STRUCTURE AND PRESENTATION This Guide is a tool for clinical decision-making. Flow charts Use of colour ■Treatments. The content is presented in a frame work of The flow charts include the following information Colour is used in the flow charts to indicate the Advice and counselling. coloured flow charts supported by information 1.Key questions to be asked. ■Preventive measures severity of a condition. and treatment charts which give further details ■Relevant procedures of care. 2.Important observations and examinations to be made. 6.Green usually indicates no abnormal 3.Possible findings(signs)based on information condition and therefore normal care is given. Information and counselling The framework is based on a syndromic approach whereby the skilled attendant elicited from the questions,observations and, as outlined in the guide,with appropriate sheets where appropriate,examinations advice for home care and follow up. identifies a limited number of key clinical signs 4.Classification of the findings. 7.Yellow indicates that there is a problem that These contain appropriate advice and and symptoms,enabling her/him to classify 5.Treatment and advice related to the signs and can be treated without referral. counselling messages to provide to the woman, the condition according to severity and give classification. 8.Red highlights an emergency which requires her partner and family.In addition,a section is appropriate treatment.Severity is marked in included at the back of the Guide to support the immediate treatment and,in most cases, colour:red for emergencies,yellow for less urgent conditions which nevertheless need "Treat,advise"means giving the treatment indicated urgent referral to a higher level health facility. skilled attendant in this effort.Individual sheets (performing a procedure,prescnbing drugs or other are provided with simplified versions of the attention,and green for normal care. treatments,advising on possible side-effects and how to messages on care during pregnancy (preparing a Key sequential steps overcome them)and giving advice on other important birth and emergency plan,clean home delivery. practices.The treat and advise column is often cross- The charts for normal and abnormal deliveries care for the mother and baby after delivery, referenced to other treatment and/or information charts. are presented in a framework of key sequential breastfeeding and care after an abortion)to be Tum to these charts for more information. steps for a clean safe delivery.The key sequential given to the mother,her partner and family at the steps for delivery are in a column on the left side appropriate stage of pregnancy and childbirth. of the page,while the column on the right has interventions which may be required if problems These sheets are presented in a generic format. arise during delivery.Interventions may be linked They will require adaptation to local conditions ASK.CHECK RECORD LOOK,LISTEN FEEL CLASSFY TREAT AND ADVISE to relevant treatment and/or information pages, and language,and the addition of illustrations and are cross-referenced to other parts of the to enhance understanding,acceptability and Guide. attractiveness.Different programmes may prefer a different format such as a booklet or flip chart Treatment and information pages The flow charts are Iinked(cross-referenced)to relevant treatment and/or information pages in other parts of the Guide.These pages include information which is too detailed to include in the flow charts: Structure and presentationStructure and presentation HOW TO READ THE GUIDE ASK, CHECK RECORD LOOK, LISTEN FEEL SIGNS TREAT AND ADVISE CLASSIFY 1 2 3 4 5 6 7 8 This Guide is a tool for clinical decision-making. The content is presented in a frame work of coloured flow charts supported by information and treatment charts which give further details of care. The framework is based on a syndromic approach whereby the skilled attendant identifies a limited number of key clinical signs and symptoms, enabling her/him to classify the condition according to severity and give appropriate treatment. Severity is marked in colour: red for emergencies, yellow for less urgent conditions which nevertheless need attention, and green for normal care. Flow charts The flow charts include the following information: 1. Key questions to be asked. 2. Important observations and examinations to be made. 3. Possible findings (signs) based on information elicited from the questions, observations and, where appropriate, examinations. 4. Classification of the findings. 5. Treatment and advice related to the signs and classification. “Treat, advise” means giving the treatment indicated (performing a procedure, prescribing drugs or other treatments, advising on possible side-effects and how to overcome them) and giving advice on other important practices. The treat and advise column is often cross￾referenced to other treatment and/or information charts. Turn to these charts for more information. Use of colour Colour is used in the flow charts to indicate the severity of a condition. 6. Green usually indicates no abnormal condition and therefore normal care is given, as outlined in the guide, with appropriate advice for home care and follow up. 7. Yellow indicates that there is a problem that can be treated without referral. 8. Red highlights an emergency which requires immediate treatment and, in most cases, urgent referral to a higher level health facility. Key sequential steps The charts for normal and abnormal deliveries are presented in a framework of key sequential steps for a clean safe delivery. The key sequential steps for delivery are in a column on the left side of the page, while the column on the right has interventions which may be required if problems arise during delivery. Interventions may be linked to relevant treatment and/or information pages, and are cross-referenced to other parts of the Guide. Treatment and information pages The flow charts are linked (cross-referenced) to relevant treatment and/or information pages in other parts of the Guide. These pages include information which is too detailed to include in the flow charts: N Treatments. N Advice and counselling. N Preventive measures. N Relevant procedures. Information and counselling sheets These contain appropriate advice and counselling messages to provide to the woman, her partner and family. In addition, a section is included at the back of the Guide to support the skilled attendant in this effort. Individual sheets are provided with simplified versions of the messages on care during pregnancy (preparing a birth and emergency plan, clean home delivery, care for the mother and baby after delivery, breastfeeding and care after an abortion) to be given to the mother, her partner and family at the appropriate stage of pregnancy and childbirth. These sheets are presented in a generic format. They will require adaptation to local conditions and language, and the addition of illustrations to enhance understanding, acceptability and attractiveness. Different programmes may prefer a different format such as a booklet or flip chart. STRUCTURE AND PRESENTATION