WORLD HEALTH DAY
Child health is a state of physical, mental, intellectual, social and emotional well-being and not merely the absence of disease or infirmity. Healthy children live in families, environments, and communities that provide them with the opportunity to reach their fullest developmental potential. Early child development sets the foundation for lifelong learning, behavior, and health. Protecting and improving the health of children is of fundamental importance. Over the past several decades, we have seen dramatic progress in improving the health and reducing the mortality rate of young children. Among other encouraging statistics, the number of children dying before the age of 5 was halved from 2000 to 2021, and more mothers and children are surviving today than ever before.
Children must be given a stable environment in which to thrive, including good health and nutrition, protection from threats and access to opportunities to learn and grow. Investing in children is one of the most important things a society can do to build a better future. In 2020-2021 an estimated 5.2 million children under 5 years died mostly from preventable and treatable causes. Children aged 1 to 11 months accounted for 1.5 million of these deaths while children aged 1 to 4 years accounted for 1.3 million deaths. Newborns (under 28 days) accounted for the remaining 2.4 million deaths. An additional 500,000 older children (5 to 9 years) died in 2019-2020.
The determinants of child health disparities include poverty, unequal access to health care, poor environmental conditions, and educational inequities. Poor and minority children have more health problems and less access to health care than their higher socioeconomic status cohorts. Factors such as adequate maternal nutrition, maternal mental and physical health, parental stress and depression, parenting styles, unemployment, limited or no income, housing conditions, and neighbourhood quality are also important determinants of early child development identified in recent research.
Leading causes of death in children under-5 years are preterm birth complications, birth asphyxia/trauma, pneumonia, congenital anomalies, diarrhoea and malaria, all of which can be prevented or treated with access to simple, affordable interventions including immunization, adequate nutrition, safe water and food and quality care by a trained health provider when needed. Older children (5-9 years) had one of the largest declines in mortality since 1990 (61%), due to a decline in infectious diseases.
Injuries (including road traffic injuries and drowning) are the leading causes of death among older children. At the country level, mortality rates for older children ranged from 0.2 to 16.8 deaths per 1000 children aged 5 years. As for children under 5, higher mortality countries are concentrated in sub-Saharan Africa. Countries with the highest number of deaths for 5-to-9-year-olds include India, Nigeria, Democratic Republic of the Congo, Pakistan and China. Globally, infectious diseases, including pneumonia, diarrhoea and malaria, along with pre-term birth, birth asphyxia and trauma, and congenital anomalies remain the leading causes of death for children under five. Access to basic lifesaving interventions such as skilled delivery at birth, postnatal care, breastfeeding and adequate nutrition, vaccinations, and treatment for common childhood diseases can save many young lives.
Malnourished children, particularly those with severe acute malnutrition, have a higher risk of death from common childhood illness such as diarrhoea, pneumonia, and malaria. Nutrition-related factors contribute to about 45% of deaths in children under-5 years of age. The patterns of death in older children reflect the underlying risk profiles of this age group, with a shift away from infectious diseases of childhood and towards accidents and injuries, notably drowning and road traffic injuries. The rise of injury deaths changes the nature of interventions to improve older child survival. There is a shift from health sector actions to prevent and treat the infectious diseases of early childhood towards other government sectors including education, transportation and road infrastructure, water and sanitation and law enforcement. All of these need to work together to prevent premature mortality in older children.
WHO calls on Member States to address health equity through universal health coverage so that all children are able to access essential health services without undue financial hardship. Moving from business as usual to innovative, multiple, and tailored approaches to increase access, coverage, and quality of child health services will require strategic direction and an optimal mix of community and facility-based care. Health sector and multisectoral efforts are also needed to overcome the inequalities and the social determinants of health. Healthy development means that children of all abilities, including those with special health care needs, are able to grow up where their social, emotional and educational needs are met. Having a safe and loving home and spending time with family?playing, singing, reading, and talking?are very important
However, a great deal of work remains to further improve the health outcomes for children. The world is facing a double mandate. More than half of child deaths are due to conditions that could be easily prevented or treated given access to health care and improvements to their quality of life.
(The writer is Incharge Abhedananda Home-Higher Secondary Institution for Specially-abled Children, Solina, Srinagar, J&K. Email: email@example.com)