World Health Assembly Endorses New Strategies to Combat Child and Adolescent Mortality

The World Health Assembly has given a powerful endorsement to new strategic directions for child and adolescent health. The strategy brings together crucial elements to reduce childhood deaths and long term disability. It also aims to reduce the 1.4 million adolescent deaths each year.Last year, the number of children and adolescents who died was double the total number of adult deaths from AIDS, tuberculosis and malaria combined. In 2000 10.8 million children under five years old died, over half of them from just five preventable communicable diseases and malnutrition. 99% of these deaths are in developing countries.“This strong support and reinforced commitment by the Member States to strengthen child and adolescent health comes at a crucial time in our efforts to save the lives of millions of children“ says Dr Tomris Turmen, Executive Director of Family and Community Health at WHO. “In recent years there has been a decrease in funding for child heath. This must be reversed. This expression of political will must be backed by more money and more human resources to accelerate development and scaling-up of effective child and adolescent health interventions at both global and country levels."In addition to highlighting the urgent need to reduce child mortality the strategy also focuses on adolescents. There are 1.2 billion adolescents world wide who face specific health threats such as HIV/AIDS, tobacco and alcohol use, depression, suicide and violence. The impact of these health problems is dramatic. Each day among adolescents there are 6000 new HIV infections, 45,000 babies born, 40,000 young people who start using tobacco, 10,000 attempted suicides with 250 deaths, 1,400 deaths from injuries and 16,000 girls who are sexually abused.An important new element of the strategy is the adoption of a life course approach to child and adolescent health. This recognizes that the quality of life at early ages is important not only for immediate wellbeing, but also for health and development later in life and, given the crucial links between maternal, neonatal and child health, for the health of future generations.“The improvement of child and adolescent health should be the easiest of the Millenium Development Goals to achieve. We can prevent and treat childhood diseases. We know a skilled attendant at delivery can save the lives of many mothers and their babies. We know that if we listen to young people the quality of health care they receive will improve. But knowledge alone is not enough. We need to follow through with new resources to revitalise our efforts. This strategy shows the way," says Dr Turmen.Seven areas have been identified as priorities for future action: Health of mothers and new borns the health and survival of the child, especially in early infancy, is intricately linked with the health of the mother, her nutritional status, and the reproductive health care she receives.Nutrition for healthy development better nutrition can break the vicious spiral of poor nutrition leading to ill-health and ill-health causing further deterioration of nutritional status often leading to death.Preventable communicable diseases can be drastically reduced through three activities: the Expanded Programme on Immunization, Integrated Management of Childhood Illnesses, and preventing mother-to-child transmission of HIV and reducing HIV among young people.Injuries community-based interventions have reduced the rates of injuries in many countries but further work is required to broaden the range of effective interventions.Physical environment can be improved by focusing on six priority issues: household water security, hygiene and sanitation, air pollution, disease vectors, chemical hazards, and injuries and accidents. - Health of adolescents – can be safeguarded when valuable relationships are established with trusted adults, and there are structures and boundaries around behaviours. Supporting protective factors are equally important to preventing risk factors.Psychosocial development and mental health affect almost 20% of children who have one or more mental or behavioural problems.Children and adolescents in difficult circumstances including street children, children at work, children and adolescents subject to commercial exploitation, those affected by natural or man made disasters, or those living with disabilities need special attention.