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Child Health

Good health allows children to learn, grow and develop, and sets the foundation for adult life. Around nine million children die globally each year before reaching adulthood, and one in ten live with disability, mostly from preventable and treatable conditions. Child and maternal health are intricately linked, and the first year of life is the most vulnerable time. Infectious disease causes the highest burden of illness and deaths in childhood, with respiratory disease, diarrhoea, malaria, measles and HIV as the main problems. Sexual and reproductive health, injury and mental health are key priorities for adolescents. Creating an environment that is safe and supports children’s health and development is an essential foundation for future health.

Childhood deaths and illness

An estimated two thirds of child deaths could be prevented by using current effective interventions. 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 affects as least one in ten children in developing countries, and the key causes are premature birth, malnutrition, infections, and injury.

Partnership for Maternal, Newborn and Child Health knowledge portal – resource of policy and practice including country reports on systems and strategies, effective interventions, essential commodities, human resources, economics and financing, and accountability and tracking.

First year of life

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. Guidelines are available for newborn resuscitation in low resource settings.  Exclusive breastfeeding, with complementary feeding after six months, full immunisation, hygiene, prevention of infection, and management of infectious diseases, are central to early child survival. A programme of checks for neonatal home visits has been developed by WHO and UNICEF. For premature babies Kangaroo Mother Care is recommended, where the baby is carried skin-to-skin with the mother to maintain warmth, encourage breastfeeding, and reduce infection. WHO guidelines for resource-limited settings are available for routine newborn care, care of small and preterm babies, dealing with complications, and managing sick babies.

WHO Basic Newborn Resuscitation: a practical guide

WHO and UNICEF. Home visits for the newborn child: a strategy to improve survival

WHO. Kangaroo Mother Care – a practical guide.

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 – tables listing key actions for health services, families and communities for maternal and newborn healthcare programmes.

Childhood infectious diseases

Preventable communicable disease causes illness and disability, and accounts for about half of childhood deaths. Preventing infection through hygiene, safe water and sanitation, good coverage of immunisations and vitamin A, use of insecticide-treated bed nets to prevent malaria, and treatment to prevent HIV infection passing between the mother and baby are key interventions. The five infections that cause most deaths are pneumonia, diarrhoea, malaria, measles and HIV. 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.

WHO recommended routine immunisation policy for children 

WHO information on diseases and vaccines

Managing childhood illness

Effective identification and treatment of childhood illness is currently low. The WHO programme for Integrated Management of Childhood Illness is 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. 

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. Guidance for referral level facilities.

WHO Emergency Triage, Assessment and Treatment course - training materials

WHO Priority Medicines for Mothers and Children 2011. Indications and administration of essential medicines for reducing deaths and illness in mothers and children under 5 years.

Adolescent health

Adolescents have specific health and development needs. Choices for lifestyle and health in adolescence set the pattern for adult life. 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, and complications of pregnancy and childbirth are a leading cause of death globally for women of this age. Adolescents are at particular risk of violence and road traffic injury, and harm from hazardous working conditions. Psychosocial support is important for health and wellbeing. Preventing use of tobacco and substance misuse are important. There is limited global information on adolescent health and health behaviours to inform policy.

WHO adolescent health documents. 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.

Context for child health

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. Poverty is linked to poorer child health and higher child deaths.  Children and young people are more severely affected by crisis and disaster, and may become vulnerable to abuse and exploitation.

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.

The physical environment causes significant health problems, particularly from inadequate drinking water and sanitation, indoor air pollution, and injuries. The Healthy Environments for Children Alliance is promoting action to reduce risks. Injury is a leading cause of childhood deaths and disability worldwide, mostly from road traffic accidents, drowning, burns, falls and poisoning.

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.

Child Health Country Information and Millennium Development Goal 4

Millennium Development Goal 4 aims to reduce deaths in children under 5 years.  In 2009, globally 8.1 million children died before they were 5 years old. The greatest problem is in sub-Saharan Africa where 1 in 8 children die under 5 years, and Southern Asia where it is 1 in 14. 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. 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

Country profiles show the most recent available information for mother and child health:

Countdown 2015 - key maternal and child health intervention monitoring

Making Pregnancy Safer - maternal and newborn health information

UNICEF children’s health and wellbeing information 

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