Child Health and the Integrated Management of Childhood Illness
Biehl and Petryna (2013) in “When People Come First” argue that in international health interventions, there is often a narrow focus on the “triad of technology delivery, patient compliance, and the basic science of disease”. This statement means that the provision of technological health in terms of medicine and equipment, eyeing a specific disease, without having a look into other factors such economy and political influence is as good as inadequate since the outcomes may not be as favorable as interventions intends. This means that global health should take into consideration on how other factors shape the health system and the consequences that may result if ignorance is followed. For example, determinants of health, such as education, water, sanitation and hygiene, vector management, and pollution, should be addressed singly not forgetting the relationship they bear to economic development, good political leadership, and human rights at large (Biehl and Petryna, 2013). The case of January is a vivid example with a reflection that illness and technology delivery are two different things and the fact that there is efficient technology does not mean that the health needs of patients are taken care of. The interaction between biology and technology is a complication that cannot be put into understanding by patients. Reasonably, for the better delivery of quality health services, the global health should in involving all other factors that contribute to the vulnerability of people at risk of diseases and also for the interest of the poor (World Health Organization 2002)
Integrated management of childhood and (newborn) IMNCI is a worth considerable intervention since it addresses multiple factors that subject children to multiple disease risks as compared to diagnosing a single disease (WHO, 2016). In developing countries, children brought for medical attention have rottenly suffered uncountable conditions. IMNCI goes a mile higher in ensuring combined treatment of these conditions thus assuring the prevention and treatment of critical childhood illness through proper immunization and correct nutrition. Through multi-county evaluation, IMNCI has been found efficient in terms of planning in child health advocacy by the concerned government and international health policies. The effectiveness of this intervention is evidenced in countries such as Brazil, Bangladesh, Peru, Uganda, and the United Republic of Tanzania (WHO, 2016). The double edge management of diseases has yielded positive results owing to the fact that multiple agencies and dialogue bases approaches have linked in a profitable manner leading to effectiveness in health provision. Through IMNCI, Malawi and Nepal have achieved substantial decreased infant and neonatal death rates in the past two decades, with appropriate adoption of strategic community involvement supported by community health workers on top of IMNCI, local groups, and health committees (WHO, 2016).
Despite its flourishing outcomes, IMNCI has faced a number of challenges. Adoption of new material and the retraining of IMNCI trained workers is very hectic, time-consuming, resource taking far away from service delivery (WHO, 2016). Also, insufficient human and monetary resources to reach out various countries are such a big hurdle for this intervention (Bhandari 2012; WHO 2016). Finding a quantity number of sick newborns for a demonstration in health centers is a setback in the IMNCI training sites. Additionally, there is a derisory provision of quantity health services at community levels, since some other governments restrict the participation of community health workers in treating sick newborns. Great difficulties are experienced in the adoption of flexibility rigidity and consumer centered current guidelines of IMNCI (WHO 2016). There are also hiccups in implementation of IMNCI policies due to unreliable infrastructure, slanted poverty, and unproved data that was incorporated in the guidelines.
Sexual and Reproductive Health
The key components of health intervention related to sexual and reproductive health, according to World Health Organization is to; upgrade maternal health, ensure family planning reduce child mortality rates and battle diseases such as HIV/AIDS, malaria, and other diseases that directly affect the reproductive and sexual health (WHO 2004). Other areas of concern included acute poverty and hunger suppression, empowerment of the girl child, and influence gender parity thus ensuring favorable environment. However, in obtaining this component there is a lot of issues on the ground. For instance, barriers to progress such as gender inequity especially in health sectors have been an issue over time (WHO 2004). Families rarely invest in nutrition school and also vocational training for girls as compared to boys. This kind of sexual discrimination has led to physical, mental and emotional stress resulting in poor control of lives, especially sexual and reproductive lives. Other challenges such as gender based violence, adolescent’s exposure to risks, unequal access to health services and lack of resources have also heavily contributed to the failure in achieving the above components (WHO 2004).
Numerous health interventions in Rwanda have confirmed the effectiveness of family planning in terms of human rights, health outcomes, and birth rates at large. According to Westoff (2013), Rwanda has significantly increased in the use of family planning from 17% to 52%. The government of Rwanda has largely promoted family planning initiative this assuring health lives. After the 1994 genocide, family planning program was abolished and by the year 2002, Rwanda was the leading population in Africa (Westoff, 2013). The input of the government initiative to curb population growth to manageable sizes has really bored fruits. In the year 2005, the Rwandese government through the ministry of health created a maternal child health care division to particularly address the issue of maternal and child mortality and also the low rates of contraceptive usage (Westoff, 2013)
Maternal and Perinatal Health
Continuum care refers to the integrated individualized patient care and condition management aiming at promoting suitable and quality care linked to all patients under care by ensuring that no patient is lost in the process of follow up (Kerber et al. 2007). It also refers to the right person at the right time and in the right place providing quality health care. the main challenges that led to the rise of continuum care for patients and health care clients include; the difficulties in accessing palliative care systems, lack of neonatal, maternal, and child healthcare in third world countries (Kerber et al. 2007). Besides, lack of women services to prepare for their pregnancies and also treat sexually transmitted diseases gave a hand in coming up with his kind of approach. Unsafe childbirth, which leads to mother-child mortality rates in developing countries was also a significant challenge which triggered the continuum care approach, especially for the antenatal facilities (Kerber et al. 2007). The need of family planning for women in reproductive age group and also the lack of appropriate education for adolescents on their nutrition and reproductive health are among key factors that led to the build of continuum care (Kerber et al. 2007).
Adolescents’ exposure to risks such as teenage pregnancy is a major problem relates to sexual and reproductive health rights. In most developing countries taboos such genital mutilation, early girl child marriage and early initiation to sex pose a great challenge when it comes to shading of light to this generation, in terms of health reproduction and any other form of support that is necessary for their health (SRHR, 2014). Adolescents have unquestionably high sexual and reproductive issues such as sexually transmitted infections, rape, defilement and high risk of getting HIV/AIDS. Gender-based violence still exists as far as the implementation of interventions is concerned. Realistically, adolescents will still indulge in early and irresponsible sex that will instantly and progressively affect their health (SRHR, 2014). For young girls, the challenge of high-risk mortality and morbidity which is associated with early pregnancy will still be expected. For instance, studies shows that Uganda has uncountable teenage sexual and reproductive issue, calling for immediate adolescent friendly interventions to address them. Therefore, there is an urgent need for interventions to meet and protect the rights of adolescents’ especially young girls in order to secure their better future (SRHR, 2014).
HIV-AIDS and the Global Tuberculosis Programme
Tuberculosis (TB) is a chief cause of morbidity and mortality all over the world, thus being accountable for more than 9.6 million emerging cases and not less than 1.5 million deaths in every year (WHO 2015). The less rich and socially barred individuals suffer the most. Thus, there is essential need to address the immediate social factors affecting health by firstly looking into ways of eradicating poverty and reaching the most targeted group whose risks are high. The global tuberculosis program aims at early and worldwide access to TB prevention measures, care, and control, prevention of external and threatening factors, and of implementation innovative ideologies (WHO 2015). Everyone suffering from TB has a right to access to quality and innovative services that can meaningfully aid in the diagnosis, prevention, and care of T.B. The global tuberculosis program also aims at ensuring that all TB patients have an equivalent, unconstrained admission to reasonably priced services, and importantly engaged in their well-being. Global tuberculosis program also targets wider coverage of universal health with the assurance of appropriate drugs and complete tuberculosis care. Countries are called upon to adopt this policy through advocacy, correct baseline preparedness a medications, and setting of baseline (WHO 2015). Collaboration in adopting tuberculosis program among different organizations and ministries is also considered sensible.
Major challenges facing this program include; the existing gap of funding by donors, more than 3.6 million of people infected go missing and therefore do not get access to TB medications and lack of accelerative response among the TB/HIV-infected (World health organization 2015). Marginalized people are constantly exposed to health problems such as TB and mostly find it difficult to access health services, making TB prevention more challenging. There is an urgent need for programs such as global fund to respond to the emerging co-epidemic of TB/HIV deeply and intensively because of the existing difficult in TB management, resulting from inadequate coverage of mutual TB/HIV programs (WHO 2015).
Bibliography
Bhandari, N., Mazumder, S., Taneja, S., Sommerfelt, H. and Strand, T.A., 2012. Effect of implementation of Integrated Management of Neonatal and Childhood Illness (IMNCI) programme on neonatal and infant mortality: Cluster randomised controlled trial. Bmj, 344, p.e1634.
Biehl, J. G., & Petryna, A. (2013). When People Come First: Critical Studies in Global Health. Princeton University Press.
Kerber, K.J., de Graft-Johnson, J.E., Bhutta, Z.A., Okong, P., Starrs, A. and Lawn, J.E., 2007. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet, 370(9595), pp.1358-1369.
SRHR Policy Brief 2014. Sexual and reproductive health rights. Available at http://srhr.dk/wp-content/uploads/2016/01/SRHR-Policy-Brief-2014.pdf (Accessed 17 May 2017)
Westoff, C. F. (2013). The recent fertility transition in Rwanda. PoPulation and develoPment review, 38(s1), 169-178.
World Health Organization, 2002. The world health report 2002: reducing risks, promoting healthy life. World Health Organization.
World Health Organization. 2004. Reproductive health strategy to accelerate progress towards the attainment of international development goals and targets. World Health Organization.
World Health Organization. 2015. The End TB Strategy. World Health Organization.
World Health Organization. 2016. Towards a Grand Convergence for Child Survival and Health. [online]. Available at http://apps.who.int/iris/bitstream/10665/251855/1/WHO-MCA-16.04-eng.pdf (Accessed 19 May 2017).
