Transcript Chapter Ten Child Health The Importance of Child Health • 8.8 million children under the age of 5 die each year • Many of.

Chapter Ten
Child Health
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
Key Terms
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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
Table 10.2: Selected Terms Relating to
Causes of Child Illness and Death
The Burden of Childhood Illness
Children Under 5 Years
• 99% of childhood deaths are in low- and middleincome 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
Figure 10.1: Neonatal Mortality Rate,
by WHO Region, 2004
Figure 10.2: Infant and Under-5 Mortality
Figure 10.4: Causes of Neonatal Deaths, by
Percentage, 2008
Figure 10.5: Causes of Postneonatal Deaths
in Children under 5, by Percentage, 2008
Table 10.3: Leading Causes of Under-5 Child Death
for Selected WHO Regions, by Percentage, 2008
Figure 10.6: Declines in Under-5 Child
Mortality, by Region, 1990-2008
Additional Comments on Selected
Causes of Morbidity and Mortality
Acute Respiratory Infections
• Leading cause of death in low- and middleincome countries
• More severe and cause higher rates of death in
low- and middle-income countries than in highincome countries
• Upper respiratory tract infections include the
common cold and ear infections, lower respiratory
infections include bronchiolitis and pneumonia
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
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
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
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
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
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
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
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
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
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
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