Academic journal article International Journal of Child Health and Human Development

Strengthening Health Systems to Address Child Health

Academic journal article International Journal of Child Health and Human Development

Strengthening Health Systems to Address Child Health

Article excerpt

Introduction

Maternal and child health is of paramount importance for healthy development of human beings. Nevertheless, child health is at peril in many developing countries. WHO data and many other data are a testament to this statement. Lack of access to functional, effective and affordable health services is one of the many factors responsible for affecting child health status adversely in developing countries. It is increasingly understood that almost all the issues related to child health can be addressed by strengthening health systems which is wide and comprehensive subject. The health systems encompass various topics such as the national leadership and health policies; financing; drugs, vaccines and medical technologies; health data; district level, sub-district level and community level health workforce; and delivery of quality, safe and efficient services to the mothers and children who need them and where they need them.

India is one of the 68 countries which account for 97% of maternal and child deaths worldwide (1). This paper aims to examine the child health issues in developing countries including India and the ways for strengthening health systems to improve the quality and utilisation of health services for new born and child health.

Child health in developing countries

Good health in the foundation years is crucial to the full potential development of a human being be that in a developing nation or a developed country (2). Therefore, every child in the world has a right to get care and services for the promotion of his/ her healthy development. However, in contrast to the rights of children, the reality is that many children die during or soon after their birth or before reaching the age of five. These high numbers of deaths of infants and children mostly occur in developing nations especially in African and Asian countries (3). According to World Health Organization (WHO), the world's average child mortality rate in the year 2000 was 67 deaths per 1000 live births which had improved from 85 per 1000 in 1990(4).

Despite significant achievement in reduction of child mortality in the last two decades (2), ten million plus children still die annually nearly all in lowincome countries from the diseases and causes that can be averted (3). Child health is closely related to the health of mothers. Therefore, knowledge of maternal health can not be ignored while understanding causes of child deaths. The figure of 10 million deaths of children includes 4 million neonatal deaths and 6 million deaths of children under 5 in addition to half a million maternal deaths (5). It was assessed that among 90% of deaths of children under 5 years in 42 countries in year 2000, the leading causes of deaths were neonatal causes (33%), diarrhoea (22%) and pneumonia (21%) (3,6). A small percentage of deaths of children under 5 could be attributed to malaria (9%), AIDS (3%), measles (1%) and less than 1% to unknown causes (3, 6). These figures haven't changed much since then.

The causes of maternal and child deaths are identified to be distal determinants such as poverty, lack of education, physical environment, social status, early marriage, low age at first child birth and proximal determinants such as under-nutrition, infectious diseases, neonatal causes and injury (3,7). The leading causes of neonatal, infant, child death that are recognized worldwide especially in developing countries are diarrhoea, pneumonia, malaria, neonatal causes such as sepsis, asphyxia and others (3,6).

In India, high infant mortality, high maternal mortality, persistent malnutrition, high levels of anaemia in women and children, early marriage and low age at child birth are amongst many challenges that Indian public health system faces (8).

Reduction in neonatal, infant and child mortality is one of the Millennium Development Goals (MDGs) and an international priority (7). There are various kinds of interventions and ample funding to reduce child death, but still insufficient efforts and lack of political commitment to reduce child death exist (1). …

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