Child health has improved greatly in the past, thanks to research that has quantified health problems and identified strategies for improving child health. The Working Group on Women and Child Health reviews the major advances in this field in developing countries since 1990 and argues that research is fundamental to further improvements in child health.
Child mortality (before age 5 years) has shown a relative decrease of 15% since 1990 but remains above 100 per 1000 live births in more than 40 countries. The risk of death can be reduced through evidence based interventions such as immunisation and oral rehydration treatment. Research has helped to quantify child health problems, identified strategies to improve health, and shown the effectiveness of interventions. In preparation for the forthcoming United Nations special session on children, we review the major advances in child health in developing countries since 1990 and illustrate the role of research in this progress.
Children’s health was once a subset of adult medicine. In the 19th and early 20th century, people recognized pediatrics as a medical specialty because of the gradual awareness that the health problems of children are different from those of adults. It was also recognized that a child’s response to illness, medications, and the environment depends upon the age of the child.
There are many aspects to children’s health. Any organization of these aspects of child health is necessarily arbitrary. For example, the topics could be presented in alphabetical order. However, it seems most logical to start with the factors that determine a child’s healthy growth and development.
Children’s growth and development
A healthy child’s development actually begins before conception with the parents’ health and their genetic legacy. It continues on to conception and through the prenatal period. During this time, there is naturally considerable overlap between pediatric concerns for the fetus and obstetrical concerns for the mother.
Once the baby is delivered, there are new and important matters to address, such as breastfeeding, newborn screening tests, and sleeping safety. All too soon, there are health care appointments to be kept for well-baby checkups and vaccinations. These are followed by other issues such as when and how to introduce solid foods, toilet training, and when to see the dentist.
The field of pediatrics recognizes classic stages in growth and development, but these are not absolute since a child’s growth and development constitute a continuum. A baby changes at an astonishing rate during the newborn period and early infancy. Before you know it, the baby becomes a toddler, next a child and, after a little more than a decade, enters adolescence. It is a busy, challenging period for both child and parent.
To be continued on the second phase, stay tune.