Prevention of mental handicaps in children in primary health care
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1Maternal and Child Health and Family Planning, World Health Organization, Geneva, Switzerland.
Insights
Preventable causes of mental handicaps in children, including birth complications and infections, can be addressed through primary health care. Training families and health workers in simple technologies is key to early detection and intervention.
Area of Science:
- Pediatrics
- Public Health
- Neurology
Background:
- 5-15% of children (3-15 years) globally experience mental handicaps, with millions affected worldwide.
- Preventable conditions account for a significant burden, particularly in developing nations.
- Birth asphyxia, trauma, infections, malnutrition, and deficiencies are major contributors.
Purpose of the Study:
- To highlight the preventable nature of many causes of mental handicaps in children.
- To emphasize the critical role of primary health care and community involvement.
- To advocate for the training and implementation of appropriate technologies for prevention and intervention.
Main Methods:
- Review of global statistics on childhood mental handicaps.
- Identification of leading preventable causes, especially in developing countries.
- Analysis of the primary health care approach and relevant technological interventions.
Main Results:
- Birth asphyxia/trauma and infections are leading preventable causes of mental handicap.
- Malnutrition, hyperbilirubinemia, and deficiencies (iodine, iron) also contribute significantly.
- Socioeconomic changes impact early childhood development and stimulation.
Conclusions:
- Primary health care, involving families and communities, is essential for preventing mental handicaps.
- Training in technologies like risk assessment, home records, and newborn resuscitation is crucial.
- Community-based interventions can effectively detect and prevent conditions leading to mental handicap.
Abstract:
Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap.