Children, The Family and Health: What it Takes to Give Children Long Life
The Singapore Workshop: The Role of Mother in the Family on Children’s Health Under Ten
The family that is the smallest social unit is the measure of a healthy society. A healthy family is a healthy nation.
Definition of the children’s health means not only good health physically, but also mentally as well as socially. In order to get children health main influenced factor which related to the children’s health problem have to be considered such as most common disease in children, nutrition, water and environmental sanitation, healthy settlement, education and early childhood care. In Indonesia the role of mother in maintaining the child health followed the result of the World Convention on the Right of the Child (CRC) based on six basic needs. Those are: love and care, child health care, good nutrition, education and stimulation to the child, prevention from accident and family planning.
The role of mother also followed the progress made toward achieving the World Summit for Children (WSC) goals for the year 2000 which each country has adopted in the National programs of action.
Children of school age phase, they followed school health service program which one of the health care program is immunization for the children, in this case cooperation between mother and the teacher is important. For the children that need special protection like disabled/handicapped children, mother should cooperate with the social worker. Literacy for female or mother and children is very important in order to get comfortable in absorbing health information and to get better health education. Active participation in utilized health facilities surrounded like Integrated Health Post (POSYANDU), or Health Centers (PUSKESMAS) and other facilities for seeking better health care needs action by the mother. Well being of children is a shared responsibility of families, communities, the private sector, non government organization (NGO), International Organization, government institutions, the mass media and children themselves.
I. Introduction
Child morbidity and mortality results in a large “burden of disease” in developing countries including Indonesia. Efforts have been made for quite a long time to reduce child mortality and morbidity through several interventions.
Most of the deaths occurred from infectious disease that is diarrhea disease, acute respiratory infection, measles and malaria.
Malnutrition also makes a major contribution to the number of deaths. Child survival intervention through immunization, nutrition, education, sanitation and better health care should be a mother role, which depend on her capacity.
All of this intervention is stated in the World Summit for Children (WSC) and the World Convention on the Right of the Child (CRC). In the case of children under difficult circumstances or children that need special protection, the role of mother needs cooperation with the social worker. Utilization of health facilities provided by government to protect the children health and national program in health sector with so far played important role in the survival of Indonesian children should be pay attention to the mother as a role. Maintaining and preventing children in order to make them always healthy is more important than just taking care of them while they are sick.
II. General Overview and Health Present Status
The majority (about 85%) of the population follows Islam. Health efforts in Indonesia are aimed at achieving a more even distribution of health services within the entire social spectrum. Emphasis is placed on health services delivery to groups most vulnerable to health hazard, such as pregnancy, woman and children especially under 5 year of age. A health status in Indonesia shows the estimated Infant Mortality Rate (IMR) in 1996 was 54/1000 live births. The child mortality death rate (CMR) estimated by Central Bureau Statistics was 81/1000 (1993); the number of Maternal Mortality Rate (MMR) was 373/100.000 (1996, House Hold Survey) and life expectancy at birth was 61.9 years for male and 65.7 for female (1996). The economic growth had resulted in the increase of the income per capita. The population income per capita was about 1,000 USD (1996) but due to the economic crisis that was attacking Indonesia this figure is tremendously down And the Growth National Product (GNP) was USD 980.00 (1996).
Basic education for children is compulsory in primary school. Adult illiteracy to women is 18.6% (1995).
III. Problems to be Addressed
Indonesian’s Infant Mortality Rate (IMR), Child Mortality Rate (CMR) and Maternal Mortality Rate (MMR) is relatively high compared to neighboring countries.
Most of the deaths in young children occurred from infectious disease. That is: acute respiratory infections (pneumonia, bronchitis, and tuberculosis), diarrhea disease, measles and malaria. Another infectious disease such as poliomyelitis, tetanus, pertusis, measles, hepatitis are covered in a large number. The programs of immunization to ensure child survival by vaccinating children against these diseases have to be enhanced.
Malnutrition also makes major contributions to the number of deaths. There are four persistent nutritional problems in Indonesia; first, Protein Energy Malnutrition (PEM) particularly among under fives and pregnant mother, PEM impairs physical and mental growth; second, deficiency of vitamin A. The risk of this vitamin deficiency is blindness; third, iodine deficiency. This will impact physical disorder like goiter and cretinism and more Over decline Intelligent Quotient ( IQ ); fourth, nutritional anemia problem which is still extensively provability among pregnant women and children because of deficiency of iron folat.
Poor progress in sanitation particularly in management of human excretions or sewage, difficult to get saved and cleaned water will caused the majority of infectious disease in children, especially diarrhea disease.
The impact the crisis of economic very severe the educational sector both to mother and children. All mothers should receive adequate health education in order to give better health education the children
These crisis also reduce school enrolment of the children in acsessing basic education. Most of the mothers haven’t received adequate health education including information about the desirability of breast feeding to be empowered to make an informed choice on how she will feed her baby
IV. The Role of Mother
The role of mother in maintaining the child health should be followed as the result of the World Convention on the Right of the Children (1989), which based on six basic needs. In Indonesia the role of mother to the children under five consist of love and care, child health care, good nutrition, education and stimulation to the child, prevention from accident and family planning. On the child 6- 10 years or on school age phase, the role of mother as a care giver should follow school health services program named Upaya Kesehatan Sekolah or UKS. The services consist of health care, environmental health and health education. Having good cooperation with the teacher is one important factor. Teacher may help parent/mother by giving the regular progress report about the children in all aspects, both emotionally and physically. For example, mother should cooperate with the teacher at school in preparing the children to have immunization at definite time. This effort would be expected to reduce children mortality rate caused by the disease such as diphtheria, pertusis, tetanus, polio, measles, hepatitis and tuberculosis. Besides, mother also has to monitor the child to have additional food based on school health services program. In order to get a healthy behavioral life for the children mother should educate them to develop positive understanding of health and to apply a healthy life as a part of their daily life based on their conscience, so the education of mother should be able to change their knowledge attitude and health practice in daily life. It would be reflected in their daily life either inside or outside the house, for example like how they maintain their personal hygiene (clean and healthy body, clothes, nail, teeth, ears, hair etc). In order to give good health education to the child, mother should increase her knowledge on health continuously. Ability to read and to write is important to the mother in order to get quick absorb information properly. Good environment as a precondition for a healthy and community life consist of physicaly, biologicaly and social environment.
Several actions could be done, such as to have a healthy house by having proper air ventilation to get fresh air and sunshine as a part of pollution control as well as pesticide control such as eliminating breeding nets of mosquitoes, flies, cockroaches, rat habitat. To get clean water supply is the one that mother should do because the increase of using clean water would reduce the cases of water borne diseases such as diarrhea, cholera and dysentery. Mother also responsible to manage of sewage and waste disposal as well as housing sanitation and environment around the house. Mother should do active participation in utililising integrated health post (Posyandu) facilities seeking better health care to her health and her babies health checking and counseling. The Posyandu is a health services unit provided by and for the community and supported by the Health Center periodically. It renders Five basic health programs: family planning; maternal and child health; nutrition immunization; and diarrhea disease control in order to manage the women and children health in the village community. At the POSYANDU beside the health worker, mother could see the family welfare movement (PKK) which majority as Posyandu’s cadrees. To get a healthy child begin with the mother herself. Mother should have a good health. That’s mean women have to take care her health from the beginning of period productive phase (before marriage) followed by during pregnancy until the time delivering her baby and then growing up her child. Exclusive breast feeding to the baby after the fourth month is one of the Indonesian targets on child welfare by the year 2000. Mother should accompany the child to see the health worker or the doctor at the health center or the private practice and give them proper medication based on the doctor’s advice. Regular visit to the health institution for consultation is important in order to monitor her child both physically and mentally. Nutritive status is a positive health indicator which is measured to access growth and development particularly to the young children, balanced nutrition is needed to the child. Nutrition consisting of high rates of protein is needed for pregnant women and children in order not to have protein deficiency. Anemia due to inadequate nutrition is still a health problem in Indonesia. Giving proper Fe (Iron) Folat tablet would be one of the best solution. Distribution of Iron tablet through health centers and Posyandus in order to eliminate vitamin A deficiency on children. Mother should select food which consist of rich vitamin A or the use of Vitamin A capsule. The usage of Iodized salt or Iodized oil capsule implemented by mother will protect the children from cretinism due to Iodine deficiency. To give nutritious meal for the child, mother should maintain the quality of food from the beginning to chose and to select the menu as well as to prepare, mode of processing and to serve the meals also to whom the food will be fed. Finally the role of the mother also cover children under difficult circumstances or children who need special protection, like disable/handicapped children through the cooperation with the social worker.
Last Modified: November 29, 2002