Child health problems

Dr Utpal Sharma Assistant Professor

Department of Community MedicineSMIMS, Gangtok, Sikkim

Introduction The main health problems encountered in the child

population are

Child health problems

Low birth weight

Malnutrition

Infections

Parasitosis

Accidents

Poisoning

Behavioural problems

Malnutrition

Most widespread condition affecting the child health

The trigger for this undesirable condition are Scarcity of suitable food

Lack of purchasing power

Beliefs and taboos about food

Documents reveals that malnutrition is the underlying cause of 50%

of all deaths amongst the children under 5 years

About 15% of the under 5 children were found to be underweight

globally in the year 2006-12

This ranges from 1.4% in the developed countries to 24% in the

developing nations

Cont….

India reports about 43.5% of the under 5 children to be

underweight at present.

About 43% of these were moderate to severely malnourished.

Of this figure 16% have severe malnutrition of which 20% have

moderate to severe wasting and 48% moderate to severe stunting

Malnutrition make the child more susceptible to infections with

slower recovery leading to higher mortality

Undernourishment hinders the achievement of full potential of

physical and mental abilities

Malnutrition in infancy and childhood manifests in the form of

micronutrients and vitamin deficiencies and leads to stunting

What could be done????

Prevention and treatment of infectious diseases like Diarrhoea Measles And other infections…

…..in infancy and childhood reduces malnutrition

Prevention of childhood morbidities breaks the breaks

the stubborn vicious cycle of infections and malnutrition

Exclusive breast feeding in first 6 months of life is very

important for the same.

Specific nutritional deficiencies

Protein energy malnutrition

Identified as the major health and nutritional issue in

India

More prevalent amongst the weaklings and infants

Characterized by Low birth weight if the mother is malnourished Poor growth And high level of mortality amongst 12-24 months age.

Morbidity in form of PEM is estimated to be the underlying

cause of 30% deaths amongst under 5 children

Cont…

It is estimated that about 37% of children suffers

from stunting in developing nations

Also about 10% children have low weight for height (wasting)

High level of stunting in children suggests the wrath of

cumulative effects of undernutrition and infections…

……since birth or before so.

Towering rates of stunting is indicative of bad environment

and/or early malnutrition

High frequency of wasting is suggestive of….

……current severe malnutrition or diseases

Micronutrients malnutrition An estimate of around 2million people suffers from these deficiencies

Nutritional anemia Affects all age groups

Even mild anemia reduces resistance to fatigue

Has profound effect on psychological and physical behaviour

Iodine deficiency Considered as a public health problem when 5% of the school children (6-12

yrs) suffers from goiter

About 1.5 million people are living in environment lacking the mineral

The result is about 30,000 stillbirths and 1.2 lac babies are born mentally

retarded, physically stunted, deaf mute or paralyzed each year

Lack of iodine even in children born healthy may result to dullness and apathy

Cont….

Vit A deficiency and nutritional blindness Young children are at greater risk owing to greater requirements and

susceptibility to infections

The catastrophe like blinding corneal destruction is seen mostly amongst

children 6 months to 6 years

Labeled as the single most frequent cause of blindness amongst pre-

school children in developing nations

About 20% of deficient children are at risk of death due to common

infections and….

..around 2% are either blinded or suffers from serious sight impairment

Nutritional deficiencies not only guarantees long and costly treatment due

to severe illness but also….

…..influence physical and psychological development and

susceptibility to infections

Infections and parasitic diseases

A known fact is child may fall sick several times a year however

the incidence increase with aggravation in a state of malnutrition

Estimated toll of 4 million deaths is due to respiratory infections

in developing nations

Another quarter is attributed to malnutrition and further quarter to

measles, pertussis, malaria and HIV/AIDS

In India in 2009, 3480 cases of diptheria, 40,840 cases of

measles, 43,697 cases of pertussis and 889 cases of neonatal

tetanus was reported...

….along with the hidden burden of intestinal parasitosis.

Cont….

Scenario explains thepoor environmental conditions and

paucity of potable drinking water in the country.

Prevention and treatment of children’s illness may

interrupt transmission of infection in the community

The simple and effective measures for prevention

and treatment of Infections and…

Intestinal parasitosis in children….

….have important long term consequences

Accidents and poisoning Relatively becoming more important child health

problems in developing nations

The common events encountered are… …burns and trauma resultant of home accidents and…

….Increasingly traffic accidents

Children and young adolescents particularly falls prey to

accidents like…. Falls

Burns

Poisoning

Drowning

Behavioural problems

Children abandoned by their families presents severe,

social and health problems

Such children are indulged in the behavioural

problems and anti-social practice (Delinquent)

India alone harbors around 1.5 million such children as estimated by International Union of Child Welfare

Other factors affecting child healthMaternal health Child health adversely affected if the mother is…

Malnourished, Too young (< 18 yrs of age) or too old (> 35yrs of age) Very frequent pregnancy (<2 yrs gap) Too many children (> 4 children) Deprived of basic pregnancy care

Family “Child health” reflects the “family health” Is an indicator of family’s physical and social environment

It determines the development of speech, personality and intellectual

potential of the child Other factors are family size, relationships, and family stability

Children from bigger families (> 4 children) have greater prevalence

of malnutrition and infections

Socio-economic circumstances

Physical and intellectual development of the child varies

with the socioeconomic status of the family

Under privileged children of same age group are found to smaller lighter and less advanced in psychomotor and intellectual performances…

…..compared to the privileged counterparts

Poverty, illiteracy and sickness creates a vicious cycle spanning

from one generation to other….

….leaving behind almost impossible scope of escaping

Differences of health conditions of rich and poor is strikingly

obvious, especially amongst the children

Environment

After the first week of life, environment plays a major role as determinants

of infant and childhood morbidities and mortality

Tetanus infection in newborn takes away a heavy toll in the first few weeks

of life.

Diseases like diarrhoea, pneumonia and infections (viral, bacterial and

parasites) are extremely common in children exposed to insanitary and

hostile environment

The stages of these infections varies according to the ecology, hygiene and

epidemiological conditions….

…..and the extend of interaction with them

Insanitary excreta and other waste disposal invites the menace of infections

and diseases

Cont….

Children develops skills by environmental stimulation

Stimulation can be provided by interaction with other people who

takes interest and help children develop

Other sources of stimulation are radio, TV and illustrated

magazines

Social support and health care

Health status of children is notably determined by community

and social support measures like…. Creches and day care centres and Organized health care systems

Thank you for

patient listening