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Child health problems
Dr Utpal Sharma
Department of Community Medicine
SMIMS, Gangtok, Sikkim
The main health problems encountered in the child
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
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
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
And other infections…
…..in infancy and childhood reduces malnutrition
Prevention of childhood morbidities breaks the breaks
the stubborn vicious cycle of infections and
Exclusive breast feeding in first 6 months of life is very
important for the same.
Protein energy malnutrition
Identified as the major health and nutritional
issue in India
More prevalent amongst the weaklings and infants
Low birth weight if the mother is malnourished
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
It is estimated that about 37% of children
suffers from stunting in developing nations
Also about 10% children have low weight for height
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
An estimate of around 2million people suffers from these deficiencies
Affects all age groups
Even mild anemia reduces resistance to fatigue
Has profound effect on psychological and physical behaviour
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
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
..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
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.
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
Intestinal parasitosis in children….
….have important long term
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….
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 health
Child health adversely affected if the mother is…
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
“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
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
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
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
Children develops skills byenvironmental
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
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