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Child Health

  Child Mortality
     Causes of Deaths
     Where Deaths Occur
  Impact of Disease
  Maternal & Child Health
  Adolescent Health
  Interventions in Health
  Measuring Progress
  Needs & Costs
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Impact of Disease

Child Development in Developing Countries

Health has long been recognized as an important determinant of human capital and productivity.¹ Many millions of children who survive infectious diseases, malnutrition and other childhood threats, suffer from physical stunting, intellectual impairment, and blindness.² These children will not reach their development potential. Compared with children who do not experience physical or intellectual deficits, these children are more likely to perform poorly in school and to be less economically productive in later life – as reflected in a 20 percent deficit in income as adults.

Limited education and poor learning have a direct bearing on job potential and earnings.
Ultimately, poor child health undermines societal development, while improved health is the first step toward enabling children to break out of a cycle of ill-health and poverty that may otherwise continue for generations.³
Childhood illness and death contribute to the impoverishment of families through expenditures on medical care they can ill afford, resulting in reduced income for other necessities, such as food and education, and economic productivity lost in caring for a sick child.

Interventions to prevent stunting and its long-term after-effects are, in fact, simple and highly cost effective, have long-term benefits on schooling and intelligence tests in adulthood⁴ and return up to $3 in additional wages for every $1 invested in improving child nutrition.⁵

Community-based programs promoting better child feeding practices can reduce stunting and cognitive impairment by 1-2 percentage points per year for an annual cost of just $5 to $10 per child.⁶
For each one point decrease in infant mortality, a study found that domestic product per capita grew by 0.145 percent.⁷

The economic cost of child mortality on lost productivity has been estimated for Senegal and Uganda, two of the world’s poorest countries, at $1,200 per death for each of the 14,000 annual child deaths in Senegal and the 33,000 in Uganda.³ Comparing this with the average cost of saving a child’s life, $887,⁸ illustrates that preventing and treating childhood illness is far less costly in economic terms and an immeasurable benefit to families and societies.

Children and HIV/AIDS

More than 530,000 young children become infected with HIV each year; most (about 95 percent) of these children become infected in utero (before birth), during delivery, or through breast milk.^{9, 10} About one-third of infected infants die within one year and more than half die before age two years unless they receive treatment. In 2006, nearly 300,000 children died from AIDS-related causes and nearly all lived in sub-Saharan Africa.^{10, 12}

Orphans and vulnerable children may live with other family members, such as grandparents, increasing the burden on those households.
Older siblings may be tasked with providing care for their parents and for younger siblings, preventing them from completing school or learning vocational skills. These children have little preparation to enable them to escape poverty.
In addition to losing their parents, many of these children have also lost teachers and other adults in the community who play a significant role in their lives.
These vulnerable children are more likely to drop out of school and to engage in risky behaviors that increase their risk of becoming infected with HIV. They experience stigma, discrimination, and poverty.

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Children and Infectious Diseases

Malaria, vaccine-preventable diseases, tuberculosis, pneumonia and neglected tropical diseases are prevalent in young children, causing hundreds of millions of illness episodes and millions of deaths among children under five. The impact of these illnesses may be long-term, resulting in lack of academic advancement and limited economic opportunities. These diseases are preventable and treatable.

Cerebral malaria. A clear example of the impact of infectious diseases on children is evident among the more than half a million African children who are stricken with cerebral malaria each year.¹³

Survivors often experience severe anemia and neurological complications that can permanently impair cognitive ability and economic productivity.¹³
Although it is well-documented that providing treatment for malaria before age six has lasting cognitive benefits,¹⁴ as few as 8 percent of affected children are seen by a health professional.¹³

Neglected tropical diseases (NTDs). More than a billion people are affected every year by NTDs and children are most vulnerable.¹⁵ More than 10,000 children under five die each year from endemic diseases that receive little attention or funding – but many more suffer long-term consequences of these diseases.¹⁶

About 70 percent of deaths from neglected tropical diseases occur in children under age 14 years.¹⁵
Children infected with NTDs may have permanent impairments, such as stunted growth, diminished cognitive development, scars, physical deformities, and blindness.

Large-scale programs to administer medications – delivered through schools, churches and mosques, health posts and clinics, and door-to-door – are used to treat these diseases.

There is a great need to integrate treatment programs, as co-infection with more than one NTD is common, as is co-infection with other infectious diseases, including malaria and HIV.
The cost of an annual chemotherapy package to treat several NTDs is about $0.40 per treatment.¹⁵

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Other Child Health Issues

Accidents and injuries, mental health disorders, asthma, gender-based violence, tobacco and smoking, and environmental pollutants in the air and water are only some of the other health issues faced by children in the developing world. Although there has been an emphasis on infectious diseases, addressing the impact of chronic conditions is of growing interest.

Gender discrimination. Despite years of informational and technological progress, gender-based discrimination persists.

In Asia, an unusually high proportion of male children suggest that gender-based abortion and infanticide have occurred, particularly in South and East Asia.¹⁷
Globally, about 60 percent of the 115 million children not in school are girls. Most live in sub-Saharan Africa and southern Asia.¹⁸
About 20 percent of girls in developing countries do not complete primary education. This adversely impacts her later economic opportunities.¹⁷
In Asia, at least 60 million girls are ‘missing’ from the population despite laws banning sex-determination testing and sex-selective abortions.¹⁹

Learn More...

Policy Brief: Overcoming Neglected Tropical Diseases with Cost-effective, Integrated Programs

Policy Brief: Decrease Violence to Decrease Risk of HIV among Women and Girls

Policy Brief: Health Equity for the World’s Children Would Save Millions of Lives

This section will be expanded soon.

¹	Ruger JP, Jamison DT, Bloom D, Canning D. Health and the economy In: Merson M, Black R, Mills A, eds. International public health diseases, programs, systems and policies. Gaithersburg, MD: Aspen Publishers. 2001.
²	Grantham-McGregor S, Cheung YB, Cueto S, et al. Developmental potential in the first 5 years for children in developing countries. Lancet, 369:60-70. 2007.
³	Islam MK, Gerdtham U. The costs of maternal-newborn illness and mortality. Geneva: WHO. Available from: www.who.int/reproductive-health/universal_coverage/issue2/index.htm. 2006.
⁴	Engle PL, Black MM, Behrman JR, et al. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet, 369:229-42. 2007.
⁵	Belli PC, Bustreo F, Preker A. Investing in children's health: what are the economic benefits? Bulletin of the World Health Organization, 83(10):777-84. 2005.
⁶	Laxminarayan R, Mills AJ, Breman JG, et al. Advancement of global health: key messages from the Disease Control Priorities Project. Lancet, 367:1193-208. 2006.
⁷	Gupta I, Mitra A. Economic growth, health and poverty: an exploratory study for India. Development Policy Review, 22:193-206. 2004.
⁸	Bryce J, Black RE, Walker N, et al. Can the world afford to save the lives of 6 million children each year? Lancet, 365(9478):2193-99. 2005.
⁹	Coovadia HM, Rollins NC, Bland RM, et al. Mother to child transmission of HIV-1 infection during exclusive breastfeeding in the first six months on life: an intervention cohort study. Lancet, 369:1107-16. 2007.
¹⁰	UNAIDS. Children and AIDS: a stocktaking report. Geneva: UNAIDS. Available from: http://data.unaids.org/pub/Report/2007/20060116_stocktaking_report.pdf. 2007.
¹¹	World Health Organization. Taking stock: HIV in children. Available from: www.who.int/hiv/toronto2006/takingstockchildren.pdf. (accessed May 24, 2007).
¹²	UNICEF. 2007. Global distribution of under-five deaths by cause. Available from: www.unicef.org/media/files/Under_five_deaths_by_cause_2006_estimates3.doc
¹³	Murphy SC, Breman JG. Gaps in the childhood malaria burden in Africa: cerebral malaria, neurological sequelae, anemia, respiratory distress, hypoglycemia and complications of pregnancy. Am J Trop Med Hyg, 64(1 suppl):57-67. 2001.
¹⁴	Jukes M. The long-term impact of preschool health and nutrition on education. Food Nutrition Bulletin, 26(suppl 2):S193-201 2005.
¹⁵	World Health Organization. Neglected tropical diseases: hidden successes, emerging opportunities. Geneva: WHO. Available from: http://whqlibdoc.who.int/hq/2006/WHO_CDS_NTD_2006.2_eng.pdf. 2006.
¹⁶	World Health Organization. WHO global burden of disease (GBD) 2002 estimates (revised). Available from: www.who.int/healthinfo/bodestimates/en. 2004.
¹⁷	UNICEF. The state of the world's children 2007. Available from: www.unicef.org/publications/index_36587.html. (accessed April 23, 2007).
¹⁸	United Nations. Progress towards the Millennium Development Goals, 1990-2005. Available from: http://mdgs.un.org/unsd/mdg/host.aspx?content=products/progress2005.htm. (accessed June 12, 2007).
¹⁹	UN News. UN envoy raises alarm over growing ‘feminization’ of poverty. Available from: www.un.org/apps/news/story.asp?NewsID=16557&Cr=least&Cr1=develop. (accessed June 12, 2007).

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