Chapter 5 Child Health Flashcards
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?
8 million
50%
33%
<1%
Does regional disparities remain when child mortality rates are decreasing?
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
Of UNDER 5 child deaths
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
Causes of mortality in children during their first five years of life (undernutrition is not listed separately but is a contributing factor)
- Neonatal deaths (including preterm birth, complications, birth asphyxia, sepsis, and other conditions) 41%
- Diarrheal diseases 14%
- Acute respiratory infections (ARIs) 14%
- Other infections 13%
- Malaria 8%
- OTHER CAUSES 4%
- Injuries 3%
- HIV/AIDS 2%
- Measles 1%
Neonatal mortality rate worldwide?
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
Causes of neonatal mortality
- Preterm birth complication 29%
- Birth asphyxia 23%
- Sepsis 15%
- Pneumonia 11%
- Others 11%
- Congenital abnormalities 8%
- Diarrhea 2%
- Tetanus 2%
Which country as the highest neonatal child mortality?
- Sierra Leone
- India
- Kenya
- Brazil
- China
- Poland, USA
- South Korea
Diarrhea
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
Treatments for Diarrhea
- Oral rehydration therapy/solution: a combination of clean water, sugar, and salt that rehydrates children with diarrhea and restores electrolyte balance
- Continued feeding (don’t restrict liquids)
Prevention (primary prevention to reduce new infections) for diarrhea
Rotavirus and measles immunization
Early and exclusive breastfeeding of infants
Vit A supplementation
Hand washing
Improved water supply quantity and quality
Community-wide sanitation
Treatment (secondary prevention)
Fluid replacement like: oral rehydration, breastfeeding, and continued feeding
Zinc supplementation
Pneumonia
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
Malaria
Can cause cerebral malaria (comas) and malarial anemia
Prevention focuses on avoiding mosquito bites
Parasitic infection
Vaccine preventable disease
Measles (remains a common cause of child death and disability)
Recommendation for undernutrition/breastfeeding
Exclusive breastfeeding for 6 months
Introduction of complementary foods at 6 months with continued breastfeeding for up to 2 years
International Code of Marketing of Breast-milk
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
Global Child Health Initiatives
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
Primary health care (PHC)
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
GOBI
Growth monitoring, oral rehydration, breastfeeding and immunization
Partnership of WHO, UNICEF and the World Bank
Added three community vased components to the GOBI- family planning, food production, and female education (GOBI/FFF)
Aim for IMCI
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
The right of children -
UN Convention on the Rights of the Child
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
ILO about child labour
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.
Special issues of the Rights of Children
Protection from child labor
Protection from girl-child
Protection of children with special needs
