Training and mentoring of local professionals is required at primary health centres until such time as the local staff is fully capacitated to care and treat children without outside assistance. Tools for providing clinical mentorship are below:
These materials can be bound into a single guide (Reference Guide) and individual components can be posted as job aides.
Checklist for Excellence in Pediatric HIV Care
This outlines the elements of quality, basic care.
Approach to the Care of HIV- Exposed or -Infected Children
This diagrams the protocol for use of clinical documentation tools that are included in the toolkit.
Checklists for Care
These list the basic elements of routine visits for exposed infants, infected children not yet on ART, and children on ART.
- Checklist for Care of Exposed Infants
- Checklist for Care of Infected Children (not on ART)
- Checklist for Care of Children on ART
HIV Testing Algorithms for Children
These algorithms diagram an approach to HIV testing based on the age of the child and types of tests available. Note: this is based on current WHO guidelines for pediatric HIV testing. Individual country guidelines will vary. Please refer to the appropriate National Testing Guidelines.
Nutrition Assessment in Children and Adolescents
Note: individual country guidelines will vary regarding definitions of moderate and severe malnutrition, and treatment guidelines for malnutrition. Please refer to the appropriate national guidelines on management of malnutrition.
WHO Clinical Staging of HIV in Children
Lists the WHO clinical staging criteria in children.
Definitions of WHO Clinical Staging Criteria in Children
Describes each of the clinical staging conditions (from:____Ref).
Criteria for Initiation of ART in Children
Outlines current WHO recommendations for initiation of children on ART based on age, clinical stage, or CD4 count/percentage. Individual country guidelines may differ. Please refer to the appropriate national guidelines for initiation of ART.
Cotrimoxazole Prophylaxis Dosing Table
Recommended dosing of cotrimoxazole prophylaxis based on age or weight.
ARV Dosing Guide
This provides dosage information for the most commonly used antiretroviral medications and formulations for children.
Adherence Calculation Sample Table
This demonstrates use of dosing table to calculate adherence.
Normal Vital Signs in Children
Specifies normal ranges for vital signs in children. Used for reference in triage or clinical review.
Developmental Warning Signs in Children
Lists important developmental milestones in children.
Clinical Documentation and Decision-Making Tools
Initial Intake Form (2-sided)
The nurse or clinician (mentee) fills this out for each new patient visit. Follow the instructions on the back to determine WHO clinical stage, ART eligibility by CD4, etc. At the bottom of the front page the user is prompted to indicate major clinical decision points: whether the child is infected or exposed, and whether the child qualifies for ART and why.
Exposed Infant Follow-up Form
If an infant is determined to be exposed and not eligible for ART at this time, the nurse or clinician should fill in this form. It is used each month that the infant returns for follow-up visits. This form is used until the infant's status is known (as indicated at the bottom of the form).
If a child is determined to be infected but not yet eligible for ART, this form is started. One row of the table is filled in at each follow-up visit until the child starts ART. Once a child starts ART, the national form used for documenting ART patient care may be used.
Pediatric HIV Consultation Form
This is used to document clinical consultations on difficult cases.