CHILD HEALTH: Factors That Affect the Health of Children 

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CHILD HEALTH

A child means"".... every human being below the age of eighteen years, unless under the law applicable to the child, majority is attained earlier."

Conventions on the right of the child. Part one, article one 1991:Every year 13 million children die from preventable diseases. More than 60% are due to 

• Pneumonia: 3.6 million.
•   Diarrhoea diseases: 3 million.
• Vaccine presentable diseases and combination of the three: 2.1 million.

• Among these deaths 75% are preventable by immunization and improved management of diarrhoea.

With  favourable  environment the process of growth and development is a normal one. Certain stages of growth and development are crucial such as young age, and reproductive age or special characteristics like pregnancy, reproduction, and growth and development.

These conditions make such groups vulnerable and expose them to disease, disability and death (the 3 D's)

Factors That Affect the Health of Children

• Some of the factors that affect the health of children include:
• Balanced and adequate diet
• Poor personal and household hygiene
• Lack of safe and adequate water supply
• Poor sanitation
• High fertility rate
• Fast increasing population growth
•  Poor matenal health services
•  Matenal education
• Low status of women
• Poverty etc.
• Perinatal Mortality (PM)

Of the 13 million deaths each year in children under 5 years old in the developing world, 3 million occur in the first week after delivery. In addition, there are some 4 million stillbirths or late fetal deaths each year. birthweight of at least 1,000 grams, who die.

Perinatal mortality is the number of late foetal deaths (also called still births) and early neonatal deaths (before day 7 (168 hours) per 1000 births. Deaths of all foetuses and new-born with at birth weight of 500 gm (gestational age of 22 weeks or crown-heel length of 25 cm, when birth weight is not known), whether alive or dead, should be considered as perinatal deaths.

Among the estimated 25 million low-birth-weight babies born each year worldwide, 24 million are in developing countries where 80% of global births occur, The perinantal mortality rate ranges from 40 to 60 per 1,000 live births in most developing countries, but it is between 6 and 10 in industrial countries. There is always problem of knowing the exact magnitude of PNM due to poor or lack of recording. The abovementioned figures, in the developing countries, usually come from hospital statistics.

Childhood Problems

Worldwide about 14 million children under the age of 5 will die each year and Majority of these deaths occur in developing countries. In developed countries, deaths under age the age of five constitute only a very small proportion of all deaths, while in many developing countries deaths of young children constitute a large share of Chital deaths. About 40. of all deaths in developing countries are deaths of children under age 5 and nearly 30% of all deaths in the world are deaths of young children in developing countries. The difference in deaths of young children in developed and developing countries shows that the majority of causes of CHM are preventable. Accordingly the major causes of death are infectious, parasitic, respiratory and diarrhoea diseases which are easily preventable in the developed world. For example, deaths from many of the most common childhood diseases are preventable through immunization.

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HEALTH SERVICES FOR CHILD CARE

In both developed and developing countries children should be placed at the center stage in all development thinking and implementation Because care for children is related with:

• Future investments as children are the future of the nation.
• . Strong belief as ours and others culture give high value for having children .
• Future health because national productivity depends on today's children. .
• Screening

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One of the most neglected services which is often forgotten is screening. It is a very important activity which has to be carried out every day in all institutions delivering child health services. There is an immense benefit for children, as well as to their mothers, by the brief assessment (history and physical examination) at every visit to the clinic. Screening is an important tool to avoid "missed opportunities. The need for vaccination, growth monitoring as well as mothers' need in terms of antenatal care, family planning etc. can be easily identified.

Expanded Program On Immunization (EPI)

Immunization is the process of protecting a person from a specific disease. It is protection of a susceptible host from a specific disease by administration of:

•  A living modified agent
• . A suspension of killed organism
• An attenuated toxin
• Immunization decreases susceptibility producing antibodies light the agent and product.

Herd Immunity

Herd immunity indicate that large proportion people certain community are immune. The implication when there susceptible natural infection cannot keep going the community and incidence goes down low level.

Immunization effective controlling communicable disease 75% population and 75% new-born have vaccinated. Discontinuing vaccination programs have serious risk causing epidemic.

Objectives EPI

1. To reduce morbidity and mortality from major diseases diptheria, pertussis, tetanus, measles, poliomyelitis and tuberculosis immunizing children throughout the world 1990.

2. To promote national self-reliance delivering immunization services within comprehensive health services.

3. To promote regional self-reliance vaccine production quality control

The activities outlined were:

• Provide immunization information about immunization every health contact
• Reduce dropout rates between the first and last immunizations
• Increase the priority given control measles, polio and neonatal tetanus
• Improve immunization services poor urban areas
• Use special approaches such national immunization days, where they strengthen the health infrastructure and contribute sustained improvement 

Strategies to conduct EPI sessions:

1.Fixed (static) facilities offering immunization every day health institutions.

Advantages

• .No additional costs for transportation
• .Personnel who can give injections and instructing parents are already available as is basic medical equipment.
• .Easier to keep vaccines at proper temperatures.
• Client records may more easily established and kept up to date.

Disadvantages

1.Parents must travel long distance to bring children to health center. The further parents travel, the less likely they are to come for immunizations.

Absence of integrated health service

2. Outreach services and mobile teams

Important, especially for children in remote rural areas and poor urban as well as other children whose parents are unable or unwilling to come to health institutions.

Disadvantage

• Scheduling visits and adhering to schedules are difficult because of transportation.
• Problems or poor weather
• Outreach services and mobile teams can be expensive
• Staff need to be paid per diem
•  Vehicles much be bought and maintained.

• Strict reminding is necessary for parents to be available on the days of  appointment

3. Intensive immunization campaigns

This consists of regularly repeated mass campaigns which are mounted to stop epidemic by quickly immunizing as many susceptible people as possible. These campaigns have sharply increased vaccine coverage, especially those of single dose vaccines. Such campaigns can involve non health workers for polio vaccination as it is given orally.