Common Health Problems, Millenium Development Goals and Evidence Based Interventions

Sources of Evidence and Guidelines

Malnutrition and MDG 1

Children and MDG 4

Maternal Health and MDG 5

HIV/AIDS and MDG 6

Malaria and MDG 6

Tuberculosis and MDG 6

Disability

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Child Health

 

• Millenium development goal 4
• Building strong foundations 
• Childhood deaths and disability
• First year of life
• Childhood Infectious diseases and prevention
• Managing childhood illness
• Adolescent health

 

Millennium Development Goal 4

• Millennium Development Goal 4 aims to reduce deaths in children under 5 years

• MDG Target 4A : is to reduce by two thirds between 1990 and 2015 the under 5 mortality rate.

 

• Since 1990, the global child mortality under 5 years has fallen by about a third,
• BUT more than 7 in 10 priority countries are not seeing a reduction in child deaths that would meet current targets.
• In 2009, globally 8.1 million children died before they were 5 years old.
• The greatest problem is in sub-Saharan Africa. Here 1 in 8 children die under 5 years (In Southern Asia the figure is 1 in 14.)

 

GUIDANCE/INFORMATION The Global Strategy for Women and Children's Health recommends country-led health plans, essential interventions and services with integrated care, health system strengthening and building workforce capacity, supported by coordinated research and innovation Countdown 2015 - key maternal and child health intervention monitoring Making Pregnancy Safer - maternal and newborn health information UNICEF children's health and wellbeing information

 

 Top of page

 

Building strong foundations

Children's health and wellbeing relies on their families and communities, and the need for a safe environment that supports their development, growth and nutrition.

Good health allows children to learn, grow and develop, and sets the foundation for adult life. Creating an environment that is safe and supports children's, nutrition, health and development is an essential foundation for future health.

Nutrition 

Good nutrition is a foundation for health and development, with appropriate and varied foods in adequate amounts, as well as essential micronutrients. Under nutrition increases susceptibility to illness and death in childhood, and, in the long term, limits growth, social and intellectual development.

Poverty

Poverty is linked to

• poorer child health  
• higher child deaths. 

Environment

The physical environment causes significant health problems, particularly from inadequate drinking water and sanitation, indoor air pollution and injuries e.g. road traffic accidents, burns, drowning, poisoning, falls.

Crisis and Disaster

Children and young people are more severely affected by crisis and disaster, and they may become vulnerable to abuse and exploitation.

 

GUIDANCE Children and young people - wider issues affecting health and the needs of vulnerable children Resources for child health, including development and disability. Resources on infant and young child feeding WHO Healthy Environments for Children Factsheet. Low cost, effective measures to reduce environmental threats to children's health.

 

 Top of page

 

Childhood deaths and disability

The majority of deaths and disability is preventable

Numbers 

• Disability : At least one in ten children live with disability in developing countries 

Causes 

• Deaths : Pneumonia and diarrhoea are the commonest causes of child deaths after the newborn period, and under nutrition contributes to over a third of deaths. Malaria, injuries, HIV/AIDS and measles are the next most important causes of death.
• Disability : The key causes are premature birth, malnutrition, infections, and injury

Prevention and Treatment

• Most deaths (an estimated two thirds) and disability could be prevented by using current effective interventions. 

 

First year of life

Child and maternal health are intricately linked. Children are most vulnerable in the first year of life.

• More than 40% of deaths under five years occur in the first four weeks of life (neonatal deaths), with three quarters in the first week after birth.
• Nearly a third of neonatal deaths are due to prematurity and low birth weight, a quarter from birth asphyxia and birth trauma, and another quarter from neonatal infections.

 

GUIDANCE  Partnership for Maternal, Newborn and Child Health knowledge portal.  This provides a resource on policy and practice including country reports on systems and strategies, effective interventions, essential commodities, human resources, economics and financing, and accountability and tracking. WHO Basic Newborn Resuscitation: a practical guide, which provides guidelines on newborn resuscitation in low resource settings.  WHO and UNICEF: Home visits for the newborn child - a strategy to improve survival. This provides a programme of checks for neonatal home visits. It recommends that central to early child survival are exclusive breastfeeding, with complementary feeding after six months, full immunisation, hygiene, prevention of infection, and management of infectious diseases. WHO. Kangaroo Mother Care - a practical guide. This is recommended for premature babies Kangaroo Mother Care. The baby is carried skin-to-skin with the mother to maintain warmth, encourage breastfeeding, and reduce infection. WHO recommended interventions for improving maternal and newborn health - tables listing key actions for health services, families and communities for maternal and newborn healthcare programmes.  WHO. Integrated Management of Pregnancy and Childbirth. Managing newborn problems - a guide for doctors, nurses and midwives. A clinical guide to assessment, diagnosis and management of sick or small newborn babies at health facilities. WHO recommended interventions for improving maternal and newborn health - This provides tables listing key actions for health services, families and communities for maternal and newborn healthcare programmes.

 

 Top of page

 

Childhood infectious diseases and prevention

Preventable communicable disease accounts for about half of childhood deaths.

The five infections that cause most deaths are

• pneumonia,
• diarrhoea,
• malaria,
• measles
• HIV.

   can be prevented through

• hygiene,
• safe water
• sanitation,
• good coverage of immunisations
• vitamin A,
• use of insecticide-treated bed nets to prevent malaria
• treatment to prevent HIV infection passing between the mother and baby 

Other infectious diseases

• Death rates from syphilis, tuberculosis and meningitis are higher in the first five years of life.
• Dengue, Japanese encephalitis, leischmaniasis and trypanosomiasis are important in some regions.
• Polio, sleeping sickness, malaria and meningitis are causes of disability. Intestinal parasites reduce nutritional status and health.

 

GUIDANCE WHO Immunisation Policy

 

Top of page

 

Managing childhood illness

 Effective identification and treatment of childhood illness is currently low.

• To help overcome this, the WHO programme for Integrated Management of Childhood Illness sets out a system for assessment, diagnosis and treatment of sick children for health workers, with materials to support clinical work and training, identifying actions across the health system, and for communities and families.
• Guidelines are available for hospital care, and appropriate use of essential medicines for children.  
• Emergency triage, assessment and treatment are important to identify children with life-threatening conditions, and reduce deaths at health facilities which often occur within 24 hours of admission. 

 

GUIDANCE WHO Integrated Management of Childhood Illness - charts for first level facilities WHO Pocket Book of Hospital Care for Children - Guidelines for the Management of Common Illnesses with Limited Resources. This includes guidance for referral to level facilities. WHO Emergency Triage, Assessment and Treatment course WHO Priority Medicines for Mothers and Children. Indications and administration of essential medicines for reducing deaths and illness in mothers and children under 5 years.

 

Top of page

 

Adolescent health

Sexual and reproductive health, injury and mental health are key priorities for adolescents.

Sexual and reproductive health are particular concerns.

• An estimated 45% of new HIV infections in 2007 affected people aged 15 to 24 years.
• About 16 million or 11% of births worldwide are to women aged 15 to 19 years Complications of pregnancy and childbirth are a leading cause of death globally for women of this age.

Adolescents are at particular risk of

• violence
• road traffic injury,
• harm from hazardous working conditions.

 

GUIDANCE  WHO adolescent health documents. This contains research reviews and policy on health and services for adolescents, including sexual and reproductive health, HIV and mental health. UNICEF State of the World's Children 2011. Adolescence: an age of opportunity.

 

Top of page