Three ways to im­prove child health

Financial Mirror (Cyprus) - - FRONT PAGE -

Over the last 15 years, the in­ter­na­tional com­mu­nity has made great strides in im­prov­ing child health. But, with mil­lions of chil­dren un­der the age of five dy­ing each year from pre­ventable and treat­able dis­eases like di­ar­rhea and pneu­mo­nia, the job is far from fin­ished.

Most peo­ple would say that malaria or even HIV/AIDS are the lead­ing child killers. In fact, di­ar­rhea and pneu­mo­nia top the charts as the big­gest threats to child sur­vival – as they have for the more than 30 years that we have been track­ing them. Ac­cord­ing to the re­cently pub­lished 2016 Pneu­mo­nia and Di­ar­rhea Progress Re­port, the two dis­eases caused 1.4 mil­lion child deaths last year, and one-quar­ter of all deaths of chil­dren un­der the age of five. They ex­act their high­est toll in South Asia and Sub-Sa­ha­ran Africa.

Tackling the two big­gest killers of chil­dren world­wide may seem daunt­ing, but we have all the knowl­edge we need to mount an ef­fec­tive re­sponse. In­deed, we know which viruses, bac­te­ria, and par­a­sites we need to tar­get; which in­ter­ven­tions are likely to work; and which coun­tries need them the most.

Just 15 child­hood coun­tries ac­count for 72% of deaths from pneu­mo­nia and di­ar­rhea. Th­ese are the coun­tries on which the Pneu­mo­nia and Di­ar­rhea Progress Re­port fo­cuses. Its anal­y­sis of na­tional ef­forts shows that, while most coun­tries have made im­prove­ments over the last year, im­prove­ment in some of the largest coun­tries has been min­i­mal, and a few coun­tries have not made any progress at all. Most deaths hap­pen in the first two years of a child’s life.

To change this, gov­ern­ments need to step up their ef­forts to pre­vent pneu­mo­nia and di­ar­rhea, in­clud­ing by en­sur­ing that par­ents have ac­cess to the in­for­ma­tion they need to pro­tect their chil­dren. Here, it is crit­i­cal that or­di­nary cit­i­zens stand up and hold their gov­ern­ments ac­count­able.

The good news is that there are rel­a­tively sim­ple in­ter­ven­tions that make a big dif­fer­ence.

The first is breast­feed­ing. An age-old, no­cost in­ter­ven­tion, breast­feed­ing ex­clu­sively for the first six months of a baby’s life is one of the eas­i­est ways to pre­vent both di­ar­rhea and pneu­mo­nia. Breast milk has all the nu­tri­ents ba­bies need to grow, as well as an­ti­bod­ies that boost their im­mune sys­tems, thereby pro­tect­ing against ill­ness and help­ing to ac­cel­er­ate re­cov­ery.

The Progress Re­port es­ti­mates that about half of all di­ar­rhea episodes, and about a third of res­pi­ra­tory in­fec­tions, could be averted by breast­feed­ing. Yet rates of ex­clu­sive breast­feed­ing dur­ing a child’s first six months re­main low. In ten of the 15 coun­tries eval­u­ated in the Progress Re­port, fewer than half of moth­ers ex­clu­sively three could breast­feed their chil­dren.

To in­crease breast­feed­ing rates, gov­ern­ments need to en­sure that moth­ers re­ceive the guid­ance and help they need. That means train­ing health work­ers; es­tab­lish­ing com­mu­nity-level sup­port net­works, such as mother-to-mother groups; in­vest­ing in be­hav­ioral-change cam­paigns; and cre­at­ing a cul­ture in which breast­feed­ing is wel­come and en­cour­aged.

The sec­ond crit­i­cal in­ter­ven­tion is im­proved wa­ter, san­i­ta­tion, and hy­giene in homes and com­mu­ni­ties. Glob­ally, ac­cord­ing to UNICEF, around 2.4 bil­lion peo­ple still do not have ac­cess to mod­ern san­i­ta­tion, and 663 mil­lion do not have ac­cess to safe wa­ter sources. Many kids still lack clean drink­ing wa­ter, ac­cess to ba­sic toi­lets, and good hy­giene prac­tices.

Poor wa­ter qual­ity and lack of re­li­able san­i­ta­tion sys­tems to treat hu­man waste play a big role in spread­ing dis­eases. UNICEF re­ports that some­thing as sim­ple as hand wash­ing with soap can cut rates of di­ar­rhea and res­pi­ra­tory in­fec­tions by more than 40% and 25%, re­spec­tively.

By in­vest­ing not only in sys­tems to pro­vide clean drink­ing wa­ter and san­i­ta­tion, but also in ed­u­ca­tional pro­grams that en­cour­age bet­ter hy­giene prac­tices and toi­let use, gov­ern­ments can break a vi­cious cy­cle of di­ar­rhea and mal­nu­tri­tion that causes ir­re­versible phys­i­cal and cog­ni­tive dam­age. The chil­dren they help are more likely to be able to at­tend school, and grow into healthy, ed­u­cated adults.

The third key in­ter­ven­tion is vac­ci­na­tion. Vac­cines rep­re­sent the most cost-ef­fec­tive in­ter­ven­tion for pre­vent­ing child­hood ill­ness, and they al­ready ex­ist for most com­mon bac­te­rial causes of pneu­mo­nia (pneu­mo­coc­cus and Hib) and for the lead­ing causes of di­ar­rhea (ro­tavirus). Yet half of the world’s chil­dren live in ar­eas where the pneu­mo­coc­cal vac­cine is not avail­able through a na­tional im­mu­ni­sa­tion pro­gramme, and only 15% of the chil­dren in the world’s poor­est coun­tries have ac­cess to the ro­tavirus vac­cine.

By mak­ing vac­cines avail­able through na­tional im­mu­ni­sa­tion pro­grammes, gov­ern­ments can pro­tect all chil­dren from the dis­eases that are most likely to harm or kill them. Ef­forts to en­sure that fam­i­lies take ad­van­tage of vac­ci­na­tion ser­vices, in­clud­ing by ed­u­cat­ing par­ents about their value, will also be needed.

Pneu­mo­nia and di­ar­rhea should not still be tak­ing chil­dren’s lives. No sin­gle in­ter­ven­tion will be enough. But the ac­cel­er­ated and co­or­di­nated im­ple­men­ta­tion of the three in­ter­ven­tions de­scribed here could go a long way to­ward pre­vent­ing pneu­mo­nia and di­ar­rhea, es­pe­cially for the most vul­ner­a­ble chil­dren, en­abling them to lead healthy, pro­duc­tive lives.

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