Central Council for Research in Homoeopathy has undertaken the initiative to prepare this manual as a comprehensive resource book for undertaking training of homoeopathic practitioners on mother and child health care. It is hoped that the practitioners would find this manual useful for not only during training but also in their clinical practice. The manual is intended to help the health care professionals to detect, control, treat and prevent a number of disease conditions encountered in women during and after pregnancy and in children.
It is hoped that this manual by setting standards for Mother and Child Health Care will promote effective coordinated action towards health promotion and treatment of diseases, This publication is timely and a valuable addition to the Government of India is efforts to raise the mother and child health standards in the country.
I hope that the efforts put in by the contributors in preparation of the Manual will translate in better health care when it is practiced in the field.
However. it has been increasingly felt that to provide quality services, enhancement of knowledge and skills by interaction with specialists and sharing of experiences is required. Various organizations conduct Continued Medical Education programs. seminars, workshops, training programs with this objective. However, Central Council for Research in Homoeopathy undertook the initiative to prepare a model training program on the basis of which quality training on mother and child health care can be conducted for homoeopathic physicians. This work has been undertaken with financial assistance from the World Health Organization. A Training Module was developed providing guidelines for conducting such programs. Now this Training Manual is prepared to form the backbone of the training program.
In this manual information has been compiled from various sources, with the help of experts from Homoeopathy. Obstetrics and Pediatrics. However, the manual would help not only during training, but would be extremely beneficial to the trainers and trainees when they go back to practice. The manual has been prepared in the form of flow charts to enhance the practical utility while making clinical decision. It is comprehensive, concise, reader friendly, providing knowledge that practitioners need to address the range of problems that women and children may face. It aims at assisting physicians in identification of problems, advising appropriate management other than therapeutic intervention and would be beneficial for both beginners and experienced practitioners. It also includes areas of limitations of Homoeopathy, so that timely referral is advised for the benefit of the patients.
It is anticipated that the sustained and coordinated efforts of the physicians to utilize the strengths of Homoeopathy for the benefit of mothers and children would be a step towards the larger goal to provide efficient care and effective quality health care services to the people of the country.
The manual has been prepared as a resource packet to train homoeopathic physicians on mother and child care so as to enhance their capacity and skills in dealing with mother and child care. It is comprehensive, concise and reader friendly, providing knowledge that practitioners need to address the range of problems that women and children may face.
The training would be conducted to utilize the services of Homoeopathic physicians in primary health care and to involve homoeopathic physicians actively in providing health education and promotion of activities that improve family and community attitudes and practices related to pregnancy, childbirth and care of children.
The manual is arranged in the form of flow charts leading to clinical diagnosis, complications and management (general and therapeutic) of individual disease conditions.
Three volumes of the manual have been prepared. Volume I deal with complaints of women. This includes chapters on provision of ante-natal care, post natal care, common conditions in the ante-natal period and common conditions in post natal period. This training module, as in the present form, does not include training on management of labor and immediate post natal care. Therefore, only basic concepts of intra-natal care are given. Detailed intra-natal care, management of intra-natal complications and immediate post-natal complications which require interventional skills and which can be acquired only through practical hands on exposure are not included.
Volume II deals with complaints of children, including complaints of young infants, gastrointestinal complaints, respiratory complaints, skin complaints, psychosomatic complaints, infectious diseases, etc. Guidelines on general neonatal care and care of growing child are included e.g. milestones of growth of an infant and a child which will help the physician identify growth and developmental lag. Separate chapters on differential diagnosis of symptoms such as fever in children, cough in children, etc. are added to enhance the clinical utility of the manual.
Besides the clinical conditions, some common symptoms are also described e.g. bed-wetting, nail biting, night terror etc. in children; constipation, headache, pica, prorates etc. in pregnant women. These conditions were selected with a view that in clinical practice patients usually complain of these conditions and detailed descriptions of these are lacking in routine textbooks where they are presented as isolated expressions. Thus this book not only provides therapeutic guidelines but also helps for appropriate management of these symptoms commonly seen in clinical practice.
General management is an important aspect in treating a disease. Management part of each condition has been incorporated in terms of dietary advice, exercise and preventive measures, etc.
Volume III deals with general chapters. In the chapter on Nutrition for women and children, instead of Recommended Dietary Allowances (RDA) and calorie requirements, nutritional requirements has been added to in terms of food intake. This has been done because calculation of nutritional requirements based on RDA and other aspects require extensive training in dietetics, which is not possible in a short training program. This section is to impress upon the physicians the importance of quality food intake in women and children.
Oral hygiene is an area of frequent neglect. A chapter on dental complaints has therefore been added. This section includes basics of dental hygiene, identification of common dental conditions in pregnancy and dental caries in children. Developmental complaints have not been covered since they are out of purview of physicians in the primary health care settings and frequently require expertise of a dental surgeon.
Chapter on Prevention includes general guidelines for primordial and primary prevention of diseases. Checklists of screening of common conditions have been added to help the physicians in risk identification and disease diagnosis at an early stage. A chapter on common first aid procedures has been added. This is of particular utility for primary health care physicians, where emergency management is sometimes required to save life. Further means of referral and transportation of patients has been added. This chapter is not specifically limited to children or women during pregnancy and follows a general approach.
In the diseases enlisted in the manual, three approaches to treatment have been suggested. First approach is treatment using homoeopathic medicines. Second approach is providing treatment using homoeopathic medicines in consultation with the obstetricians/pediatrician who may prescribe their medicine(s) under standard treatment procedures. The third approach is referral of cases to obstetrician/ pediatrician for appropriate care and treatment. This has been done taking into consideration the requirements for intervention, scope of the therapies, facilities available and physician's expertise in routine clinical practices particularly in primary health care settings.
Homoeopathic therapeutics have been suggested, which includes the characteristic physical and mental generals and the particular symptoms related to the disease. This has been done to emphasize upon the individualistic and holistic approach of Homoeopathy, which forms the fundamental basis of prescription.
The manual would be useful to homoeopathic physicians in routine clinical practices as a ready reckoned for diagnosis, general management and prescription of the similimum. Chapter on administration of medicine has been added. However, homoeopathic physicians need to follow the principles of homoeopathic phonology.
The manual can be used independently or as a part of the training program / capacity building workshops along with the training module. The training for homoeopathic physicians would be undertaken to improve the skills of homoeopathic practitioners and to utilize their services as primary health care physicians in area of mother and child care.
These can be organized as Continued Medical Education (CME) programs or Re-orientation Training Programs (ROTP) for physicians in field and educators in homoeopathic educational institutions.
Separate training manual and module for conducting deliveries and managing labor related complications, immediate post natal complications and complaints of neonates is envisaged.
Book's Contents and Sample Pages
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