Chapter 5 Child Health

Question 1

How many child deaths worldwide in 2010?
How many percent in Sub-saharan Africa?
How many percent in South Asia?
How many percent in high income countries?

Answer 1

8 million
50%
33%
<1%

Question 2

Does regional disparities remain when child mortality rates are decreasing?

Answer 2

Yes

1 in 5 new borns in central Africa
1 in 13 newborns in South Asia do not survive to their fifth birthdays

1 in 167 newborns in N.America
1 in 270 newborns in Western Europe die during their first five years

Question 3

Of UNDER 5 child deaths

Answer 3

1/3 in neonates (first month of life)
1/3 in infants (29 days - 11 months old)
1/3 in children 1-4 years old

Question 4

Causes of mortality in children during their first five years of life (undernutrition is not listed separately but is a contributing factor)

Answer 4

1. Neonatal deaths (including preterm birth, complications, birth asphyxia, sepsis, and other conditions) 41%
2. Diarrheal diseases 14%
3. Acute respiratory infections (ARIs) 14%
4. Other infections 13%
5. Malaria 8%
6. OTHER CAUSES 4%
7. Injuries 3%
8. HIV/AIDS 2%
9. Measles 1%

Question 5

Neonatal mortality rate worldwide?

Answer 5

3.5 million (3,500,000)
with most deaths in low-income countries
*about 3 mil stillbirth (at least 7 months in the womb) that does not include in the 3.5 million of live births

Question 6

Causes of neonatal mortality

Answer 6

1. Preterm birth complication 29%
2. Birth asphyxia 23%
3. Sepsis 15%
4. Pneumonia 11%
5. Others 11%
6. Congenital abnormalities 8%
7. Diarrhea 2%
8. Tetanus 2%

Question 7

Which country as the highest neonatal child mortality?

Answer 7

1. Sierra Leone
2. India
3. Kenya
4. Brazil
5. China
6. Poland, USA
7. South Korea

Question 8

Diarrhea

Answer 8

Usually caused by infections that could be prevented with clean water, hygiene, and sanitation

More than 1 mil child deaths worldwide/ year are due to diarrhea (out of 2.5 bil diarrhea cases in under-5 children)

Loss in electrolytes can lead to kidney and heart failure, and eventually to death

Usually caused by an infection like rotavirus (vaccine preventable)

Unsafe drinking water and inadequate availability of water for hygiene contribute to 90% of deaths from diarrhea each year

Question 9

Treatments for Diarrhea

Answer 9

1. Oral rehydration therapy/solution: a combination of clean water, sugar, and salt that rehydrates children with diarrhea and restores electrolyte balance
2. Continued feeding (don’t restrict liquids)

Question 10

Prevention (primary prevention to reduce new infections) for diarrhea

Answer 10

Rotavirus and measles immunization

Early and exclusive breastfeeding of infants

Vit A supplementation

Hand washing

Improved water supply quantity and quality

Community-wide sanitation

Question 11

Treatment (secondary prevention)

Answer 11

Fluid replacement like: oral rehydration, breastfeeding, and continued feeding

Zinc supplementation

Question 12

Pneumonia

Answer 12

About 150 mil under-5s have pneumonia each year

Can be prevented with vaccines (pneumococcus and Hib)

Many cases are bacterial and can be treated with antibiotics

Question 13

Malaria

Answer 13

Can cause cerebral malaria (comas) and malarial anemia

Prevention focuses on avoiding mosquito bites

Parasitic infection

Question 14

Vaccine preventable disease

Answer 14

Measles (remains a common cause of child death and disability)

Question 15

Recommendation for undernutrition/breastfeeding

Answer 15

Exclusive breastfeeding for 6 months

Introduction of complementary foods at 6 months with continued breastfeeding for up to 2 years

Question 16

International Code of Marketing of Breast-milk

Answer 16

Marketing personnel (including healthcare professionals) should not directly contact pregnant women or new mothers , health facilities should not promote formula use

Nestle and other major formula producers have adopted the international code of marketing of breastmilk substitutes

Question 17

Global Child Health Initiatives

Answer 17

Horizontal programs: emphasize routine access to comprehensive primary care

Vertical programs: Target selected diseases with specific interventions that are managed outside of routine health care

Question 18

Primary health care (PHC)

Answer 18

Is a horizontal program that emphasizes routine access to comprehensive primary care

Prioritize prevention of locally infectious diseases, promotion of nutrition, provision of essential drugs and treatments for common diseases and injuries, coordination of health services with traditional health practitioners, and programming for maternal and child health.

Hallmark of scheduled health clinics for children under 5 years of age

Question 19

GOBI

Answer 19

Growth monitoring, oral rehydration, breastfeeding and immunization

Question 20

Partnership of WHO, UNICEF and the World Bank

Answer 20

Added three community vased components to the GOBI- family planning, food production, and female education (GOBI/FFF)

Question 21

Aim for IMCI

Answer 21

to improve family and community health practices and to improve case management skills of healthcare staff

IMCI also provides home healthcare guidelines for families with young children

Question 22

The right of children -

UN Convention on the Rights of the Child

Answer 22

Child rights include an adequate standard of living, freedom from all forms of exploitation, protection from all forms of violence, access to education and appropriate information, the right to be heard, and the right to rest, leisure, and play

Question 23

ILO about child labour

Answer 23

ILO estimates that are more than 300 mil children between the ages of 5 and 17 were engaged in labor in 2008, 115 mil conducted hazardous work.

Question 24

Special issues of the Rights of Children

Answer 24

Protection from child labor
Protection from girl-child
Protection of children with special needs