Health and Hygiene
Immunisation schedule
At birth: BCG, OPV-0 and Hepatitis B birth dose. At 6, 10 and 14 weeks: pentavalent (DPT-HepB-Hib) and OPV, with fractional IPV at 6 and 14 weeks. At 9–12 months: measles-rubella first dose, JE first dose where endemic, PCV booster. At 16–24 months: MR second dose, DPT booster-1, OPV booster and JE second dose. At 5–6 years: DPT booster-2. Pregnant women receive TT/Td as per schedule.
Micronutrient and deworming days
Vitamin A at 9 months, then every six months until five years. Albendazole 400 mg (half dose for 1–2 years) on National Deworming Day, observed on 10 February and 10 August.
Diarrhoea and pneumonia
Diarrhoea: ORS after every loose stool plus zinc for 10–14 days, continued feeding. Danger signs - sunken eyes, no urine, lethargy, unable to drink - mean immediate referral. Pneumonia: fast breathing and chest indrawing require referral.
Growth monitoring
Weigh children under three years monthly and plot on WHO charts. Weight-for-age shows underweight, height-for-age stunting, weight-for-height wasting. MUAC for 6–59 months: below 11.5 cm is severe acute malnutrition, 11.5–12.5 cm moderate. Bilateral pitting oedema means SAM regardless of weight.
Hygiene at the AWC
Handwashing with soap at five critical times, safe drinking water, covered food storage, clean toilets, safe disposal of waste, menstrual hygiene supplies and privacy.
Worked example
An 18-month-old attends the AWC. Reasoning: check the card; due items are MR-2, DPT booster-1, OPV booster and JE-2 where applicable, plus Vitamin A if six months have passed since the last dose.
Traps
Confusing OPV-0 at birth with OPV-1 at six weeks; giving ORS without zinc; using MUAC without confirming the child's age; ignoring oedema.