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  • Title: Children's health in the developing world: much remains to be done.
    Author: Yunes J, Chelala C, Blaistein N.
    Journal: World Health Forum; 1994; 15(1):73-6. PubMed ID: 8141986.
    Abstract:
    The principal causes of ill-health and mortality among children in the developing countries are outlined and the prospects for improvement through the provision of education, health services, adequate nutrition, clean drinking-water, sanitation and other basic needs are discussed. Despite improvements in infant mortality, 500,000 infants die every year in the Americas. In Costa Rica, child mortality dropped from 68/1000 live births in 1970 to 20/1000 in 1980 as a result of improved hygiene and nutrition, immunization, and treatment. In most other countries of the Americas, infant mortality rates have declined substantially mainly because of public health programs. Educational levels of mothers and per capita national product also exert a notable influence on infant mortality. Poverty inflicts health problems: 177 million children are malnourished, and 40% of children in developing countries are undernourished, a state of affairs responsible for almost 60% of infant deaths. Breast-feeding plays a vital role in the first year of life by providing high quality nutrition and immunological protection, and emotional bonding between the mother and the child. Unfortunately, breast-feeding prevalence and duration is on the decline in developing countries. Safe drinking water and good sanitation are crucial in preventing and reducing child mortality. Women who become pregnant at either extreme of the reproductive age are exposed to higher maternal and pediatric risks; so are multiparous women, and women with short birth intervals. Most child deaths between the ages of 1-4 are preventable by health intervention: the main causes are diarrheal and respiratory diseases, malnutrition, and vaccine-preventable infectious diseases. Intestinal infections cause almost 5 million child deaths a year, and oral rehydration therapy is the most effective preventive measure. Vaccination is the most effective means of preventing measles, polio, tetanus, diphtheria, tuberculosis, and pertussis. In many countries, malaria has resurfaced with some 250-300 million new cases every year. Children and pregnant women are especially vulnerable to suffer serious complications. There were a quarter million cases of cholera in the Americas between early 1991 and August, 1992. AIDS is also a threat to child health because of the rising numbers of infected mothers and pregnant women.
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