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CHILD HEALTH SEMINARCHILD HEALTH SEMINAR

GROUP 1

CHILD HEALTH STATUS

AND CHILD HEALTH

SERVICES IN MALAYSIAAND SUDAN

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GROUP MEMBERSG

ROUP MEMBERS DR. LEELA A/P V SABAPATHY

PN ROSMINAH BT MOHD.DIN PN CHE PUN BT BUJANG

DR OSMAN HASSAN ELHAG BILAIL

MR SHAALDEEN HAMZA ELHUSEIN DR ABDELGADIR SULIMAN SALEH

DR BUSHRA AHMED ABDGADIR

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CHILD HEALTHCHILD HEALTH

SERVICES IN MALAYSIASERVICES IN MALAYSIA

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POST INDEPENDENCEPOST INDEPENDENCE

3 tier system of referral for MCH care

Unit consist:

Main Health centre, 4 health subcentres and20 midwife stations

- Each midwife station covering 2000 popn

- Mid 50s- immunization vs diptheria & tetanus

- 1961- BCG Immunization to all newborn

babies

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Child health services in 1970sChild health services in 1970s

1972- Routine infant and childimmunization for TB ,poliomyelitis,

DPT integrated into existing MCH

services 1974- 2 tier system rural health services

-Health centres for 15-20,000 popn

-Midwife clinic upgraded to kelinikdesa with 2 community nurse for

4000 population

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Child Health ServicesChild Health Services 70s70s

Delivery health care to infants andtoddlers

Home deliveries & aftercare of

childImmunization

Treatment of minor ailments

Routine assessment &screening of child forabnomalities

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Child Health servicesChild Health services 70s70sPre-school programme emphasized

Kindergarten(tadika) set up in ruralcommunities- provide social &

intellectual stimulation for the children

School Health services &nutritionprogrammes

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Present SituationPresent Situation

Child Health services- under FamilyHealth Dept . MOH

Objectives relevant to CH

Promote &maintain health of infant

& children up to school going age

Promote and maintain healthynutrition,thus improve nutritional

status of children

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Programme StrategiesProgramme Strategies

Strengthen infant & childcareEarly Detection & intervention of child

health(growth development)

Maintain high immunization coverageInitiates studies & activities on home injuries

Provide care to children with special needs

Intensifies breast feeding promotion thruimplementation of baby friendly initiative in

all hospitals

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Programme StrategiesProgramme Strategies

Strengthen nutrition promotion

Healthy eating practices

Development of Healthy recipes

Strengthen prevention & control of

micronutrients deficiencies

Iodine disordersIron deficiency anemia

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Programmes InitiatedProgrammes Initiated

Congenital Hypothyroidism ScreeningEarly detection & intervention to prevent

mental retardation

Early childhood Development & StimulationEarly detection & intervention for abnormal

child(delayed milestone)

Adolescent Health- activitiesScreening health problems,nutrition &

counselling

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Programmes InitiatedProgrammes Initiated

School Health Services

Healthy School Program- Program

Bersepadu Sekolah Sihat(Health

promoting concept advocates by WHO)Detect & treat common child illness

& infestations such as Headlice,

worm infestations etc

Immunization coverage primary &

secondary sch children, booster

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Immunization coverage for schoolImmunization coverage for school

childrenchildren

96 96

88

8990

91

92

93

94

95

96

percentage

1994 1999

year

B.Polio

B. DoubleAntigen

Tetanus

Toxoid

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Immunization coverageImmunization coverage

Msia had achieved universal Childimmunization target

To further improve immunization

coverage

QA indicator- 90% or more coverage for

DPT 3rd dose

HTA conducted:

Update current immunization schedule

Introduce new immunization ,Hib,MMR

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Immunization coverage forImmunization coverage for

Infants 1996Infants 1996--19991999

75

80

85

90

95

100

105

%cove

rage

1996 1997 1998 1999

year

BCG Hepatitis 3rd doseDPT 3rd dose Polio 3rd doseMeasles

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CHILD HEALTH STATUSCHILD HEALTH STATUS

Health status seen from vitalstatistics in form indicators

Generally the lower the value of

rates, the better is the Health Status

VITAL INDICES

Msia young population- 44%under age 20

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Vital IndicesVital Indices

Children under 5 -About 12% of totalpopulation

CBR per 1000 popn decline from 31.3

(1985) to 24.4 (1999)Improve health status - Infant mortality

rate per 1000 reduce from 23.8 (1980) to

8 (1999)Toddler mortality rate per 1000

2.1(1980) to 0.4(1999)

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Mortality PatternMortality Pattern

Leading cause of infant death:Causes originating in perinatal

period

Septicaemia

Congenital anomalies

Acute Respiratory Illness

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Toddler mortality patternToddler mortality pattern

Leading causes of death:

Acute Respiratory illness

Septicaemia

Congenital anomalies

Diarrheal diseases

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Morbidity PatternMorbidity Pattern

Common conditions in presch child seenin clinics

Diarrhoel diseases, acute respiratory

infec & worm infestations

School children 7-12 yrs

Headlice,skin infections, dental carries

worm infestations

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Nutritional StatusNutritional Status

Nutritional Surveillance

Anthropometric indicator of wt for age-

measure nutritional status in child under 5

Severe malnutrition (bwt less than 3SD )

% unchange from 1995 to 1999

Mild nutrition (bwt > -3SD to < -2SD) 17.3% (1998) to 14.7% (1999)

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Nutrition PromotionNutrition Promotion

Activities include:Promotion healthy eating

practicesSchool canteen guidelines

Active and aggressivepromotion breast feeding

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Nutritional RehabilitationNutritional Rehabilitation

Rehabilitate malnourish child under 6yrMonthly provision of food basket

Food provides 180% of optimum daily

calorie requirement and 273% proteinsThis excess allows possibility of food

sharing among family members

Stop when recover or start schooling-Rancangan makanan tambahan dan

program susu sekolah

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ConclusionConclusion

Malaysian Child health Services has

been a success story in terms of

progress made in achieving better

health with relatively low health per

capita expenditure