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Academy Matters

Indian Pediatrics 2001; 38: 482-487  

Workshop on Voluntary Action for "Children in Need of Special Attention" - An Interface Between Pediatricians and Non-Government Organizations


The United Nations’ General Assembly has proclaimed 2001 as the International Year of Volunteers (IYV-2001). The Indian Academy of Pediatrics (IAP) supports this campaign. IAP has committed itself for the welfare of children, especially those in need of special attention. As part of IYV-2001 activities, IAP Delhi, in partnership with the IYV – India Team of the United Nations Volunteers organized one day Interface between Pediatricians and Non Government Organizations (NGOs) in New Delhi on 8th December 2000. The list of participants is enclosed as Appendix I.

Aims and Objectives

The workshop aimed to develop mutual understanding and partnership between pediatricians and NGOs working for the children in need of special attention.

Objectives were defined in the workshop, which are as follows:

1. To bring together pediatricians and NGOs working for Children at Risk.

2. To form an interface between Pediatricians and NGOs and others working in the field of child welfare.

3. To facilitate involvement of pediatricians in voluntary action.

4. To have accountability for the responsi-bilities and actions.

Recommendations

The theme subjects were discussed in four groups and each group prepared the recommendations, which were discussed and finalized by all the participants. The final recommendations are as follows:

1. Theme: Provision of Special Facilities in Hospitals for Children in Need of Special Attention, Including the Children Looked After by NGOs

1.1 Expectations and Realistic Needs of NGOs from Hospitals:

1.1.1 Hospitals must provide some priority to the children in need of special attention,

1.1.2 All services of the hospital should be available FREE to these children,

1.1.3 Hospital staff must be sensitized for the needs of such children, and they should pay more attention to these children,

1.1.4 Medical Social Worker or Nurse or Volunteer should be available at registration/inquiry counter to help and guide these children,

1.1.5 All relevant information should be made available to the NGOs.

1.2 Expectations of Hospitals from NGOs

1.2.1 The children must be accompanied by some worker/ volunteer of the concerned NGO.

1.2.2 The worker/volunteer must carry an Identity Card of the NGO.

1.2.3 The NGOs should try to take maximum benefit of the regular services of the hospitals, and for special services like health camps, etc. prior arrangements can be made.

1.2.4 The NGOs should have a prior understanding with hospital for providing special facilities like making the services free of cost, minimal waiting period, early appointments for special investigations/services, etc. for these children.

1.3 Provision of Nodal Officer in Hospitals

1.3.1 The hospital must identify one doctor as Nodal Officer for interacting with NGOs, and for ensuring that the regular services of the hospital are made available to these children,

1.3.2 Preferably there should be a ‘Cell’ comprising of Nodal Officer, and 1-3 Medical Social Workers who are assigned the duties to help and guide the NGOs bringing these children in the hospitals,

1.3.3 The Nodal Officer should be either the Deputy Medical Superintendent of the hospital, or Head, Department of Pediatrics, or a Pediatrician who is easily available in the hospital,

1.3.4 The Nodal Officer should, preferably, be empowered to exempt the payments, if any, for an investigation or a procedure like surgery, etc. for the children brought by the NGO. For this purpose there should be a good understanding between Nodal Officer and the NGOs.

1.4 Assigning Hospitals to NGOs

1.4.1 Hospitals should be identified according to the convenience of NGOs and the availability of services in a particular hospital,

1.4.2 An understanding should be made between NGOs and hospitals for utilization of the services available in the hospital,

1.4.3 IAP Committee on Child Abuse Neglect and Child Labor (CANCL) should act as a facilitator in establishing such understanding.

1.5 How to include all Government Hospitals, Charitable Hospitals, and if Possible, Private Hospitals

1.5.1 This has to be done on personal or individual level.

1.5.2 State/Local Government authorities can be requested to issue instructions/request to all hospitals to participate in this program (of helping children looked after by NGOs).

1.5.3 IAP CANCL and NGOs can together talk to Private Hospitals to participate in this program.

1.5.4 All participating hospitals should be given due acknowledgment for their help and services at appropriate forums including media.

1.6 How to Utilize the "Paid Services" Even in Government Hospitals

1.6.1 Although efforts should be made to have all the services of the hospital free of cost, even then it is not possible in all cases (like cardiac surgeries, etc.), then the special provisions/funds available with the governments may be utilized.

1.6.2 NGOs and IAP should advocate for simple and easy procedure for availing such funds to these children (as many of these children do not posses any proof of residence also, as required by many schemes such as "Arogya Nidhi" of the Delhi Government).

1.6.3 Efforts should be made to make available funds from Prime Minister/ Chief Minister Relief Fund.

2. Theme: Inter-sectoral Co-ordination (i.e., co-ordination between IAP, NGOs, and other Agencies) - Recommendations for formation of "Co-ordinating Group"

For Inter-sectoral Co-ordination there should be a three tier system. The co-ordination should be done at National, State and District levels.

2.1 At National Level, the Co-ordinating Group will comprise of

· IAP Committee on Child Abuse Neglect and Child Labor.

· Planning Commission Representative.

· Representatives of Union Ministries of Health, Social Justice and Empower-ment, and Department of Women and Child Development (Ministry of Human Resource Development).

· UN Volunteers.

· UNICEF.

· NGOs.

This group will analyze the various related policies of the government, and will provide the recommendations/guidelines on various issues related to child protection.

2.2 The State level groups will also work on similar lines.

2.3 The District level group will comprise of IAP (CANCL) and Representatives of NGOs. Functions of this group will be as follows:

2.3.1 This group will prepare the lists of participating NGOs, hospitals, and IAP Volunteers.

2.3.2 This group will do the "mapping" of city and co-ordinate between NGOs, hospitals, and volunteers.

2.3.3 This group will asses the needs of various NGOs, and will try to provide volunteers, and services accordingly.

2.3.4 This group will interact with various Government agencies, hospitals, HOD Pediatrics, etc. for better co-ordination of the services.

2.3.5 This group will try to develop partnership between various agencies and individuals.

2.3.6 This group will have regular interaction with NGOs once in 2-3 months.

2.3.7 This group will take all the follow-up actions on the recommendations of this, and such other workshop(s).

2.4 It is also recommended to establish an e-mail group comprising of IAP volunteers and NGOs.

3. Theme: Development and Implementation of Training Programs for Volunteers Working for Children in Need of Special Attention

3.1 Assessment should be made for the needs of the training in consultation with the NGOs. This will include identification of persons requiring training in areas of health care of children.

Suggested persons for such training include Health Care Volunteers, Social Workers, Teachers, Public Health Nurse, and Parents-Volunteers (for community participation).

3.2 Areas of training should be chosen according to the needs of NGOs. It was recommended to develop a questionnaire for assessing the needs of NGOs for training of their workers/volunteers. The following subjects can be included in such training:

· Child Health: Nutrition, Immunization, Child Development, Common Infections, Diarrhea, Fever, URI and LRTI, Common Emergencies, First-Aid, Seizure Disorders, Colic, and Transport of Sick Children.

· Sanitation and Hygiene.

· Safe Drinking Water and Food Handling.

· Maternal Health: Ante-natal care including nutrition, tetanus, high risk mother identification and referral; safe delivery (role of Trained Birth Attendant)

· Essential Newborn Care.

· Family Planning.

· Home Management of physically and/or mentally challenged children, Non-formal Education

3.3 Efficient networking of participating NGOs and Health Care Centers should be established and the NGOs must be very clear for referral of children (WHEN and WHERE to refer).

3.4 Resource persons for training of the health care workers should be selected by IAP and NGOs. The resource persons will prepare the training modules, pamphlets, and other material.

3.5 The Resource Persons will train the TRAINERS. The Trainers would be the local pediatrician-volunteer who will provide training to the workers of NGOs. These Trainers (pediatrician-volunteers) will be taken from IAP members. Trainees would be identified by NGOs and IAP (local branch).

3.6 Implementation of these recom-mendations could be done in three phases. In first phase a workshop can be organized where the Resource Persons will prepare the Training Materials (for Trainers, as well as for workers) including Teaching Aids. In second phase, the Resource Persons would train the Trainers. In third phase the trainers will provide training to the health Care workers.

3.7 The modalities of training of health workers (phase two and three above) should be decided by the local NGOs and local branch of IAP.

4. Theme: Involvement of Pediatricians/Doctors in (Out of Hospital) Management of Illness in Children Looked after by NGOs; Expectations of NGOs and Finding Ways to Fulfill Them; Preparation of Guidelines, Manuals, Handbooks, etc. for Volunteers Looking After These Children and to Customize Them for Local/Individual Use

4.1 The health care needs of the children looked after by the NGOs should be assessed by IAP-Volunteers in consultation with the concerned NGOs. Needs should be assessed in terms of nutrition, immunization, growth and development, first-aid, disease preventive measures, and identification of at risk children, etc.

4.2 The doctor should be available within reasonable distance (not necessarily in the premises or place of working of the NGOs, although this is the best). Medical and paramedical professionals should be sensitized for the total well being of the child, and there should be regular interactions between the NGOs and IAP-volunteer/doctor about the needs of the children.

4.3 Doctors can be involved in special health programs, health melas/camps, in screening of diseases, and in school health programs.

4.4 For emergency management of illnesses, the workers (at NGOs) should be trained especially in First-Aid, and in Home Management of Common Illnesses, with clear guidelines for when to consult a doctor, and when to rush the child to hospital emergency department. Help of the IAP-Volunteer attached to the NGO may be taken.

4.5 Protocols should be developed for medical professionals for management of epidemics at shelter homes, screening of abandoned newborn and older children, screening for adoption, routine medical examination, preventive health measures, and immunization (when delayed). Similarly protocols should be developed for health care or other workers (from NGOs) for ‘Home Management’ of Common Illnesses (this must include clear guidelines when to consult a doctor, and when to rush the child to the hospital emergency service), and First-Aid for common injuries. Their manual must include list (with contact numbers) of hospitals and doctors, ambulance services, and other necessary information. The protocols for NGOs’ workers should be in the form of pocket-book size manuals, which are easy to carry and to keep always with them. The information provided in these manuals should be customized for local use like including the contact numbers of nearby hospitals, doctors’, etc.

Compiled by: Dr.Y.C.Mathur, President, Indian Academy of Pediatrics, Kailash Darshan, Kennedy Bridge, Mumbai 400 007, India and Dr. Harish K. Pemde, Secretary, IAP Delhi CANCL, Department of Pediatrics, BJRM Hospital, Jahangirpuri, New Delhi.

Correspondence to: Dr.Y.C. Mathur, President, Indian Academy of Pediatrics, Kailash Darshan, Kennedy Bridge, Mumbai 400 007, India.

E-mail: iapcoff@bom5.vsnl.net.in

Appendix I

List of Participants

  1. Dr. R.N. Srivastava, Former President, IAP, Apollo Hospital, New Delhi.

  2. Dr. Swati Y. Bhave, President, IAP, Bombay Hospital and Medical Research Center, Mumbai.

  3. Dr. Y.C. Mathur, President Elect, IAP, 5 Subodaya Apartment, Boggul Kunta, Hyderabad.

  4. Dr. Shanti Ghosh, Pediatrician, 5,Sri Aurobindo Marg, New Delhi.

  5. Dr. R.N. Salhan, Chairman, IAP Committee on Child Abuse Neglect and Child Labor (CANCL), Ministry of Health and Family Welfare, Government of India, Nirman Bhavan, New Delhi.

  6. Dr. Kiran Aggarwal, Secretary, IAP CANCL, D-II/2, 14 Rajpur Road, Civil Lines, Delhi.

  7. Dr. Uma Aggarwal, Treasurer, IAP CANCL, Department of Pediatrics, Kasturba Hospital, New Delhi.

  8. Dr. T.S. Jain, President, IAP Delhi, and Chairman IAP Delhi CANCL, ESI Hospital, Okhla Phase-I, New Delhi.

  9. Dr. Subhash Aggarwal, Vice-President, IAP Delhi, Tirath Ram Shah Hospital, Rajpur Road, Delhi.

  10. Dr. Sangita Yadav, Secretary, IAP Delhi, Department of Pediatrics, Maulana Azad Medical College, New Delhi.

  11. Dr. Harish K.Pemde, Secretary, IAP Delhi CANCL, Department of Pediatrics, BJRM Hospital, Jahangirpuri, New Delhi.

  12. Dr. Narinder Kaur, Psychiatrist, C-57, Anand Niketan, New Delhi.

  13. Dr. K.C.Tamaria, Pediatrician, Depart-ment of Pediatrics, Colony Hospital, Malviya Nagar, New Delhi.

  14. Dr. Anju Aggarwal, Pediatrician, Department of Pediatrics, ESI Hospital, Basaidarapur, New Delhi.

  15. Dr. Kanak Mittal, Executive Director, Salaam Balak Trust, DDA Community Center, Chandiwali Gali, Paharganj, New Delhi.

  16. Dr. N. Sahukar, Principal, SAHARA School, E-214, Greater Kailash-II, New Delhi.

  17. Ms. Chirag, Co-ordinator, Women and Children Home, SAHARA, E-214, Greater Kailash-II, New Delhi.

  18. Ms. Ellora Guha, Co-ordinator Child Line South Zone, Butterflies, U-4, Green Park Extn., New Delhi.

  19. Ms. Sangeeta Dhaon, Delhi School of Social Work, Delhi University, Delhi.

  20. Ms. Sneh Dhawan, Delhi School of Social Work, Delhi University, Delhi.

  21. Ms. Maushami G. Roy, Program Officer, Deepalaya, 46, Institutional Area, Janakpuri, New Delhi.

  22. Ms. Shallu, Occupational Therapist, Deepalaya, 46, Institutional Area, Janakpuri, New Delhi.

  23. Mr. Aditya Nath, Program Officer, Action Aid, E/270, Greater Kailash-II, New Delhi.

  24. Dr. Doris C. Visscher, Director, Child Development Foundation, G-43, FF, Lajpat Nagar-I, New Delhi.

  25. Sulakshana Saxena, Consultant, Association for Social Health in India, 4, Deen Dayal Upadhyay Marg, New Delhi.

  26. Ms. Shefali, Researcher, Voluntary Health Association of India, 40, Institutional Area, Qutub, New Delhi.

  27. Ms. Himani Dhawan, Program Officer, PRATIDHI, Shakarpur Police Station Complex, Shakarpur, Delhi.

  28. Dr. Ajay Grover, Navjyoti Police Foundation, Sanjay Amar Colony, Yamuna Pushta, Delhi.

  29. Dr. Dinesh Paul, Joint Director, National Institute of Public Co-operation and Child Development, 3, Siri Institutional Area, Hauz Khas, New Delhi.

  30. Shantum Seth, Advisor, IYV-2001, United Nations Volunteers, UN House, 55, Lodi Estate, New Delhi.

  31. Rajeev R. Singh, Specialist in Volunteer Promotion, IYV-2001, United Nations Volunteers, UN House, 55, Lodi Estate, New Delhi.

  32. Rohini Kohli, National UN Volunteer, IYV-2001, United Nations Volunteers, UN House, 55, Lodi Estate, New Delhi.

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