child health L4

Child Health

Lec- 4
Prof Dr Najlaa Fawzi


IMCI is an integrated approach to child heath that focuses on the well being of the whole child Aims to reduce death, illness, and disability and to improve growth and development among children under 5 years old Includes both preventive and curative elements that are implemented by families, communities, and health facilities

Key elements of IMCI

1 - 4 year Mortality Rate 
No. of deaths of children aged 1-4 years during a year Total no. of children aged 1-4 years at the middle of the year
1-4MR =
X 1000
Mid-year estimated population means population counted on the 1st of July 
It is more advanced indicator of social situation of country than IMR . It reflects environmental health hazards.

1-4 years mortality rate - causes

Developing countries Diarrhea ARI Malnutrition Infectious diseases Accidents
Developed countries Accidents Congenital anomalies Malignancies Influenza Pneumonia

Under-five mortality

CHILD HEALTH PROBLEMS
The leading causes of death among children under five are : Preterm birth complications Pneumonia Intrapartum-related complications Diarrhea Congenital abnormalities.

Nutritional deficiency Problems include

Malnutrition Vitamin A Deficiency
Iron Deficiency Low Birth Weight

Under 5 Mortality Rate

Number of deaths of < 5 years of age in a given year U5MR = x 1000 Total number of live births in the same year

Why use the U5MR as the single most important indicator of the state of the world’s children? For the following reasons
1-The U5MR reflects the nutritional health and the health knowledge of the mothers.
2-The level of immunization and ORT use.

3-The availability of maternal and child health services [including the antenatal care].

4-Income and food availability in the family.
5-The availability of clean water and safe sanitation.
6-The overall safety of the child’s environment


Child Survival Index
1000 – under 5 mortality rate CSR=
10
This figure shows the percentage of those who survive to the age of 5 years.
U5MR of Iraq in 2006 = 39/1000 live births = 1000 –39/10 = 96.1%

INDICATORS OF MATERNAL AND CHILD HEALTH CARE

WHO defines Indicators as “variables which measure change”

Maternal and child health status is assessed through mortality, morbidity and growth and development and other indicators . Commonly used mortality indicators are : Maternal mortality rate
Mortality in infancy and childhood: Perinatal mortality rate Neonatal mortality rate Post neonatal mortality rate Infant mortality rate 1-4 mortality rate Under 5 mortality rate Child survival rate

Other indicators for MCH

Skilled attendant at birth is a measure of a health system’s ability to provide adequate care for pregnant women during labour and delivery.

mortality.

maternal
WHO optimal rate for CS between 10-15%
A rate falling outside this range
of inadequacy
is indicative
in the
availability of or
inappropriate use
of caesarean delivery.


6- Children under five who are stunted
Indicator :Number of children under five years of age whose length-for-age or height-for age Is below minus two standard deviations from the median of the WHO Child growth standards
Stunting reflects continued, long term exposure to poor health and nutrition, particularly during the first two years of life

7-Exclusive breastfeeding for six months (0–5 months)