Why Should 5,000 Children Die in India Every Day? Major Causes of Death and Managerial Challenges

2010 ◽  
Vol 35 (2) ◽  
pp. 9-20 ◽  
Author(s):  
K V Ramani ◽  
Dileep Mavalankar ◽  
Sanjay Joshi ◽  
Imran Malek ◽  
Tapasvi Puvar ◽  
...  
Keyword(s):  
Child Health ◽  
Service Providers ◽  
Average Rate ◽  
Child Death ◽  
Infant Mortality Rate ◽  
Child Health Services ◽  
Under Five ◽  
The Government ◽  
Mdg 4 ◽  
Health Programmes

Globally, more than 10 million children, under five years of age, almost all in poor countries, die every year (20 children per minute), mostly from preventable causes. The major causes of child death include neonatal disorders (death within 28 days of birth), diarrhoea, pneumonia, and measles with malnutrition being a major contributing factor for childhood illnesses. India alone accounts for almost 5,000 deaths of under-five years children (U5) every day. In 1975, the Integrated Child Development Scheme (ICDS) was launched in the country to provide integrated health and nutrition services focusing upon the holistic development of children at the village level. Yet by 2005, 50 per cent of the children in India were still malnourished. India's neonatal mortality, which accounts for almost 50 per cent of the U5 deaths, is one of the highest in the world. India launched the Universal Immunization Programme (UIP) in 1985. Yet full immunization in India had reached only 43.5 per cent by 2005-06, as per the NFHS 31. This paper, besides discussing the status of mortality of children and the situation of child health services, examines the managerial challenges of the child health programmes in India. There is a need for improving the management capacity amongst health service providers, specifically the planning and implementation of child health programmes such as immunization, control of diarrhoea, and pneumonia. The analysis of the trends of the past decline shows that during 1990-2008, India achieved a decrease in infant mortality rate (IMR) at a very low annual average rate of 1.9 per cent. To achieve Millennium Development Goals (MDG) 4, between 2009— 2015, the rate of reduction of IMR needs to be increased to a very high level — at 6.74 per cent every year. This means that the government and the private sector need to improve the effectiveness and efficiency of the child health programmes substantially. Incremental improvement over “business-as-usual” will not help in achieving MDG 4. Effective and efficient management of child health programmes would require focused political and administrative attention and managerial capacity.

Health Cadres Commitmentin Child Health Care in Moslem Society of Banyumas District

2016 ◽  
Vol 1 ◽  
pp. 60-65
Author(s):  
Umi Solikhah ◽  
Hari Kusnanto ◽  
Fitri Haryanti
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services ◽  
Group Discussion ◽  
Community Empowerment ◽  
Child Health Services ◽  
Child Health Care ◽  
Minimum Requirements ◽  
Social Esteem ◽  
The Government

Community empowerment with regard to maternal and child health services at the community level carried out by cadre.Cadre is health volunteers, selected by the community.404 number of active cadres in primary health care of South Purwokerto entirely female, although it may be a cadre of men. Active cadre toddler actively providing services every month for child before 5 years age. Interest to know the various reasons committed cadres in performing their duties. The method used is qualitative study,to describe a variety of reasons commitment to perform cadre duties in child health care. Retrieving data using interview techniques through the focus group discussion. Data from 30 cadres.Results of interviews taken until the data saturation, as a reason believed by cadres in the commitment to carry out tasks of serving the Muslim community. Characteristic respondent are mean of age 38 years (the youngest age of 25 years and the oldest 55 years old), a 100% Islamic religion, level of education majority of senior high school(at least primary school). Educational level health cadres in Banyumas has met the minimum requirements by the WHO.Results of the analysis showed thatcommitment includes a cadre of dedicated, caring community, a desire to learn, social esteem, individual satisfaction, togetherness, organization, and spirituality. The spirit of cadre to the community need the attention of the government for development and prosperity in accordance with their duties.Spiritual reasons become one of the motivations in providing health services to the community, albeit to a spirit of dedication and a great desire to learn. Cadres continue to provide services, even to families with different spiritual.

Child Saving and Child Spacing in Africa: The Evolution of a Concept

1973 ◽  
Vol 3 (4) ◽  
pp. 765-768
Author(s):  
Robert D. Wright
Keyword(s):  
Family Planning ◽  
Child Health ◽  
Maternal And Child Health ◽  
Child Death ◽  
Child Health Services ◽  
Tropical Africa ◽  
Low Visibility ◽  
Child Spacing ◽  
High Level ◽  
And Child Health

In tropical Africa the primordial presence of enormous young child death rates precludes a successful frontal attack on birth rates through specialized programs. Experience in Nigeria indicates that gradual, quiet pressure can influence the power structure to tolerate and eventually espouse child spacing as an integral part of a program of services for child saving. The approach involves four phases: a low visibility start; obtaining high level acceptance; establishment of a federal training center to train cadres for state training programs; and deployment of trained primary care auxiliaries as a local maternal and child health-family planning service. In tropical Africa governmental attitudes toward family planning range from positive policy, to neutrality, to strong opposition. At present most Anglophone countries are favorable. Most Francophone countries are opposed. The general trend is toward a more favorable attitude toward family planning when it is a part of maternal and child health services.

scholarly journals Community involvement in reproductive health: Findings from research in Karnataka, India

2004 ◽  
Author(s):  
Keyword(s):  
Child Health ◽  
Reproductive Health ◽  
Health Services ◽  
Community Participation ◽  
Community Involvement ◽  
Child Health Services ◽  
Reproductive And Child Health ◽  
The Government ◽  
The Impact ◽  
And Child Health

In 1996, the government of India decided to provide a package of reproductive and child health services through the existing family welfare program, adopting a community needs assessment approach (CNAA). To implement this approach, the government abolished its practice of setting contraceptive targets centrally and introduced a decentralized planning strategy whereby health workers assessed the reproductive health needs of women in their respective areas and prepared local plans to meet those needs. They also involved community leaders to promote community participation in the reproductive and child health program. Since 1998, several evaluation studies have assessed the impact of CNAA on the program’s performance and community participation. These studies showed that the performance of the maternal health-care program improved, whereas the functioning of the family planning program initially declined but later recovered. The approach achieved little in boosting community involvement. This project tested a new model of health committee to help stimulate community participation in reproductive and child health activities at the village level. The experiment, described in this report, was conducted in the Hunsur block of the Mysore District in Karnataka for two years. Researchers evaluated the impact in terms of community involvement and utilization of reproductive and child health services.

scholarly journals Factors influencing rapid progress in child health in post-conflict Liberia: a mixed methods country case study on progress in child survival, 2000–2013

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e021879 ◽  
Author(s):  
Marie A Brault ◽  
Stephen B Kennedy ◽  
Connie A Haley ◽  
Adolphus T Clarke ◽  
Musu C Duworko ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Civil War ◽  
Child Health ◽  
Child Survival ◽  
Rapid Progress ◽  
African Region ◽  
Under Five ◽  
Post Conflict ◽  
Mdg 4

ObjectivesOnly 12 countries in the WHO’s African region met Millennium Development Goal 4 (MDG 4) to reduce under-five mortality by two-thirds by 2015. Given the variability across the African region, a four-country mixed methods study was undertaken to examine barriers and facilitators of child survival prior to 2015. Liberia was selected for an in-depth case study due to its success in reducing under-five mortality by 73% and thus successfully meeting MDG 4. Liberia’s success was particularly notable given the civil war that ended in 2003. We examined some factors contributing to their reductions in under-five mortality.DesignA case study mixed methods approach drawing on data from quantitative indicators, national documents and qualitative interviews was used to describe factors that enabled Liberia to rebuild their maternal, neonatal and child health (MNCH) programmes and reduce under-five mortality following the country’s civil war.SettingThe interviews were conducted in Monrovia (Montserrado County) and the areas in and around Gbarnga, Liberia (Bong County, North Central region).ParticipantsKey informant interviews were conducted with Ministry of Health officials, donor organisations, community-based organisations involved in MNCH and healthcare workers. Focus group discussions were conducted with women who have experience accessing MNCH services.ResultsThree prominent factors contributed to the reduction in under-five mortality: national prioritisation of MNCH after the civil war; implementation of integrated packages of services that expanded access to key interventions and promoted intersectoral collaborations; and use of outreach campaigns, community health workers and trained traditional midwives to expand access to care and improve referrals.ConclusionsAlthough Liberia experiences continued challenges related to limited resources, Liberia’s effective strategies and rapid progress may provide insights for reducing under-five mortality in other post-conflict settings.

REPRODUCTIVE AND CHILD HEALTH SERVICES AND DEMOGRAPHIC CHANGE IN THE DISTRICTS OF UTTAR PRADESH, 2002–13

2016 ◽  
Vol 49 (5) ◽  
pp. 685-709
Author(s):  
Mamta Rajbhar ◽  
Sanjay K. Mohanty
Keyword(s):  
Child Health ◽  
Antenatal Care ◽  
Fixed Effects ◽  
Uttar Pradesh ◽  
Infant Mortality Rate ◽  
Child Health Services ◽  
Reproductive And Child Health ◽  
Female Literacy ◽  
And Child Health ◽  
Over Time

SummaryThis study examined the effect of reproductive and child health (RCH) services on fertility and child mortality in the districts of Uttar Pradesh. It specifically measured the effect of antenatal care, medical assistance at birth, child immunization and use of modern methods of contraception on Total Fertility Rate (TFR), Infant Mortality Rate (IMR) and Under-five Morality Rate (U5MR) before and after the National Rural Health Mission (NRHM) period. Data from the 2002–04 District Level Household Survey (DLHS-2), 2012–13 Annual Health Survey (AHS) and the 2001 and 2011 Censuses of India were used. The TFR and U5MR were estimated from the Census of India with district as the unit of analysis. Descriptive statistics, composite indices, random- and fixed-effects models and difference-in-difference models were used to understand the effect of RCH services on the reduction in TFR, IMR and the U5MR. The results suggest large inter-district variations in the coverage of RCH services in the state. During the post-NRHM period, improvement was highest in safe delivery followed by immunization coverage and antenatal care and least for contraceptive use in most districts. The relative ranking of districts has not changed much over time. In 2002–04, the RCH Index was highest in Lucknow (0.442) followed by Ballia and least in Kaushambi (0.115). By 2012–13, it was highest in Jhansi (0.741) and lowest in Shrawasti (0.241). The districts of Kaushambi, Unnao, Mahoba, Banda and Hardoi performed better in the RCH Index over time, while Ballia, Gautam Buddha Nagar, Kanpur Nagar, Pratapgarh and Sonbhadra remained poor. The RCH service coverage and demographic outcomes were poor in seven districts, particularly those in eastern and western Uttar Pradesh. The regression analyses suggest that the RCH Index exerts greater influence on the reduction in IMR and U5MR, while female literacy exerts greater influence on the reduction in TFR. The results of the hybrid model suggest that a 10% change in RCH Index would lead to a 3 point decline in IMR, and a 10% increase in female literacy would lead to a 0.2 point decline in TFR. The study suggests continuing investment in female education and RCH services with a greater focus on poor-performing districts to realize demographic and health targets.

scholarly journals Closing the know-do gap for child health: UNICEF’s experiences from embedding implementation research in child health and nutrition programming

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Debra Jackson ◽  
A. S. M. Shahabuddin ◽  
Alyssa B. Sharkey ◽  
Karin Källander ◽  
Maria Muñiz ◽  
...  
Keyword(s):  
Child Health ◽  
Implementation Research ◽  
Service Providers ◽  
Lessons Learned ◽  
Theory And Practice ◽  
Health Systems Strengthening ◽  
Child Health Services ◽  
Local Context ◽  
Full Potential ◽  
Health And Nutrition

AbstractUNICEF operates in 190 countries and territories, where it advocates for the protection of children’s rights and helps meet children’s basic needs to reach their full potential. Embedded implementation research (IR) is an approach to health systems strengthening in which (a) generation and use of research is led by decision-makers and implementers; (b) local context, priorities, and system complexity are taken into account; and (c) research is an integrated and systematic part of decision-making and implementation. By addressing research questions of direct relevance to programs, embedded IR increases the likelihood of evidence-informed policies and programs, with the ultimate goal of improving child health and nutrition.This paper presents UNICEF’s embedded IR approach, describes its application to challenges and lessons learned, and considers implications for future work.From 2015, UNICEF has collaborated with global development partners (e.g. WHO, USAID), governments and research institutions to conduct embedded IR studies in over 25 high burden countries. These studies focused on a variety of programs, including immunization, prevention of mother-to-child transmission of HIV, birth registration, nutrition, and newborn and child health services in emergency settings. The studies also used a variety of methods, including quantitative, qualitative and mixed-methods.UNICEF has found that this systematically embedding research in programs to identify implementation barriers can address concerns of implementers in country programs and support action to improve implementation. In addition, it can be used to test innovations, in particular applicability of approaches for introduction and scaling of programs across different contexts (e.g., geographic, political, physical environment, social, economic, etc.). UNICEF aims to generate evidence as to what implementation strategies will lead to more effective programs and better outcomes for children, accounting for local context and complexity, and as prioritized by local service providers. The adaptation of implementation research theory and practice within a large, multi-sectoral program has shown positive results in UNICEF-supported programs for children and taking them to scale.

scholarly journals Lessons for responding to COVID-19, from Exemplars in Under-five Mortality Reduction

2020 ◽  
Vol 4 ◽  
pp. 120
Author(s):  
Lisa R Hirschhorn ◽  
Nathaniel Gerthe ◽  
David E Phillips ◽  
Oliver Rothschild ◽  
Manpreet Singh ◽  
...  
Keyword(s):  
Child Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal And Child Health ◽  
Health Workers ◽  
Child Health Services ◽  
Data Systems ◽  
Under Five ◽  
Success Stories ◽  
And Child Health

COVID-19 may not have the same direct effects on children as it does on older adults, but its indirect effects still pose a threat to child health, by disrupting delivery of routine health services like immunizations. This has happened during previous crises, and early indications point towards similar disruptions due to the coronavirus pandemic. To mitigate this, countries need to build resilient health systems capable of maintaining essential maternal and child health interventions, while also responding to COVID. How can this be accomplished? To find some answers, we can learn from countries in the past who improved health outcomes in the face of challenging circumstances. Specific to child health, countries with positive-outlier performance in reducing under-five mortality provide helpful strategies. These lessons include a clear national plan that drives rapid response, leveraging existing data systems to inform decision-making, engaging communities via community health workers, and focusing on equity. Today, countries around the world are facing the challenge of responding to the pandemic while building resilient health systems that continue to deliver invaluable maternal and child health services. Studying lessons from previous success stories can help inform the road ahead.

scholarly journals Pengaruh Pendidikan Kesehatan Tentang Deteksi Dini Perkembangan Anak Usia Balita Terhadap Peningkatan Pengetahuan dan Ketrampilan Ibu Dalam Melakukan Deteksi Dini Perkembangan Anak di Pusat Kesehatan Masyarakat Sikumana, Kota Kupang

2017 ◽  
Vol 15 (1) ◽  
pp. 1-13
Author(s):  
Agustina Agustina ◽  
Mariana Oni Betan
Keyword(s):  
Child Development ◽  
Health Education ◽  
Child Health ◽  
Early Detection ◽  
Health Services ◽  
Maternal And Child Health ◽  
Child Health Services ◽  
Children Under Five ◽  
Under Five ◽  
And Child Health

Early childhood is the "golden period" of child development, the window of opportunity and the critical period. This period is a sensitive period, a period of rapid and important growth and development. If there is a drift of growth and not detected early then it will affect the growth of the next flower (Siswanto, 2010). Based on data from East Nusa Tenggara Health Profile (2010), early detection in children under five in Kupang City was 1,506 children (9.3%) of 16,121 children under five. Research Ina A., 2014, in Kota Kupang, found 19 respondents experiencing development deviations. Existing phenomenon in the field rarely found early detection activities of child development in Maternal and Child Health Services. Assessment of progress with KPSP is easy to do as long as you know how. This study aims to analyze the influence of health education on early detection of the child under five development of children towards improving mother's knowledge and skill in early detection of child development, at Maternal and Child Health Services, health center of Sikumana, Kupang City ". This type of research is experimental with one group design pre-test and post-test design. The sample size was 44 people, ie 22 treatment and 22 no treatment. Random sampling. The results of this study indicate that there is an effect of health education on early detection of the development of children under five on improving mother's knowledge and skills in early detection of child development, in Maternal and Child Health Services Sikumana Health Center, Kupang City "with p = 0,000, for knowledge and p = 0,000 for skills.

scholarly journals Child Health Monitoring Description in MCTS at Ranuyoso PHC Lumajang

2017 ◽  
Vol 4 (2) ◽  
pp. 151
Author(s):  
Bettis Wijayanti
Keyword(s):  
Mortality Rate ◽  
Child Health ◽  
Infant Mortality ◽  
Health Center ◽  
Health Monitoring ◽  
Infant Mortality Rate ◽  
Advanced Analysis ◽  
The Government ◽  
Alternative Solutions

 Infant Mortality Rate in Lumajang was always higher than the infant mortality rate in East Java Province. Ranuyoso is a region with the highest infant mortality rate and AKABA in 2013 and 2014, with 33 and 22 deaths. The Government had implemented a program to improve the health and the consolidation scope is monitored by the Pemantauan Wilayah Setempat Kesehatan Ibu dan Anak (PWS KIA). PWS KIA had not been going well according to its purpose as a tool for monitoring the KIA service coverage to increase the range and quality of KIA services. The purpose of this research was to describe the implementation of PWS KIA for indicators of child in Health Center of Ranuyoso which based on attributes of simplicity, acceptability, sensitivity, representativeness, data quality, timeliness and stability. This research used descriptive method evaluative with coordinator midwife, midwives health center and eight village midwives as the respondent. Description based on the attributes of surveillance system showed that PWS KIA indicator of child in Health Center of Ranuyoso was not simple, sensitive but not supported well by the midwives, the data were less quality, not timely and unstable. Alternative solutions to problems that had been found were to performing the advanced analysis to determine the causality amount variables by midwives, holding routine supervision from the senior midwives, procurement of SOP or guidebook for midwives, and computerizing the recording until reporting start from village midwives, also the making of the attendance and expeditions book to record the reporting date of midwives. Keywords: MCTS, attributes surveillance, child health monitoring

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