Firoz Mahmood Iqbal
CHILD HEALTH IN SRl LANKA.GENERAL INTRODUCTION
The Democratic Socialist Republic of Sri Lanka is a beautiful Pearl shaped island situated off the southern coast of India. It has a land area of 65,6OO square kilometres. The estimated mid-year population for the year 1994 was17.86 millions of which 35.2% is children under 15 years. Sri Lanka's economy is mainly based on agriculture and tea, rubber and coconut are the main export crops and the paddy being the main domestic crop. With the introduction of free market economy since late eighties, the export oriented industries have been gradually replacing the traditional exports. For the purpose of administration the island is divided in to 24 Districts and 9 Provinces.BACIC HEALTH INDICATOR
Crude birth rate - 19.9
Crude death rate - 5.5
Infant mortality rate - 18.2 Neonatal mortality rate - 15.0
Life expectancy at birth-males - 67.8 years.
females - 71 .7 years.
Literacy rate - 87.2
Gross National Product ( per capita ) - 652 US Dollars.Birth Weight and Nutritional status of children
Information on birth weight is important for two reasons. It gives an indication of the well being of neonates and women of reproductive age. It also gives an important determination of the survival of a new born. Demographic and Health Survey (1993 ) revealed that the mean birth weight was 2.8 Kg. The percentage of low birth weight babies ( 2.5 Kg. ) is 18.7%. The nutritional status of children below 5 years of age showed that 15.5% are suffering from chronic mal-nutrition. 1993 Health Survey also revealed that 57.7% of the children are under-weight.
There has been a steady decline in the incidence of Kwashiorkor; but stunting (chronic malnutrition) nutritional anaemias are still prevalent.COMMON DISEASE
Acute lower respiratory tract infections and diarrhoel diseases are the major cases of hospitalization in our children. Post measles Broncho Pneumonia was a major cause of admission to hospitals in early eighties. This is hardly seen today due to the introduction of measles vaccination to the primary immunization schedule for infants in 1985. Bronchial Asthma, other infectious diseases, Congenital heart diseases and its complications, Acute Rheumatic Fever, Post Streptococcal Glomerulo-Nephritis are the other common causes of hospitalization.
Complicated Malaria - specially Cerebral Malaria, Snake bite and its complications and Thalassaemia are the other special problems that we commonly see in our Province. It is a distressing sight to see seven to eight blood transfusions are being given daily to bronze coloured, pot-bellied children with Thalassaemia in our Unit. Due to the lack of adequate number of infusion pumps most of our Thalassaemics have features of Haemochromatosis.
The commonest causes of perinatal morbidity and mortality are lower birth weight and its complications and birth asphyxia.IMMUNIZATION
An important indicator of child health in a country is the proportion of children protected through immunization against potentially life threatening childhood diseases. 1995 Health Survey showed 82.5% of children had been given BCG at birth, 86.6% had received 5 or 4 doses of Diphtheria Pertussis and Tetanus ( DPT ) Vaccine and 86.5% had received 3 or more doses of oral Polio Vaccine. Measles vaccination also shows an overall coverage of 80%. The above figures are very high compared with many other developing countries and it is a tribute to our expanded programme on immunization (EPI) .HEALTH EDUCATION
With the collaboration of the Provincial Director of Health Services, Family Health Bureau of the Ministry of Health, Sri Lanka and the Obstetricians we are presently engaged in several Health Education Programmes. The main objective of these Programmes, is to educate the doctors, nurses and the health care workers involved in the maternal and child health care in the Province. The Health Education activities include -
1 . Safe motherhood programme.
2. Introduction to the concept of Baby Friendly Hospitals.
3. Breast feeding management.v 4. Neonatal examination.
5. Safe weaning practices.
6. Practical demonstration of neonatal resuscitation.
