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Chapter Ten Child Health
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The Importance of Child Health
8.8 million children under the age of 5 die each year Many of these deaths are preventable Children are a particularly vulnerable population Closely linked with poverty Insufficient progress has been made in certain parts of the world in reducing childhood morbidity and mortality
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Key Terms Perinatal : first week of life
Neonatal : referring to the first month of life Infant : referring to the first year of life Under-5 : referring to children 0-4 years old
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Table 10.2: Selected Terms Relating to Causes of Child Illness and Death
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The Burden of Childhood Illness
Children Under 5 Years 99% of childhood deaths are in low- and middle-income countries Half of these deaths occur in India, Nigeria, Democratic Republic of the Congo, Pakistan, and China 41% of under-5 child deaths occur among neonates Rates and causes vary across and within countries General trend is decline, but rates of decline also vary considerably by region
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Figure 10.1: Neonatal Mortality Rate, by WHO Region, 2004
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Figure 10.2: Infant and Under-5 Mortality
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Figure 10.4: Causes of Neonatal Deaths, by Percentage, 2008
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Figure 10.5: Causes of Postneonatal Deaths in Children under 5, by Percentage, 2008
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Table 10.3: Leading Causes of Under-5 Child Death for Selected WHO Regions, by Percentage, 2008
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Figure 10.6: Declines in Under-5 Child Mortality, by Region, 1990-2008
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Additional Comments on Selected Causes of Morbidity and Mortality
Acute Respiratory Infections Leading cause of death in low- and middle-income countries More severe and cause higher rates of death in low- and middle-income countries than in high-income countries Upper respiratory tract infections include the common cold and ear infections, lower respiratory infections include bronchiolitis and pneumonia
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Additional Comments on Selected Causes of Morbidity and Mortality
Diarrhea Caused by bacteria, viruses, protozoa, and helminths Causes dehydration, loss of nutrition or wasting, and damage to the intestines Infants 6-11 months are particularly vulnerable because they have been introduced to unsafe water and foods
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Additional Comments on Selected Causes of Morbidity and Mortality
Malaria 750,000 children die from malaria each year A child in sub-Saharan Africa is likely to have a case every 40 days Associated with premature birth and intrauterine growth retardation, which reduce chances of survival
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Additional Comments on Selected Causes of Morbidity and Mortality
HIV/AIDS Can be transmitted from mother to child during birth or breastfeeding Number of HIV-infected children has grown, particularly in sub-Saharan Africa
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Additional Comments on Selected Causes of Morbidity and Mortality
Measles Acute respiratory infection with complications including pneumonia, diarrhea, encephalitis, and blindness Children who are vitamin A deficient or infected with HIV are more at risk of death Extremely contagious if a population is not vaccinated
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Additional Comments on Neonatal Mortality
41% of children under 5 who die annually, actually die in the first month Little progress in reducing neonatal death rate Every day that a child lives increases the likelihood that he or she will stay alive To reduce childhood death rates, the world needs to focus more precisely on when the deaths occur
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Risk Factors for Neonatal, Infant and Child Deaths
Nutrition status Household income and education of mother Access to trained healthcare provider to attend birth and provide counseling Water quality and sanitation
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The Cost and Consequences of Child Morbidity and Mortality
High costs of caring for a sick child Potential long-term disability Poor school attendance and performance
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Addressing Key Challenges in Child Health
Progress has been largely between 1 and 5 years; very little has been made in reducing the death rate of neonates Insufficient progress in sub-Saharan Africa and South Asia Low-cost, highly effective interventions are not being implemented where they are needed most
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Addressing Key Challenges in Child Health
Critical Child Health Interventions Ensuring nutrition and health of the mother and mother-to-be Essential newborn care, extra care for small babies, and emergency care for newborns Preventing and managing diarrhea with hygiene, proper nutrition, measles vaccinations, and ORT Basic vaccinations
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Addressing Key Challenges in Child Health
Community-Based Approaches to Improving Child Health Women’s groups to raise awareness of maternal, fetal, and neonatal issues Community-based promotion of hygiene, umbilical cord care, and keeping the baby warm
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Addressing Key Challenges in Child Health
Integrated Management of Childhood Illness Integrated healthcare approach for children because of many interrelated factors Healthcare workers trained at all levels, particularly home and community-based
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