Strengthening Child Health: New WHO/UNICEF Manual for Kyrgyzstan’s Primary Care

The new WHO/UNICEF pocket book on primary health care for children and adolescents in Kyrgyzstan, developed in close collaboration with the WHO Regional Office for Europe, UNICEF Kyrgyzstan and the Ministry of Health of the Kyrgyz Republic, represents a milestone in public health reform. Designed for everyday use by family doctors, nurses and community health workers, the manual fuses technical precision with a strong rights-based ethos. From the outset, it reminds readers that children and adolescents are not passive recipients of treatment but individuals entitled to dignity, protection, and participation in decisions that affect them. By rooting its guidance in the UN Convention on the Rights of the Child, the document sets a clear moral framework that underpins the clinical instructions that follow.

From Emergencies to Everyday Care

The manual begins where the stakes are highest: life-threatening emergencies. It lays out a structured ABCDE assessment, airway, breathing, circulation, disability, exposure, followed by a paediatric life-support algorithm that is practical and easy to follow. Providers are guided through rescue breaths, chest compressions at the correct rhythm, timely epinephrine dosing and the importance of continuous reassessment. The approach is designed for rapid action while also reminding health workers to communicate with families, even in moments of crisis. Once the basics of emergency care are established, the book shifts to the everyday rhythm of primary care. Consultations are framed around careful history-taking and gentle examination techniques that minimize distress, encouraging clinicians to listen to the child’s own account whenever possible. Red flags such as persistent fever, convulsions or refusal to drink are highlighted, with precise referral instructions to avoid delays in escalation.

Building a Culture of Prevention

Where the manual is most ambitious is in its blueprint for prevention. It sets out a full schedule of well-child visits, starting in the first 72 hours of life and stretching through adolescence. Each visit is structured to include growth monitoring, developmental checks, immunizations, and counselling for families. Growth is tracked using WHO z-score charts, while developmental progress is measured against clear milestone tables. The first month of life receives especially detailed coverage, with newborns screened for hearing loss, metabolic disorders, and congenital heart disease through pulse oximetry. Jaundice is managed using strict bilirubin thresholds, and parents are taught about safe sleep, kangaroo care, breastfeeding, and vital micronutrient supplementation such as vitamin K and vitamin D. As children grow, the focus expands to include complementary feeding at six months, dietary variety, vaccination reminders, and behavioural advice. Toddlers are counselled to avoid screen time, maintain consistent sleep routines and engage in free play. School-age children are encouraged to exercise at least one hour per day within a total of three hours of movement, reinforcing a culture of health that extends beyond the clinic.

Tackling Illness and Chronic Conditions

The manual devotes extensive space to the conditions that most commonly bring children to clinics. Respiratory infections, diarrhoea, abdominal pain, rashes, seizures, anaemia and eye problems are all covered with clear diagnostic approaches and first-line treatments. Alongside these acute issues, the book also recognizes the growing importance of chronic and complex conditions in child health. Primary care providers are trained to coordinate ongoing care for children with asthma, diabetes, congenital heart disease, cerebral palsy, cancer, HIV, and tuberculosis. Developmental disorders such as autism and ADHD are also addressed, alongside guidance on managing children with disabilities in ways that support both medical needs and social inclusion. Sensitive issues are not ignored: substance use, problematic internet behaviour, and the provision of palliative care all have their place, reflecting the reality of challenges faced by families in Kyrgyzstan today.

Adolescents at the Centre

Perhaps the most progressive aspect of the pocket book is its treatment of adolescents. Confidentiality and respect are emphasised as essential foundations of effective care. Providers are equipped with pathways to discuss puberty, sexual and reproductive health, contraception, pregnancy, sexually transmitted infections, and menstrual issues with sensitivity and openness. Mental health is given prominent attention, with detailed advice on depression, suicidality, anxiety and attention disorders. The aim is to transform clinics into safe spaces where young people feel they can seek help without fear or stigma. The final chapters return to emergencies such as burns, poisoning, drowning, and electrocution, presenting quick-reference guides for immediate action. A compact drug list and recipes for oral and intravenous rehydration solutions ensure that essential information is never out of reach. Annexes add further practical support, from instructions on how to design child-friendly clinics to lists of essential equipment and guides for procedures such as wound care, intravenous fluid administration and thoracocentesis.

In the end, the pocketbook is much more than a clinical manual. It represents a philosophy of practice that integrates prevention, compassion and respect with technical excellence. By embedding international standards into Kyrgyzstan’s health system, it seeks to ensure that every child and adolescent receives care that is high-quality, equitable, and humane. In doing so, it signals a shift away from fragmented services and towards a vision of health care that is continuous, family-centre,d and rooted in rights. For Kyrgyzstan’s children, it is a promise that their health and dignity will be protected not just in emergencies, but in every encounter with the health system.