THE PRESS SATURDAY, SEPTEMBER 25, 1982. Improving child health

Press, 25 September 1982, Page 14

THE PRESS SATURDAY, SEPTEMBER 25, 1982. Improving child health

New Zealand’s once enviable place in the forefront of child health, due in no small measure to the Plunket Society, has slipped. A Government-appointed committee of 22 makes this point in the report of its four-year study of child health in New Zealand that is intended as a blueprint for the future development of child care services. The finding does not necessarily mean that the standard of health care for children has degenerated, although evidence suggests this might be true in isolated facets of child care. It means, rather, that improvements have not kept pace with overseas developments in comparable countries. Although New Zealand’s total child health services have been getting better every year, those in other countries have been getting better much faster. The committee has made almost 200 recommendations to improve this state of affairs. These do not provide a magic checklist for the Government, the Health Department, or any other body to implement for instant success. The scope for administrative and imposed solutions is not large. By far the greater number of possible improvements to child health in New Zealand require changes of attitude and less complacency from both parents and the wider community. The disturbing feature of the report is the high proportion of child deaths directly attributable to the actions, or inaction, of parents and other adults. Accidents are the most common cause of death in children over the age of one year. Road accidents, child drownings, burns, and poisonings can all be reduced. Campaigns have been waged to educate parents and encourage the use of restraints for child passengers in cars, to encourage supervision of children near water, and to store medicines and poisons out of reach of children; Children still die because parents are inattentive, careless, or simply irresponsible. Because some parents lack the wit or the will to care properly for their offspring, legislation compelling the use of child restraints in cars and the erection of fences around swimming pools becomes the only answer. Laws should not be necessary for these things. The report also shows that spontaneous abortions and birth defects are still occurring because women smoke and drink

to excess during pregnancy. Once again this occurs in spite of repeated warnings and publicity campaigns of the dangers. Instances such as these, and the immunisation programme against rubella, show that the State can only go so far to improve the health of the children and reducing child mortality rates. No matter how much money and effort the State expends, the co-operation of a responsible community is essential; unfortunately, the community will always include people who are deficient in a sense of responsibility. One recommendation of the report that rests with the Government, for funding, and with the medical authorities, for implementing, is a call for an intense study to be made of cot deaths, properly known as the sudden infant death syndrome. This is the cause of more than a third of infant deaths in the first year after birth; the nature of the elusive symptoms is not understood. The committee believes that careful research on the uneven incidence of cot deaths in different sections of the population is likely to yield clues to its cause and thus enable preventive measures to be taken. The seriousness of the syndrome and the large contribution it makes to infant mortality argue for an early start on the study. The report identifies a growing problem, resulting in pairt at least from increasing numbers of ex-nuptial births and solo parents. According to the report, doctors examine fewer than a quarter of babies at nine months of age. Throughout childhood, children in one-parent families are more likely to suffer from health disadvantages, including fewer health checks and immunisations. Many of these children are in below-average living quarters. Children in low-income families also have less frequent health checks than the average. These are social problems as much as medical ones. The committee’s suggestion to lock all children into a system of regular health and development checks from birth would at least ensure earlier detection of disorders in many children. This could reduce the need for eventual hospital treatment and prove to be the cheaper approach in the long run. Even if the costs were greater in money, the emphasis on prevention rather than cure is positive and the proper course to take.