommade ophtalmique guide de l animateur pour les modules guide de l animateur pour activit clinique au dispensaire soutien aux tablissements pratiques familiales et communautaires alimentation familiale planification familiale respiration rapide maladie f brile valuation de l alimentation conseil alimentaire probl me

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