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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