Professional Documents
Culture Documents
Demography, Child Health
Demography, Child Health
07/01/21
CHILDREN IN INDONESIAN : 77.8 million
(Unicef, 2000)
• Infants 4.5 m
• Underfives 22 m
• Adolescences 22 m
07/01/21
GROWTH
Increase of physical size
Height, weight, head circumference etc.
DEVELOPMENT
Increase of ability in human function
-physical (motoric),
-cognitive (intelligence)
- affective (emotion-social),
.
07/01/21
CHILD GROWTH & DEVELOP. QUALITY
Determinants : INTRINSIC (genetic- heredoconstitutional)
+ EXSTRINSIC ( environment)
(Kobayashi, 1985;
Sularyo, 1989;
Ismael, 1991,) ENVIRONMENT
ROLE:
to met :
Bio +
Psycho-soc
need
Mother, subtitute mother
PSYCHO
BIO:
SOCIAL
, Parent, sibling, caregiver,
toys, norm, rule, stimulation nutrition,
imunisation,
Health Service, Education
Love, care, Neighbor, peer
medicine,
Gov. Policy, International cloth, etcl
Stimulation UNICEF, WHO
cognitive,
07/01/21
THE QUALITY OF FAMILIES
1. EDUCATION : illiteracy 16 millions
• Father: 49 % Primary + Secondary School
• Mother : (Primary 31.7%, Secondary 11,7 %).
• Illiteracy : adult female 12 %, male 10 % (Unicef, 1999).
• Female illiteracy (1997) on village 19.12 %, urban 8.06%,
• Male illiteracy on village 9.26 %, urban 2.87 %.
(females 2 - 3 X > males )
.
2. AGE ON FIRST MARRIED, FAMILY PLANNING
first married < 17 tahun : village 24.4 %, urban 16.1 %
Use contraceptive (1997/1998) 66.9 %
07/01/21
THE QUALITY OF MATERNAL
and CHILD HEALTH SERVICES
2. DELIVERY
• traditional birth attendance 47.5 % (2,3 m deliveries)
• by family 8.2 % (400.000 deliveries),
• at home 71.9 % (SKRT 1995).
07/01/21
THE QUALITY OF MATERNAL
and CHILD HEALTH SERVICES
3. POSYANDU (INTEGRATED SERVICE POST)
• 244.032 Posyandu : 45 % elementary (110.563),
active posyandu 80 % ( 37.6 % - 85.6 %).
• 1996 ; each Posyandu have 4.6 kader,
1997 4.4 kader / Posyandu
• balita brought to Posyandu : 1.2 x / fam / year
(range 0.1 - 4.62)
07/01/21
THE QUALITY OF MATERNAL
and CHILD HEALTH SERVICES
6 .REFERRAL HOSPITAL
•Pediatricians on Hospital type D : 0.24 / Hospital,
•Obs-Gyn : 0.35 / H.
•blood bank, medicine, budget, facility
• Distance, geographic, transportation
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MATERNAL HEALTH STATUS
07/01/21
MATERNAL HEALTH STATUS
07/01/21
MATERNAL HEALTH STATUS
4. MATERNAL MORTALITY
• 373 / 100.000 pregnancy (18.000 maternal /year )
• Every day : 50 maternal mortality
• Every hour : 2 maternal mortality
07/01/21
MATERNAL HEALTH STATUS
MATERNAL MORTALITY
UNDIRECT CAUSES
1. Nutritional status (Chronic malnutrition, anemia)
2. Reproductive characteristic (age, spacing, no. of
delivery)
3. Maternal health care (delayed or never)
4. Unable to pay for delivery
.
BASIC CAUSES
• Education (< Secondary school)
• Women status in society or family
• Poverty
• Geographic handicap, distance, transportation
07/01/21
CHILD MORTALITY
BIRTH RATE : 4.8 million / year (9 babies /minute)
PERINATAL MORTALITY (umur < 1 bulan)
1 baby < 1 mo / 10 minutes
INFANT MORTALITY (age < 1 year)
40/ 1000 life birth / year (Unicef, 2000)
186.500 babies die / year, 511 babies / day,
22 babies / hour , 1 baby / 3 minutes
UNDERFIVE MORTALITY (56-59 / 1000 lifebirth)
(Depkes 1998, Unicef 2000), 261.000 under5 / year,
715 under5/ year , 30 under5/hour 1 under5/ 2 mnt
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Perinatal Mortality (> 1 mo)
Direct cause :
Fetal/perinatal problems :
respiratory & circulatory distress (45.5%),
Low birth weight / premature (32.8 %)
Infection (6.9%)
Hypothermia (5,9 %)
Tetanus (3.4%)
Metabolic (1.7%)
Maternal problems :
Nutritional status, reproduction (age, spacing, birth),
prenatal care, diseases
07/01/21
Cause of death
on infant and underfives
Severe acute respiratory tract infection (pneumonia)
diarrhoea
malnutrition
other infection
07/01/21
INFANT & CHILD HEALTH STATUS
1. LOW BIRTH WEIGHT (< 2.5 kg) : 450.000/year
2. PERINATAL CARE (< 1 mo) unadequate
Umbilical care : traditional 17,7% (800.000 perinatal).
Never seen by health staff before 1 mo of age (30 % )
Pra lacteal feeding :
banana 17 % air tajin 9.3%, sugar or honey 3.1 %,
others 9.5%.
Geographical handicap, poverty, culture
07/01/21
INFANT and CHILD HEALTH STATUS
2. NUTRITIONAL STATUS
• SEVERE MALNUTRITION (Unicef 2000) 8 % under5
(1,8 milllions underfive)
• SEVERE + MODERATE MALN.: 34 % (7 million under5)
• MILD MALNUTRITION : 26 % (5.2 million underfive).
1996 : mild malnutrition 20.96 %,
increase 5 % (1 millions underfive).
• VITAMINE A DEFF Severe Malnutrition
• Fe ANEMIA : underfive 40.5 % (9,4 million underfive)
• . Primary School age : 45 – 70 % anemia
• IODIUM DEFF. 30 million s lower intelligence
• family consumed Iodine Salt 62 %
07/01/21
INFANT and CHILD HEALTH STATUS
3. IMMUNIZATION
10 % (450.000) not fully basic immunization .
4. DENTAL:
• Decay, missing, filled : school-age 74.41 %,
• mean 2.5 teeth / child
• Dental health service for primary school 60.16 %.
• malnutrition
5. MORBIDITY & MORTALITY
• Acute respiratory tract infection (pneumonia),
• Diarrhoea,
• Malnutrition
Geographic handicap, poverty
07/01/21
INFANT and CHILD HEALTH STATUS
7. EDUCATION
• Drop out Primary School : 900.000 child/year
• Primary & Second. School Age not enroll : 6 million
• Secondary School age not enrollbut : 3.6 juta
• Enrollment on Secondary School : 71, 87 %
• Lower intelligence ? : IQ borderline ?, Mentally
retarded ?
• Parent appreciation, poverty, geographics
07/01/21
INFANT and CHILD HEALTH STATUS
07/01/21
Improving quality of mother, father
and adolescens girl
1. Improving nutritional status of mother and adolescence
girl: chronic malnutrition, Fe deffiency Anemia Iodium
defficiency
2. Improving educational status mother, father and
adolescen girl : reading for health information and its
application
07/01/21
07/01/21