Major Health Problems of Children – Here we discuss Major Health Problems of Children
The incidence of low birth weight babies, weighing less than 2500 g is between 22 and 28%. The LBW belong to two categories (a) Pre-term babies born before 37th weeks of gestation and (b) small for gestational age (SGA) i.e. they are full term babies and have intra-uterine growth retardation (IUGR). LBW is a predominant cause of high IMR.
Factors for LBW are adolescent and maternal malnutrition, anemia, early marriages, teenage pregnancies, less spacing between births, high birth orders and lack of or inadequate ante-natal care besides inadequate diet and inadequate consumption of IFA tablets; besides poverty and illiteracy.
ii) Inadequate Newborn Care
Newborn babies receive inadequate care. Though 80% of them are born in institutions, but they go home within 24 hours of deliveries, hence they need care at home after delivery or after discharge from newborn stabilization and special Newborn Care units. ASHAs and ANMs have been made responsible for home-based newborn Care. Inadequate newborn care leads to high neonatal deaths, disease and disability.
iii) High Level of Neonatal, Infant and under-five mortality
Though substantial progress has been made in reduction of IMR, the neonatal mortality has declined at a very slow speed in the past 10 years. This component of IMR needs special attention. India Newborn Action Plan has been launched to reduce Neonatal Mortality and still births to single digit by 2030 through package of evidence based interventions.
iv) Adverse Child Sex Ratio
One of the most disturbing features of demography is adverse and declining ratio of female children below the age of 6 years (Juvenile/ child sex ratio). Female child sex ratio has low. In this dubious club were the states of Punjab, Delhi and Chandigarh. Jhhajar and Mohindergarh are the bottom most districts on child sex ratio that lie in the state of Haryana too. There is alarming practice of selective sex abortions and misuse of ultrasound technology and its easy availability in urban areas.
v) Discrimination against Girl Child – Gender issues
Girl child is not allowed to be born. Girl child is considered as lesser child.Wide spread discrimination in upbringing girl child prevails in the society. Morbidity and mortality rates in girl child are very high in comparison to male children.
There is also urban and rural divide, regional variations and economically divide between wealthy and weaker section in maternal and child mortality and development of health services in various states.
importantly 7.5% children suffered severe acute malnutrition. Iodine and Iron and folic
acid. Iodine deficiency disorders: 333 districts are endemic where iodine deficiency disorders are more than 5% (TGR) in children aged 6-12 years. Over 58% of children between 6 and 59 months are anaemic in India.
Rationale andGoals ofMCH
Over-nutrition – Obesity: It is an emerging problem in young children and adolescent age group. One in ten children is obese in India translating to a total of 14.4 million obese children.
See Also : Scope in Nursing Profession
Wrong beliefs and faulty feeding practices: Many harmful dietary beliefs and practices prevail in the individual, family and community, which are detrimental to the nutritional status. Cereals are considered to be harmful for young children, common belief is that cereals and GLYs can’t be digested by young children and lead to protuberance of abdomen and bad for liver; hence avoided or given in very small quantity in the diet of young children. Whole milk is considered to be heavy and is diluted several times with water. Several dietary restrictions are imposed during diarrhoea and acute respiratory infections. Some foods are considered hot and abortifacient and are not given to pregnant mothers. Initiation of breast-feeding is delayed. Complementary foods are given in little quantities. Best practices are universal breast-feeding in India, curd, green gram and rice are encouraged and considered to be light and easily digestible; by sick children.
vii) Pneumonia and Diarrhoeal Diseases
Pneumonia and diarrhoea together are responsible for 27% of deaths in under-five children in India. Large proportion of these deaths are preventable or avoidable by actions at the household and community. Family response such as fluids and feeding and use of ORS and Zinc, hand washing with soap and water and drinking safe water and use of sanitary latrines can prevent diarrhoeal deaths. Rotavirus vaccine also prevents diarrhoeal deaths. Similarly pneumonia deaths are preventable by use of specific antibiotics and immunizations against measles, Hib (Haemophilus influenza type b), whooping cough and diphtheria as also prevention of Indoor air pollution. Integrated Plan on Prevention and Control of Pneumonia has been launched in four states where 50% of under 5 deaths occur each year.
viii) Worm Infestations
Worm infestation is quite common in children and adolescent and pregnant women as also in adults. Heavy infestations lead to anaemia in children and pregnant women.
ix) Childhood Disability and Impairment
Visual, hearing and physical disabilities are common in children, mental impairment due to iodine deficiency, residual neurological effects after JE, visual impairment due to Vitamin A deficiency and refractive errors, congenital defects due to rubella, cerebral palsy and mental retardation are some others to mention. Most of these impairments are preventable and some need rehabilitation for life long.
x) School Health Enrolment, School Health Services and Services for Adolescents
Low levels of enrolment for girls and unorganized school health and adolescent health services.
xi) Weak Public Health Care Delivery Systems
Maternal and child health services are to be delivered in the existing health care delivery system which must be functional and strong to ensure uninterrupted services of high quality based on equity and convergence. However present system is weak because of insufficient human resources in health, inadequate budget and lack of equipment and supplies and essential drugs are important bottlenecks in the system to name a few.