Infant and Child Survival Maternal Health

Reflect on what you have learned about the history and systems related to infant and child survival.

• If we want to improve child survival, health, and development, is it better to invest in primary prevention programs or tertiary prevention programs? Is it better to invest in general community development initiatives (horizontal programs) or in programs that address specific health concerns (vertical programs)?
• Should the global community shift toward investing ore resource in early childhood development programs, or should the focus continue to be on infant and child survival?

Create a new blog post within the “Blog 5” folder that discusses the one or both of the 2 items listed above. Your best option is to write about ONE of these themes (or a related theme) in depth rather than covering multiple topics superficially.

Your blog entry must be at least 350 words long and use a professional writing style (with correct grammar, punctuation, spelling, and so on). You should include at least one copyright-free image. Read the syllabus carefully so that you know how to avoid academic integrity violations. Include hyperlinks within the text to any external sources that were useful to you as you reflected on the writing prompt and wrote your blog post.

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material:

1. Infant Mortality Epidemiology and Risk Factors: The neonatal period—the first 28 days after birth—is a risky time, with the risk of death especially high on the day of birth. There are some neonatal deaths that are not preventable, even with the most advanced medical technology. Some newborns have genetic disorders or other congenital defects that are not compatible with survival. However, the majority of stillbirths and neonatal deaths in lower-income countries occur because of lack of access to even basic medical care. Simple interventions like keeping babies warm, breastfeeding them shortly after birth, and keeping them clean so that they do not get infections—a challenge when 2 women give birth at home on dirt floors—can substantially reduce the risk of death. These interventions do not require advanced technologies, just effective health education.

☐ Read the neonatal mortality factsheet available from the World Health Organization at https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. This is not a formal source, but it provides a foundation for understanding the epidemiology of neonatal disorders

-Approximately how many newborns (first month after birth) will die this year? How many fetuses will be stillborn this year? What percentage of neonatal deaths occur during the first week after birth? What percentage of neonatal deaths occur during the first 24 hours after birth?

-How much did the annual neonatal mortality rate (NMR) decrease between 1990 and 2018? What are the major causes of neonatal mortality? Are these preventable and/or treatable conditions?

-What are the most important newborn care practices?

2. History of Child Survival Programs In 1978, the Alma-Ata conference (held in the city that is now called Almaty, Kazakhstan) established the importance of primary health care (PHC) in ensuring that all of the world’s people had access to “Health for All.” Since then, a variety of PHC-oriented initiatives have been launched by UNICEF, WHO, and other partners. For example, IMCI (the Integrated Management of Childhood Illnesses) provides health workers in clinics and in communitybased settings with guidelines for effective and cost-efficient treatment of child health concerns. Between 1990 and 2015, the annual number of under-5 child deaths decreased by 3 more than half, from about 12.7 million to about 5.9 million. However, that means that many thousand young children are still dying every day from preventable causes. Improving health equity for children is one of the major priorities of global health.
☐ Read the child mortality factsheet available from the World Health Organization at https://www.who.int/news-room/fact-sheets/detail/children-reducing-mortality.

-About how many children will die this year worldwide? What is the age distribution of the fatalities? Approximately what percentage of these deaths could be prevented with simple, affordable interventions?

-What are the major causes of death for infants and children who are less than 5 years old?

-What are the major causes of death for children ages 5–14 years?

☐ In public health, we talk about three types of prevention.

• Primary prevention includes actions that keep an adverse health event from ever occurring. Primary prevention targets healthy people.

• Secondary prevention detects health problems at an early stage when they have not yet caused significant damage to the body and can be treated more easily. Secondary prevention targets asymptomatic people.

• Tertiary prevention seeks to reduce impairment, minimize pain and suffering, and prevent death in people with symptomatic health problems.

☐ Watch this UNICEF video about child health promotion in Sierra Leone: 

-What are all of the interventions that are featured in this video?
-Who were the partners for the funding and implementation of this project?

3. Child Health Initiatives in the 21st Century: Global child health initiatives in the 21st century have shifted from focusing merely on survival to promoting interventions that help children thrive. Comprehensive child health programs combine traditional interventions like vaccinations and nutrition support with programs that support psychosocial and cognitive development, such as early childhood education programs that prepare children to succeed in school and community-based 5 therapy programs that help children with disabilities make progress toward achieving developmental milestones.

☐ Watch this video from UNICEF:  What –world region is featured in this video?

-What was the main message of the video?

-What interventions were featured?

-Do you think that it makes sense to invest in early childhood development (ECD) programs in low- and middle-income countries when so many children are still dying worldwide each year?

-Should the focus stay on survival?

☐ Global health programs are often described as being horizontal or vertical:

+A horizontal program strengthens an existing health system so that it can deliver additional health services. Horizontal programs are often described as integrating newly funded packages of health services into existing primary care delivery systems.

-What are some examples of horizontal child health programs?

+A vertical program delivers disease-specific services that are not fully integrated into the health system. Vertical programs are often used to address global health priorities like disease eradication efforts that demand an intensive but time-limited series of coordinated efforts

– What are some examples of vertical child health programs?

-Which type of program do you consider to be most valuable for child survival, health, and development initiatives today?