notes

1. Child health problems

2. Introduction
 The main health problems encountered in the child
population are
Child health
problems
Low birth
weight
Malnutrition
Infections
Parasitosis
Accidents
Poisoning
Behavioural
problems

3. 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

4. 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

5. 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.

6. Specific nutritional
deficiencies

7. 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

8. 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

9. 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

10. 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

11. 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.

12. Cont….
Scenario explains the
poor 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

13. 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

14. 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

15. Other factors affecting child health
Maternal 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

16. 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

17. 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

18. 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