Health Problems among Children in India

Dr. Radhika Kapur

Abstract
In India, children are experience health problems, and get effected by illnesses and
diseases. There are number of reasons that cause these problems among them. It is the
essential responsibility of the parents to ensure that they provide their children with proper
diet and nutrition, education, and the environment within the home should be created in such
a manner that it should promote health and well-being of the children in an appropriate
manner. The main areas that have been highlighted in this research paper are, causes of health
problems, prevalence of childhood health problems, child health interventions and measures
to prevent health problems among children. It is vital for the individuals belonging to
deprived, marginalized and socio-economically backward sections of the society to generate
awareness in terms of these measures. Individuals, irrespective of their categories,
backgrounds and occupations need to be aware of health problems among children and their
remedies.
Keywords: Behaviours, Children, Education, Health Problems, Nutrition

The children within the country constitute important human resources. It has been
understood that children are the future citizens of the country and opportunities should be
provided leading to their operative growth and development. In India, 10 to 30 percent of the
children experience the conditions and the behaviours that have an impact upon their health.
There are number of factors due to which the health problems arise among the individuals.
Nutritional disorders, both malnutrition and over-nutrition, use of tobacco and alcohol, other
substance use, high risk sexual behaviours, stress, depression, common mental disorders, and
injuries due to road traffic, accidents, suicides, violence of different types unambiguously
effect this population and have a long lasting impact. Multiple behaviours and conditions
often co-exist in the same individual, and adding a cumulative risk for their deprived health
conditions. The detrimental effects that take place are in terms of morbidity, mortality,
disability and socio-economic losses (Singh, & Gururaj, 2014).
Many health policies and programs have put emphasis upon the prioritized individual
health problems and incorporated co-ordinated approaches, both vertical and horizontal are
found lacking. Healthy life-styles and health promotion policies and programs are regarded as
imperative aspects for the health conditions of the youth, driven by vigorous population-
based studies. These studies are required in India, which will also report the increase in the
NCDs and injuries (Singh, & Gururaj, 2014). The prevalence of health problems, illnesses
and diseases among children are due to inadequate diet and nutrition, exposure to weather
conditions, such as cold, heat, rainfall without taking precautions or putting on the necessary
attire, experiencing various types of criminal and violent acts such as, verbal abuse, physical
abuse, torture, stress, pressure, anxiety, poverty, homelessness, inaccessibility to health care
and medical treatment and in some cases, when children do not perform well academically or
when they are unable to fulfil their aspirations, then their health gets affected as a result of
stress and depression.
Causes of Health Problems
The causes of health problems among the children takes place due to number of
factors. Most of these problems are connected with societal factors and lifestyles operating
and interrelating in multifaceted environments that stimulate these conditions or behaviours.
Developmental transition of the children normally makes them susceptible particularly to the
environmental, contextual or surrounding influences. Environmental factors, including
family, peer group, school, neighbourhood, policies, and societal cues, can both support or
challenge young people’s health and well-being. The children are prone to a number of health
impacting conditions due to personal choices, environmental influences and lifestyle changes,
including both contagious and non-communicable disorders and injuries. Others include
substance use disorders, i.e. tobacco, alcohol and others, road traffic injuries (RTIs), suicides,
sexually transmitted infections (STI) including human immunodeficiency virus (HIV)
infections, teen and unplanned pregnancies, homelessness, violence and so forth. In all
countries, whether developing, or developed, health problems and chronic illnesses are often
induced or compounded by economic destitution, unemployment, sanctions, restrictions,
poverty or insufficiently distributed wealth at both individual and country level (Singh, &
Gururaj, 2014).
Malnutrition – Malnutrition is considered as one of the most common factors that
effects the health of not only children but also adults within the country. This is the condition,
when the individuals are unable to receive proper and sufficient diet and nutrition.
Malnutrition can be understood in two aspects, under-nutrition and over-nutrition. Under-
nutrition is the state, when individuals are unable to obtain the essential nutrients and their
health conditions gets affected. On the other hand, over-nutrition is the state, when the
individuals consume excessive diet, more than what is required and the ultimate outcome is
obesity and overweight. Poverty is the main cause of under-nutrition, when individuals are
unable to make provision of the essential nutrients. When children do not obtain the essential
nutrients, they experience various types of health problems and illnesses. During the early
childhood stage, the problem of malnutrition is harmful to their effective growth and
development.
Poverty – The conditions are poverty are detrimental upon the lives of the individuals
to a major extent. The individuals residing in the conditions of poverty not only experience
physical health problems, but also psychological health problems. The lack of proper
nutrition, unavailability of civic amenities and other facilities, lack of clean drinking water,
unhygienic living conditions, and so forth are the factors that lead to not only health problems
among the children, but also adults. The poverty stricken individuals normally are unable to
make provision of medical and health care facilities for their children and other family
members. As a result, the children do not receive the facilities and hence, their health gets
negatively affected. Exposure to weather conditions, such as excessive heat, cold or rainfall
also affects the health conditions of the individuals, who are unable to take adequate
precautions.
Injuries and Accidents – Children normally get prone to accidents and injuries in a
number of ways. These include, while playing, walking on the streets, or making an attempt
to prepare their meals or when making use of tools and devices. The injuries and accidents
can be major or minor. When they are in a minor form, then they do not have an effect upon
ones health to a major extent, can be cured easily and are not long lasting. On the other hand,
when they are in a major form, then they have an effect upon the health conditions, both
physically and psychologically. The injuries and accidents can result in permanent or
temporary disabilities, and they may experience illnesses and other types of health problems,
such as fever, pneumonia, pain etc. Psychological problems that one experiences may be
stress, depression, and trauma. These are especially experienced by the individuals, when the
health problems are for long term.
Lack of Schooling and Employment – From the early childhood stage, it is essential
for the parents to get their children enrolled in nursery schools. When the children go out of
their homes to even play schools or get engaged in some kind of job, provided it does not
interfere with their growth and development, then they normally feel contented and
pleasurable. On the other hand, remaining confined within the homes, not being engaged in
any kind of work or activity imposes detrimental effects upon their psychological well-being.
Education renders a significant contribution in generating awareness among the individuals
regarding their well-being, health and in terms of other aspects, necessary to make one’s life
productive. Lack of education enables the individuals to experience anger, frustration and in
some cases, due to unawareness, they even get engaged into violent and criminal acts.
Though employment opportunities are not considered worthwhile for young children, but
during their school vacations, they sometimes get engaged into work in order to make pocket
money. This gives them experience and they feel contented when they earn income.
Lack of Health Care Facilities and Medical Centres – The lack of health care
facilities and medical centres are one of the major causes of increase in health problems
among children. In rural and remote areas, individuals do not have proper access to medical
and health care centres. They either have to travel to distance places or depend upon the
natural environmental conditions in order to make provision of medicinal herbs and plants to
treat their illnesses, and other health problems. The individuals residing in these areas,
usually are unaware regarding modern and innovative techniques and methods. The use of
traditional methods usually help them to treat their illnesses and diseases to some extent. In
case of severe health problems and illnesses, they have to travel to urban areas and distant
places.
Lack of Facilities and Infrastructure – The civic amenities, facilities and
infrastructure are regarded as essential aspects for the sustenance of one’s living and health
conditions. Within one’s house, all individuals desire to have proper heating and cooling
equipment in accordance to the weather conditions. Another factor that affects the health
conditions is indoor pollution, which is caused due to usage of traditional stoves for cooking
purposes. With the advent of science and technology, within the rural communities too,
individuals are using modern stoves. These are the ways that curb indoor pollution. During
the winter season, these individuals usually make provision of heat by burning of coal or
wood, which may cause health problems. In the present, the usage of electric heaters is one of
the aspects that curb health problems among the individuals.
Criminal and Violent Acts – There have been prevalence of criminal and violent acts
among the individuals within the country. These acts effect not only the adults, but also the
children, who are below ten years of age are getting subjected to various types of crime and
violence. The various types of criminal and violent acts that are imposing detrimental effects
upon the children include, verbal abuse, physical abuse, sexual harassment, child trafficking,
child labour, rape and murder. When young children get subjected to these acts, they
experience severe health problems. The prevalence of illnesses and diseases are common, but
they remain confined within their homes. When the children feel apprehensive in going
outside of their homes, then their communication abilities get obstructed, they are unable to
acquire education or get engaged in extra-curricular activities. In some cases, they do not
even participate in cultural, social and religious programs. As a result, they become secluded
and less communicative in nature.
Homelessness – Homelessness is one factor that is destructive upon the health
conditions of the individuals. This problem is usually experienced by the individuals, when
they migrate from one region to another. The individuals belonging to deprived, marginalized
and socio-economically backward sections of the society from rural areas usually migrate to
urban areas in search for better livelihoods opportunities. During the initial stage, they have
problems in finding accommodation because of limited resources that they possess. Hence,
they are homeless. In some cases, they may reside at their relative’s or friend’s place for
some time, or they reside nearby the road-side or temples, or within construction areas. When
individuals and their children do not have proper shelters, they experience health problems
and suffer from diseases. They usually get exposed to the weather conditions and do not
possess the needed attire, they do not have proper diet and nutrition and usually depend upon
the religious places for the fulfilment of their nutritional requirements. They do not have
access to health care facilities, clean drinking water and other hygienic living conditions.
These individuals usually are unfamiliar with the places and areas, hence, lack of awareness
and knowledge are the major factors that lead to health problems among them.
Toxins and Drugs – In some cases, the children, who are below 18 years of age, take
toxins, drugs and even consume alcohol. These aspects cause health problems among them to
a major extent. The health problems can be severe to a major extent, which may even lead to
an increase in the mortality rate, if not checked on time. These children mainly possess the
viewpoint that if they would get involved into smoking or use of alcohol, then they would be
able to reduce their intake of food. Research studies have highlighted the point that when
individuals get involved into excessive smoking or use of alcohol, then they would be able to
curb their hunger. In most cases, they communicate with the individuals, who get them
addicted to the use of toxins, drugs, alcohol and smoking. These factors also impose
psychological effects upon the individuals. Their mental abilities and thinking capacity gets
impeded. The individuals also impede traits such as, wisdom, honesty, truthfulness, morality
and decency.
Hazardous Occupations – In India, there are employment of children in hazardous
occupations which have a severe impact upon their health. The hazardous occupations are
involved in plantations, agriculture, mines, lock industries, glassware, silk weaving, gem
polishing, carpet industry, brassware industry, hotel industry, beedi rolling, agarbatti, and
construction work. In these occupations, jobs are difficult and children are made to work for
long hours, which affects their health by causing stress. In order to perform their job duties
well, it is vital for the children to obtain proper training. Lack of training may cause accidents
and injuries. Exposure to dust and fumes, while working in industries also effects the health
conditions of the individuals, hence, for the children as well as the adults involved, it is vital
to take safety measures, use appropriate tools, machines and equipment and wear proper gear
while working. The children are made to work long hours and their pay is comparatively less,
hence, this aspect does not enable them to incur the feeling of job satisfaction.
Prevalence of Childhood Health Problems
The children below five years of age not only comprise a large group but they are also
susceptible or high risk group. The risk is connected with the growth, development and
survival. First five years are full of health hazards. Since they are the high risk group, under
five children are exposed to many environmental factors leading to illnesses and diseases in
children. Two major infective illnesses in children are respiratory tract infection and
diarrhoea. Skin infections like scabies, boils, furuncles and impetigo are fairly common in
children as 30 percent of all the out patients, who make a visit to a paediatrician consist of
dermatological cases. Intestinal helminthic infestation is one of the multiple etiologies of
malnutrition and of the helminths. Ascariasis is associated with development of pre-school
children. Eye diseases, mainly conjunctivitis are also noticed often in children. The
assessment of health status of under the age of five or pre-school children reflects the health
condition of a nation. It also helps in obtaining base line data for planning, interventions,
follow up and evaluation of health services, provided to these children (Ansari, Khan,
Khalique, & Siddiqui, 2008).
The children, below five years of age, make visits to the medical and health care
centres for the purpose of taking advice, guidance and treatment along with their mothers and
other family members (Ansari, Khan, Khalique, & Siddiqui, 2008). Since, they are young, it
is apparent that they would be accompanied by their parents or other family members in the
absence of parents. The physicians examine the children usually in the presence of the family
members, so that they do not feel vulnerable. In making provision of advice and treatment to
the children, the physicians are friendly and courteous. History of the present illnesses is
recorded after the complete physical examination. Treatment is provided after making the
provisional diagnosis. After the examination and medical treatment, the physicians usually
give the suggestions and the medicines in writing to the parents. In case, the individuals are
not educated, they are not able to read and write, then they are explained verbally.
Most low and middle income countries are making slow progress in addressing the
issue of child mortality. Diarrhoea, pneumonia, and malaria account for 37% of deaths
globally of children, below five years of age, with only about one-third of children with these
illnesses receiving proper treatment. They are also the leading causes of disability adjusted
life years across all age groups, contributes loss of two million young children each year. The
SEARO-WHO carries 30 percent of the global problem, and these diseases affect in most
cases poverty stricken and marginalized groups. Simple, safe and inexpensive interventions
with proven efficiency are now available, but low coverage has resulted in poor control of
these diseases. Incredibly, pneumonia which kills more children under five than AIDS,
malaria and measles, combined has received far less consideration and funding than any of
them (Chaturvedi, Roy, Katiyar, Agrawal, & Mukherjee, 2014).
Child Health Interventions
There have been introduction of number of vertical programs to report the matter of
child health and mortality, it is evident that the success of these programs has been partial.
The immunization program has been efficacious in causing a decline in the proportion of
vaccine preventable diseases (VPDs), but the diarrhoea control program has been only
moderately operative in causing a decline in the proportion of mortality among the children,
below five years of age. Approximations of the burden of diarrhoeal diseases in India by the
National Institute of Cholera and Enteric Diseases (NICED) specify that diarrhoeal diseases
contribute to about 9.1% of deaths within the age group of zero to six years. It has been
further estimated that the years of life lost (YLL) due to diarrhoeal diseases in the zero to six
years population currently contribute to about 98% of disability adjusted life years (DALYs)
and would remain unchanged over the next decade till 2016. It evidently indicates the need to
shift gears to address the projected stagnation in diarrhoea-related mortality among the
children (Burden of Disease in India, 2005).
Nevertheless, the pneumonia related deaths, childhood tuberculosis and under-
nutrition still remain major problems. This reflects the problems in the Acute Respiratory
tract Infections (ARI) Control Program, the Revised National Tuberculosis Control Program
(RNTCP) vis-à-vis childhood tuberculosis, i.e. the new RNTCP strategies for childhood TB
have been published only this year and it is expected that these will fill the existing void and
the other programs related to nutrition. All these vertical single disease interventions have not
taken understanding of the one fact that sick children, especially those below five years of
age, consistently experience from more than one illness and are also often undernourished
and unimmunized. There is a need to observe the children, who are experiencing illnesses and
diseases and to implement measures that may lead to improvements in their conditions,
holistically, both when they come as outpatients and while treating them as inpatients
(Burden of Disease in India, 2005).
The IMNCI package of the World Health Organization (WHO) attempts to fill this
gap and also makes provision of the modules for inpatient treatment of childhood illnesses
and diseases. This constituent has not been evaluated nor adapted for India. However, one of
the major problems in its implementation is the training schedule. In the RCHII, the IMNCI
has been integrated as a major package for intervention. There is a need to evaluate the
capability of the health system to train the massive cadre of health care providers required.
One needs to put into place a full-time nodal agency to administer the training, follow-up and
scrutiny of its implementation. The implementation also requires the augmentation of health
systems; else this determination will also emerge with all the other programs (Burden of
Disease in India, 2005).
Measures to Prevent Health Problems among Children
The measures to prevent health problems among children have been stated as follows:
Adequate Diet and Nutrition – Proper diet and nutrition are regarded as imperative
aspects that are essential for maintenance of good health among children. It has been stated
that the health and well-being of the person is dependent upon what they eat. The parents
need to possess adequate knowledge in terms of the diet and nutrition that they should give
their children, especially when they are young. The consumption of essential nutrients is for
the prevention of diseases and other types of health problems. The children should be given
foods such as, fruits, vegetables, breads, cereals, milk and so forth. These foods make
provision of the vital nutrients, necessary for their operative growth and development.
Medical Treatment – It is essential to give proper vaccinations to the children and
they should be provided with proper medical treatment in case of any health problems and
illnesses. The individuals belonging to deprived, marginalized and socio-economically
backward sections of the society, who are not well aware and literate prefer taking their
children to health care centres, even when they experience any minor health problems. The
physicians and medical practitioners are able to provide adequate guidance in order to
maintain good health and keep oneself free from any types of health problems and illnesses.
When the individuals are unable to acquire understanding in writing, they are explained
verbally, so that they are able to put them into practice appropriately.
Clean Environmental Conditions – Whether the living accommodation of the
individuals is large or small, whether the family is large or small and so forth. Irrespective of
all these areas, it is imperative to maintain the environmental conditions, especially within the
house, clean and pollution free. When there are young children within the house, it is
essential for the individuals to carry out the functions of cleaning and washing in an adequate
manner. They should make use of uncontaminated water and prepare meals using clean
utensils. Young children, usually have the habit of playing and even touching various objects,
hence, it is vital to perform the task of sweeping in an adequate manner, making use of proper
liquids, as there are number of illnesses that take place from the germs found on the floor.
Hygiene and Lifestyle – Hygiene and lifestyle is not only considered essential for the
maintenance of good health and well-being among the adults, but also children. When the
children began to get enrolled in pre-schools, then they generate awareness in terms of
hygiene and lifestyle. Hygiene is referred to the cleanliness and sanitation that is usually
necessary to keep oneself healthy and well. Lifestyle is referred to the tasks and functions that
one carries out normally as a part of their daily routine. Parents usually encourage their
children to wake up early in the morning, get engaged in physical activities, go to school,
attend coaching classes, these may be regarding academic subjects, as well as extra-curricular
activities and they are encouraged to go to bed early at night. Following a healthy routine and
consuming healthy and nutritious diet, developing positive thinking and wholeheartedly
getting engaged in one’s tasks and functions are some of the important aspects that lead to
alleviation of health problems, physically and psychologically.
Carefulness when going Outdoor – Health problems also affect the children, when
they get prone to injuries and accidents, when going out of the house. The children usually
get engaged in play activities in parks or streets, they may travel in personal or public
transportation or when they are going somewhere, they need to be careful and remain with
their parents or caregivers. Studies have indicated that number of accidents take place on the
roads as well as in schools. The children, who become victims of such accidents normally
suffer from injuries and health problems, which may be long-term or short-term. These may
be temporary or permanent. Hence, it is vital for the children to be careful and parents or
caregivers also possess the responsibility of taking adequate care.
Curbing Pollution – Various forms of pollution cause health problems among the
individuals, particularly air and water pollution. In India, some regions and cities have high
pollution. Therefore, it is vital for the parents to ensure that their children wear proper gear in
order to protect oneself from air pollution. On the other hand, there are number of
individuals, who are dependent upon the water bodies for their survival and to carry out the
household responsibilities. The water bodies too are polluted and usage of contaminated
water causes health problems. Hence, one needs to be cautious and ensure that the water that
they are using from the water bodies is not polluted.
Maintenance of Good Relationships and Conditions – Apart from physical health,
psychological health is also considered important for the individuals. Within the home, when
children found strenuous relationships with their parents or even other family members, they
may feel upset and stressed. Stress and pressure may have a negative effect upon their mind-
sets. Maintenance of good relationships and conditions are essential not only within the
home, but also outside the home. Children go to school or get engaged in any other activities,
for the purpose of which, they join coaching classes or training centres. In educational
institutions and training centres, it is vital for the individuals to communicate effectively with
others, so they are able to not only perform their tasks and functions in an appropriate
manner, but also maintain good terms and relationships with others.
Mistreatment of Children – Mistreatment of children is also considered as one of the
imperative areas that is detrimental upon their health and well-being. Research has indicated
that children, even below 10 years of age have been subjected to various types of violent and
criminal acts. These acts have caused injuries and health problems. Hence, prevention of
mistreatment of children is one of the areas that is necessary to maintain their good health and
well-being. Acts such as beating, hitting with objects, burning, torturing, acid attacks are
some of the heinous acts that have a negative effect not only upon their physical health, but
also psychological health.
Symptoms, Signs and Ill-defined Conditions – Symptoms, signs and ill-defined
conditions are stated to be those situations, which prove to impose negative effects upon the
children (May, n.d.). For instance, some children are allergic to certain foods or may develop
cough or cold on an immediate basis, when getting exposed to cold weather conditions or
when they do not obtain what they need, then they may form negative viewpoints against the
situations or the circumstances. These factors may affect their health physically and
psychologically. Hence, it is vital for the individuals to conduct an analysis of the factors that
may prove to be unfavourable to their health and well-being.
Curbing Use of Alcohol and Tobacco – Smoking, chewing tobacco and using alcohol
are the health risk behaviours, which begin at an early age among the individuals, belonging
to all age groups. There is a large difference in the behaviour related to smoking among the
individuals within the country and it generally begins with the teens. These factors not only
affect the health conditions of the individuals, but it may increase the rate of diseases, which
may lead to mortality (May, n.d.). In order to curb the usage of alcohol and tobacco, it is vital
for the individuals themselves to take measures, which may lead to a decline within the
intake.
Conclusion
Individuals encounter number of problems and adversities in their lives and in the
implementation of tasks and functions, when he or she experiences health problems. There
are various types of health problems and illnesses. Some may be long-term or short-term,
some may be temporary or permanent and so forth. Causes of health problems are,
malnutrition, poverty, injuries and accidents, lack of schooling and employment, lack of
health care facilities and medical centres, lack of facilities and infrastructure, criminal and
violent acts, homelessness, toxins and drugs and hazardous occupations. In some cases, one is
able to find adequate treatment to their health problems. On the other hand, there have been
cases of individuals, who are unable to acquire the facilities for treatment. The various causes
are poverty, illiteracy, unawareness etc.
When the children get affected by the health problems to a major extent, then parents
usually discourage them from going to school or in getting engaged in any other work. The
health problems prevent the children from going to school, getting engaged in play and
creative activities, leisure and recreation, or involvement in any tasks and functions.
Measures to prevent health problems among children include, adequate diet and nutrition,
medical treatment, clean environmental conditions, hygiene and lifestyle, carefulness when
going outdoors, curbing pollution, maintenance of good relationships and conditions,
mistreatment of children, symptoms, signs and ill-defined conditions and curbing use of
alcohol and tobacco. When individuals possess adequate knowledge in terms of these factors,
then they are able to prevent health problems and contribute to a much greater extent in the
prevention of illnesses and diseases.
Health problems are primarily common among the children belonging to deprived,
marginalized and socio-economically backward sections of the society as compared to the
children belonging to wealthy and educated families. The individuals need to ensure that their
jobs do not cause any types of health problems. Jobs are considered important for all
individuals, as they are the source of income. Some may not feel satisfied but they have to
work to generate a source of income. When children are engaged in any types of hazardous
occupations, it is vital for them to acquire proper training and possess appropriate skills. The
other area of utmost significance is, individuals need to create an agreeable environment and
make provision of all the necessary facilities and civic amenities within their homes that
contribute in the maintenance of good health conditions and prevention of illnesses and
diseases.
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