Children, The Family and Health: What it Takes to Give Children Long Life
The Singapore Workshop: Towards Better Health for Our Young Children
I am happy to be here this evening to officiate at the opening of the Workshop on “Children, The Family and Health”, organized by the Singapore Council of Women’s Organisations on behalf of the Pan Pacific and Southeast Asia Women’s Association (PPSEAWA). I would also like to extend a very warm welcome to all our local and overseas participants who will, over the next days discuss the state of health of younger children in our region, as well as establish ways to improve their health conditions.
Children are our most important and vital asset who will influence the future of our society. A healthy child will grow into a healthy adult. Good health combined with a stimulatory environment can help ensure that the full potential of our children is achieved.
Health in Children - The Size of the Problem
On a worldwide scale, it is reported that about 12 million children die each year before the age of five years. This occurs mainly in the developing countries. Nearly three-quarters of these childhood deaths are caused by preventable conditions, namely pneumonia, diarrhoea, measles, malaria and malnutrition.
More thatn two million children die of pneumonia annually. Diarrhoeal diseases, which are often caused by consumption of contaminated food and water, account for another two million childhood deaths every year. Measles is the third major killer responsible for infecting over 40 million children and killing more than 800,000, followed by Malaria which claims the lives of 600,000 children. In certain parts of the world, malnutrition continues to be the main cause of ill health and even childhood death. This is due not only to a lack of food, but also to poor feeding practices, poor knowledge of the type and range of food to feed the child, and unattended illnesses.
Alarming and sad though it is, it has been predicted that these five conditions will continue to be the major causes of childhood mortality in the year 2020, if efforts are not made to prevent and control them now. We cannot aford to let this tragic scenario happen. We must do something to prevent these diseases from claiming more innocent young lives in the developing world.
Although each country in the region has to work under its own set of unique circumstances, there is much we can share in terms of ideas and experiences.
Maintaining Good Health in our very young children
In Singapore we have learned that disease prevention and health promotion are the best strategies to combat illness and all the costs and suffering that illness brings to individuals, families and the community. Investing in hospitals, clinics, drugs and equipment to treat the sick is necessary, but this can never be enough because, like all other coountries, our resources are limited. Thus, we place a great deal of emphasis on disease prevention and health promotion. This applies to both the young and the adult population.
About 16% of our resident population are below the age of 10 and about 8 % are below the age of five. Although our infant mortality rate at 3.6 per 1,000 live births (1997) is one of the lowest in the world, my Ministry takes child health seriously. We provide a systematic and comprehensive schedule of immunization and child health surveillance for young children. Our immunization programme has been very successful, as 90% and more of our very young pre-school children are immunized against the nine major infectious diseases (These are: TB, hepatitus B, diptheria, whooping cough, tetanus, polio, measles, mumps and rubella). For school-going children, my Ministry also provides health screening, immunization and health education through school and clinic based programmes. In this way, health problems can be detected early, communicable diseases prevented, and good health habits incalcated.
With the elimination of the major communicable diseases among our chiodren, the leading causes of morbidity and mortality among children in Singapore are congenital abnormalities, although the numbers affected are very small. We have set up a system to screen all newborn babies. Blood tests are routinely done for all newborns to detect two very important conditions, namely G6PD deficiency and congenital hypothyroidism. All pregnant women have acess to antenatal care. Genetic counselling is available to all those who have a history of genetic conditions such as thalessemia. In many hospitals, birth defects clinics have been set up to manage children with birth defects. My Ministry has set up a national Birth Defects Registry to help monitor the trend of common birth defects so that appropriate attention can be given. As a result of all these measures, the number of children with severe congenital abnormalities has remained low.
As the child grows, my Ministry continues to monitor his physical and social development, through child health screening or surveillance programmes at our Government clinics. These programmes have been implemented since the start of the 1970’s in all our Government clinics. They are regularly updated and improved upon with the latest major revision in 1998, to ensure early detection of any developmental abnormalities, so that early intervention can be introduced. These programmes are provided free of charge and are offered at regular intervals, coinciding with the child’s clinic attendance for immunization. This has ensured that the response rate of children to our developmental screening programme is nearly 80% of all children.
Our school Health Service also provides school-based medical screening, vaccination and health education to all students. The medical screening includes growth and development, eyesight and spinal screening at critical stages of the child’s development. Where necessary, the child is referred to a specialist at the Student Health Centre.
I might have given you the impression that all that needs to be done to ensure good health is to have good screening programmes and good child health services provided by the Government. This is not true. Apart from the role of the Government, parental involvement is most important to the success of any child health surveillance programme. Parents are ultimately responsible for ensuring the child’s health. Immunization may be offered free of charge and parents receive reminders to bring their young child for immunization at the required intervals. It is the parents who have to bring the child to receive the immunization. Thus, parent’s education is a very important component of our child health surveilance programmes. For example, during the immunization visits, the child’s health and development are assessed and reviewed with parents. A questionnaire on various aspects of the child’s health and development is also given to the parents when the child resches specific ages. This is particularly useful as parents are in constant contact with their children, and any problem noted by parents can be identified quickly and highlighted to the doctor.
Apart from parental involvement, we have learnt that community participation is also important for disease prevention and health promotion; community participation is effective in spreading knowledge, skills and attitudes about child health issues. Thus, my Ministry regularly and frequently holds educational talks on child care and nutrition demonstrations for children of various ages. These are conducted not only at government polyclinics, but also at community centres throughout the island. One particular community activity that has been found to be attractive to participants from the community is healthy baby competitions. These invariably draw crowds and enthusiastic participants from among mothers, grandparents, caregivers and so on. These are good occasions to spread the right messages on health and nutrition for infants andyoung children. On a more serious note, my ministry organises health talks and roving health education exhibitions that go around the community centres at every possible opportunity provided by community organisations.
To conclude, one of the most important aspects in child health management is a healthy environment. A healthy home and living environment is essential in the healthy development of the child. Good hygiene and good feeding practices should be practiced rigorously at home, in the nursery and in school. Parents have a duty to provide a healthy home and to ensure that children get prompt medical care when required, receive proper immunizations, and undergo child health checks regularly. All these will go a long way in achieving continuous good health for our children.
The role of the Workshop Participants
All the participants here have been working with children. Whether you are a teacher, a community worker, a social worker or a parent, you have an important role to play in the development of good health in children. Over the next days you will have the opportunity to identify, discuss and share your experiences in tackling health problems in children of the Pan Pacific Southeast Asian countries. I hope the workshop will prove to be enlightening and fruitful for all participants and observers.
On that note, I have the pleasure to officially open the Workshop on “Children, The Family and Health”.
Last Modified: June 05, 2010