child health problems

1. Child health problems
Dr Utpal Sharma
Assistant Professor
Department of Community Medicine
SMIMS, Gangtok, Sikkim

2. Introduction
 The main health problems encountered in the child
population are
Child
health
problems
Low
birth
weight
Malnutrition
Infections
ParasitosisAccidents
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 byenvironmental
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