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Chapter – 5 

Preventing Children’s Death and Sickness

Too many innocent children are victims of preventable diseases.

  • Art Buck

According World Health Organization 5.9 million children under the age of 5 died in 2015, worldwide.  More than half of these deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.  Leading causes of death in under-5 children are premature birth complications, pneumonia, birth asphyxia (lack of oxygen), diarrhea and malaria.  About 45% of all child deaths are linked to malnutrition.

Neonatal Death

A child’s risk of dying is highest in the neonatal period – the first 28 days of life.  Safe child birth and effective neonatal care are essential to prevent these deaths.  Upto one half of all neonatal deaths occur within 24 hours of life. 75% occur in the first week.  The 48 hours immediately following birth is most crucial period for new born survival.

What can be done to reduce neonatal mortality?  The followings:

  • Mothers should receive antenatal care (prior to birth) form a skilled health worker.
  • Mothers should be immunized against tetanus.
  • Mothers should not smoke and drink during pregnancy.
  • All births (if possible) should be attended by a skilled health worker at home or in a hospital.
  • Washing hands before touching the baby to reduce infection.
  • Cutting the umbilical cord with sterile equipment.
  • Keeping the baby warm (skin to skin contact between mother and baby).
  • Ensuring that the baby is breathing.
  • Starting the new born on exclusive breast feeding right away (no formula).
  • Early transfer of premature and sick babies to an appropriate center for further care.

Under – 5 Child Deaths 

More than half of under – 5 (under 5 years of age) child deaths in developing countries are due to diseases that are preventable and treatable through simple, affordable interventions.  Malnourished children, particularly those with severe acute malnutrition have a higher risk of death from common child hood illness such as diarrhea, pneumonia and malaria.  Nutrition – related factors contribute to about 45% of deaths in children below 5 years of age.  Following steps can be taken to reduce under – 5 child deaths.

  • Breast feeding of all children as long as possible.Breast feeding children have less diarrhea and infections.
  • Provide adequate nutrition to all children.
  • Provide safe – drinking water.
  • Provide adequate sanitation and hygiene.
  • Provide mosquito nets to all families.
  • Provide vaccinations to all children.
  • Provide oral rehydration solutions for diarrhea (ORT).


Some of the most deadly childhood diseases, such as measles, polio, diphtheria, tetanus, whooping cough, pneumonia (due to Hemophilus, influenza andStrept pneumonia), hepatitis A, hepatitis B, TB (BCG), rotavirus (for diarrhea) can be prevented by vaccination.  All the children should be immunized against these diseases.  Vaccinations for malaria, HIV/AIDS are being developed.More and more vaccines for other diseases are also being developed.

Other Preventable Deaths 

Injuries (road traffic, drowning burns, and falls) rank among the top 3 causes of death and lifelong disability among children 5-15 years.

Similarly, the world wide number of overweight children increased from 32 million in 2000 to 42 million in 2013.  Even in developing countries like – India, the childhood obesity rate is increasing.  It is estimated that by 2025, the overweight rate of under – 5 years of age will rise to estimate 11% from present 7% worldwide.

Causes of childhood obesity are very similar to adults – more total caloric consumption compared to total caloric use.   Young children who are overweight are likely to be overweight and obese as adults.  The health risk is very similar – type 2 diabetes, heart disease, high blood pressure, sleep apnea and lack of stamina to play and have a good time.  Incidence of depression is also higher.

Saheb Sahu, M.D., F.A.A.P., MPH.




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