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Introductory 1 Introductory Who is a child ? reasons for giving loving care to children, l A child is a growing person. Thus the there are more compelling reasons why child Pediatric age group includes boys and health is a top priority. These are listed below: girls till they complete their growth and l Children below 18 years form more this occurs at approximately 16 years than half of India's population in girls and 18 years in boys. Pediatrics Therefore the mere force of numbers therefore deals with this early and demands attention and investment in sensitive period of growing years. terms of financial allocations. l A child should not be considered a l Growing children are more vulnerable small or compressed adult. All that to sickness and death than the adult applies to the adult does not population, particularly in automatically apply to the child on a underdeveloped and developing smaller scale. countries. l The differences are both quantitative l Children are said to be an economic as well as qualitative, and are : resource to the country and therefore v In body structure no country can afford to ignore this v In function important human resource. v In response to disease l There are many diseases in childhood v In response to medication. which, if not detected and treated These differences are discussed promptly in childhood can result in elsewhere in this book. increased sickness, poor quality of life Definition of age groups and diminished longevity in adulthood. Therefore health care and The newborn differs from the infant, prompt treatment given to ensure good the infant from a toddler, a toddler from a health in childhood automatically school child and the school child from the ensures normal healthy adulthood, adolescent. Conventionally, children are grouped into the following age groups on proving the adage that "Pediatrics is the basis of differences and peculiarities in Preventive Medicine" their growth and development after birth. Hence, whatever the reason, children are a priority to any nation. Greater the care Why is child care a priority ? and attention given to them in terms of their Apart from the mere sentimental welfare, more prosperous and developed is PREGNANCY 1ST BIRTH TO BIRTH TO 1ST 5 TO 12 TO 16 GIRLS 28th Week 7 DAYS 28 DAYS 12MONTHS 5 YRS 12 YRS 12 TO 18 BOYS EMBRYO PERINATAL NEONATE INFANT PRE- SCHOOL ADOLESCENT & & FETUS PERIOD SCHOOLER CHILD SCHOOL CHILD that nation. Given below are some As a consequence of these population facts that underline the priority disadvantages, these populations suffer from that is due to children and the vulnerable higher rates of sickness (Morbidity) and population that includes mothers in the death (Mortality) and these are shown in the child bearing age. tables given below. Morbidity and Mortality Age group Approximate or Proportion of Certain commonly used parameters Parameter population that give a measure of sickness and death in a community are defined below: Less than 1 year 3 per cent l Morbidity: Relates to illness. 1 to 3 years 6 per cent l Mortality: Relates to deaths 3 to 6 years 8 per cent l Morbidity rate: Number of people sick Total 1 to 6 yeas 17 per cent or disabled in a defined population per unit population per year. May relate to Children below 14 yrs 40 per cent area, age groups, sex, and community. Mothers 15-44 yrs. 22 per cent l Mortality rate: This relates to number Child bearing age of deaths in a defined population per Total Vulnerable population 62 per cent unit population per year. May relate to age, sex, area, community, also in Current scenario in disadvantaged relation to disease, communities: l Incidence of a disease: Number of Major proportions of populations of people falling sick in a given period of developing countries suffer from certain time in a given population. For disadvantages. These make them vulnerable example Incidence of Polio means how to higher rates of disease and death. many new cases appear every year. It does not include the cases already These disadvantages are: affected in previous years. l Large populations from high birth l Prevalence of a disease: Number of rates. people ill from a disease at any one l Poverty: among families, regions and point of time in a given population. states. For example prevalence of polio l Lack of education means how many cases of polio can be counted at one time in a given l Nutritional deficiencies community. It includes old cases that l Higher rates of infections from may already be afflicted with polio crowding and poor hygiene plus the new ones that may be present l Poor transport facilities in rural areas at the time of a survey. l Poor outreach of educational and For mortality rate see table below health services 2 Selected rates by country for crude For the sake of measuring health care birth rates, infant mortality rates and of the population in general and children in under-five mortality rates (2007) particular, terms in common use, their definition and significance are given in the Crude IMR Under-five table (see below): Country birth per mortality rate per 1000 rate per Rights of the Child 1000 live 1000 live popu births births With progress and awakening of lation people, awareness of the needs and rights of children and women has been appreciated. India 23 54 72 International organizations like the WHO, Pakistan 27 73 90 UNICEF and others have established targets Bangladesh 25 47 61 for their health and welfare. Each nation has Thailand 15 6 7 its own programs and constitution designed to promote health of children. Sri Lanka 15 17 21 China 13 19 22 United Nation's declaration of the Switzerland 9 4 5 rights of the child: UK 12 5 6 The declaration of the rights of the USA 14 7 8 child was adopted by the General Assembly of the United Nations, on 20th November Singapore 8 2 3 1959. These are: Japan 8 3 4 1. Right to develop in an atmosphere of TERM USED DEFINITION SIGNIFICANCE Infant Mortality Number of deaths under age I year Indicates health status of a community, Rate (IMR) per thousand live births in a defined particularly efficiency of perinatal community services. Under Five Number of deaths under 5 years in a Reflects health services for children in Mortality Rate given year, per thousand live births the community, especially related to newborn care, immunization, nutrition, medical & health services. Maternal Mortality Total number of deaths in women at Measures risk of women dying from Rate child birth or within 42 days during a causes at labor and therefore reflects given year per thousand live births in socioeconomic, obstetric and related a defined community health status Neonatal Mortality Number of deaths during first 28 days Reflects deaths from low birth weight Rate per thousand live births in a year and congenital disorders (internal causes). Reflects care in antenatal period and labor. Post neonatal Deaths between age 28 days and I Unlike Neonatal, Post-neonatal Mortality Rate year per thousand total live births mortality indicates deaths from external during the given year causes 3 affection and security and wherever children below the age of 14 years in possible, in the care and under the factories responsibility of parents l Article 39: prevents abuse of children 2. Right to enjoy benefits of social of tender age security, including nutrition, housing l Article 45: provides for free and and medical care. compulsory education for all children 3. Right to free education until they complete the age of 14 4. Right to full opportunity for play and years. recreation National Policy for children 5. Right to a name and nationality In August 1974, the Government of 6. Right to special care if handicapped India adopted a National Policy for Children 7. Right to be among the first to receive which declares: protection and relief in times of "It shall be the policy of the State to disaster. provide adequate services to children, both 8. Right to learn to be a useful member before and after birth and through the period of society and to develop in a healthy of growth, to ensure their full physical, and normal manner and in conditions mental and social development. The State of freedom and dignity shall progressively increase the scope of such 9. Right to be brought up in a spirit of services so that within a reasonable time, all understanding, tolerance, friendship children in the country enjoy optimum among people, peace and universal conditions for their balanced growth" brotherhood Universal Children's day: 10. Right to enjoy these rights regardless of race, color, sex religion, national or In 1954, November 14 was designated social origin. as "universal children's day" by the UN general assembly assigning to UNICEF the Relevant articles in the Constitution responsibility of organizing celebrations on of India: the day for promotion of child care. l Article 24: prohibits employment of 4 Who is a good Pediatrician? l Knowledge is acquired from books, Children need 'tender loving care'. Let lectures, discussions and so on. us call it 'TLC' which should be the central l Skills can be learnt in stages, e.g., first object of caring for children both well and by reading instructions of a particular sick. Well children need attention for procedure then watching the ensuring continued, illness-free growth techniques being carried out by through monitoring and charting growth experienced teachers and senior periodically, immunization and education to colleagues, and finally carrying it out mothers. Sick children need support and under supervision before finally doing professional care during the illness The it independently.
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