From Big Medical Encyclopedia

CHILDREN'S HOME — healthcare institution to the USSR intended for education and delivery of health care to children — to orphans, the thrown children and children with defects of physical or mental development.

In Russia similar institutions were created only at the expense of charitable about - century. The first educational house was open for the thrown and illegitimate children in Novgorod in 1706 (see. Educational house, children's shelter ). Big density and bad leaving in educational houses resulted in high incidence and mortality of children. Due to the shortage of educational houses and high mortality sending children for education to villages, i.e. system of contempt of the thrown orphan children — patronage was organized. Many children sent to the village died.

After Great October socialist revolution in system of protection of motherhood and an infancy the state D. began to be created by river. The Moscow educational house was reorganized: on its base it was open State in-t of protection of motherhood and an infancy. At the first stage of establishment for education of orphan children and thrown to 3-year age were two types: shelters for children aged till 1 year and shelters for children from 1 year to 3 years. Special attention was paid to keeping of children of chest age. Shelters of the first type began to be called houses of the baby, and the second — D. of river. Soon institutions of the mixed type where children from the birth up to 3 years were raised gained distribution. In 1949 the uniform name — Children's home was established.

The network of children's homes underwent changes depending on an economic condition of the country and position of women at different stages of construction of socialism in the USSR.

During civil war bodies of health care were forced to increase network D. of river sharply. In 1922 in their RSFSR there were 765. In the next years in connection with improvement of welfare of workers, strengthening of a family and expansion of network of a children's day nursery and gardens D.'s number of the river was reduced. In 1941 across their Soviet Union was 397 on 24 722 places. In the Great Patriotic War the number D. of river increased: by 1949 there were 688 D. of river on 49 486 places. In process of post-war recovery and development of the national economy D.'s number of the river began to be reduced and they qualitatively changed forms of the work. Many of them were reformed and reorganized into sanatorium D. by river (for the children infected with tuberculosis, suffering hron, dysentery, defeats of c. N of page, defects of hearing and speech).

In D. children according to permits of public health department are accepted by river, to-rogo it is under supervision. D.'s administration of river within 3 days on the basis of the acceptance report registers the child in a registry office; if there is no information about parents, to children in D. the river appropriates a surname, a name, a middle name. The information about the rubles who came to D. or who are written out goes to an information desk of militia. Documents on each arrived child are stored in a first-aid kit with the indication of a surname, age and date of receipt. Of river children leave D. to parents, on patronage, adoption, and on reaching 3 — 4 years — in child care facilities of the Ministry of Public Education or the Ministries of Social Welfare (disabled children).

Children aged up to 2 months go directly to children's group D. of river, children are more senior than 2 months for prevention of infectious diseases — in reception and quarantine department for 21 days. At establishment at the child of an infectious disease it would be transferred to the relevant department of infectious.

D.'s power of river — not less than 30 and no more than 100 places. In D. the river on 30 places will organize 2 children's groups: one — to 1 g 2 months, the second — from 1 g 2 months up to 3 years. In D. of river on 45 places children accommodate in 3 groups: the first for children up to 9 — 10 months, the second — from 9 — 10 months to 2 years, the third — from 2 to 3 years. In D. of river on 60 places 4 groups: the first — for children up to 9 — 10 months, the second — of 9 — 10 months to 1 g 2 months, the third — from 1 g 2 months up to 2 years, the fourth — from 2 to 3 years. In chest and polzunkovy groups — on 13 children, and in average and senior — on 15 — 17 children. Each age group has the mode, but in the presence in group of children, different in age, in it there can be also various modes. The most rational are D. of river on 60 places. At establishment of the mode the age, and also development of motility and the state of health of the child is considered.

The organization of the healthy and balanced diet of children is the ruble conducting D. in a day regimen. D. the ruble receives breast milk for children up to 3 — 4 months from wet nurses and from blood donor centers. G of the first days of arrival of the child of any age to it appoint a balanced diet under control of the doctor; calculation of a diet is also made by the doctor. As a part of a diet the following ratio of products is provided: fats — 35 — 40%; proteins — 10 — 15%; carbohydrates — 45 — 50%. In special sanatorium D. of river expenses on food are established 15% above, than in usual.

In D. the river regularly holds recreational events: a dream on air, walks, air and solar bathtubs, hydrotherapeutic procedures, massage, gymnastics, radiation by a quartz lamp, etc. From the cities take out to the summer period of children on dachas.

In D. from the first days of arrival of the child the close check behind his health and development is established by river.

Again arrived child is examined by the doctor, necessary researches are conducted, the corresponding mode, food, treatment is appointed. Appointments and data on a condition of the child are entered in history of development of the child (see). Anthropometrical measurements are taken monthly within the first year of life and every 3 month 1 g is aged more senior. The analysis psychophysical is carried out to the same terms. development of the child. Children with deviations in the state of health are inspected more often — at the discretion of the doctor. The sick child isolate in prigruppovy boxing (see. Boxes ) or translate in insulator (see), at an infectious disease — would transfer to infectious. Periodically children are examined by doctors of narrow specialties (the oculist, the otolaryngologist, the surgeon-orthopedist, the psychoneurologist, the dermatologist) from the next-tsy or policlinics.

Of river is provided with pedagogical grants and toys, soft and firm stock, the medical and economic equipment according to the approximate norms approved by M3 of the USSR. In chapter D. r, there is a chief physician who is responsible for statement of medical, educational, social and legal and administrative work. The states medical, pedagogical and administrative personnel are approved by M3 of the USSR.

In specialized sanatorium D. additional states depending on their profile are established to river. The organization of work is defined by the instruction approved by M3 of the USSR.

Each group D. of river has the personnel (sisters and nurses); transfer of personnel from one group in another is not allowed. In the help with service of children, especially younger groups, wet nurses are attracted. The teacher directs educational work. At each D. of river; tutorial (trustee) council will be organized.

Of river has the rooms answering a dignity. to norms for these institutions.

The room of children's group D. of river consists of a razdevalna, two nurseries, verandahs and a toilet ache — a bathroom. In the main children's placements on each child 4 m are necessary 2 , including in game-table — 2,5 m 2 , in a bedroom of 1,5 m 2 . Group rooms are isolated from each other and have separate entrances. Except the specified group rooms, in D. the river provides rooms for reception and quarantine department, the insulator, office, offices of the doctor and the teacher, procedural, rooms for linen, by a laundry, kitchens, for wet nurses and blood donor center. The insulator will be organized for service of sick children at the rate of 10% of total quantity of beds and consists of a reception, 1 — 2 chambers, a bathroom. Premises of quarantine department are isolated from group rooms, have a separate entrance and consist of a reception, a dignity. node, 1 — 2 chambers and verandah.

Of river have the fenced land plot from calculation: a) for D. of river on 60 — 66 places — 3500 m 2  ; b) on 75 — 83 places — 4000 m 2  ; c) on 100 places — 5000 m 2 . On the site for isolation for each group the certain platform fenced with green plantings with a canopy is allocated (the area not less than 25 m 2 ) for protection of children from the sun and a rain. The sizes of playgrounds are defined at the rate of 7 m 2 on the child are also located near escaping of rooms of children's group. Optimum air temperature in children's group rooms: 20 — 22 ° in the insulator, quarantine department, chest groups, 18 — 20 ° in the senior groups.

See also House of mother and child , Protection of motherhood and childhood .

Bibliography: Nazarovo N. S. Kidswear and equipment for a day nursery and children's homes, M., 1957; The Management for doctors of a day nursery and children's homes, under the editorship of L. V. Grechishnikova, M., 1957; Instructions on service of children in children's homes, under the editorship of L. V. Grechishnikova, M., 1949.

L. K. Skornyakova.