| CHILD CARE |
| Preventing pneumonia deaths among children |
Exclusive breastfeeding, vaccination and treatment with antibiotics along with supportive measures to improve nutrition can save the lives of infants, say Dr Panna Choudhury and Dr Naveen Thacker
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 Pneumonia in children is commonly seen in India, but does not get the attention it deserves. The sight of a small child struggling to breathe is heartbreaking and the parents’ plight is painful. Pneumonia is largely preventable and curable, but it strangely remains the leading cause of death among infants worldwide.
India tops the list of 15 countries that accounts for three-quarters of childhood pneumonia cases worldwide. The disease takes the lives of more than 4,00,000 children every year, which constitutes more than 20 per cent of all childhood deaths in India. It is really distressing that pneumonia does not receive the attention it warrants.
The Indian Academy of Paediatrics (IAP) has led the push for action to fight pneumonia.
The Academy recommends a three-pronged strategy of protection with exclusive breastfeeding, prevention with vaccination, and treatment with antibiotics along with supportive measures.
Combating risks
Initiating breastfeeding within an hour of birth and exclusive breastfeeding for six months can protect infants from many infections, pneumonia included, by providing adequate nutrition at a critical age. Routine immunisation for measles and administration of the pertussis (whooping cough) vaccine substantially prevent pneumonia complications due to these diseases. The routine immunisation rate in many states in India is dismally low. Though current efforts in our health care system have shown some encouraging results in increasing immunisation coverage, a lot more needs to be done.
A significant number of child pneumonia deaths are attributed to two strains of bacteria — Haemophilus influenzae type 2 (Hib) and Streptococcus pneumonia (pneumococcus). The World Health Organization has recently published estimates that these two bacteria cause 1,80,000 pneumonia deaths every year in India in children under the age of five.
Empower health workers
Training at community health centres must be improved to care for children who may otherwise die of pneumonia at home without treatment. Accredited Social Health Activists (ASHA) can serve as a bridge between Auxiliary Nurse Midwives (ANM) and the community/village for arranging care for children with pneumonia.
The IAP is acting at the National, State and District level to promote policies such as those mentioned above to prevent and control pneumonia on a priority basis. Educating health professionals at all levels is an urgent need. We need to work with policy makers to have a credible national and local strategy to fight this killer. We need to attack pneumonia with vaccines, antibiotics and supportive measures to improve nutrition and reduce susceptibility.
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