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Health Policy and Planning, Vol 14, 1-10, Copyright © 1999 by Oxford University Press

ARTICLES

Review article: child health promotion in developing countries: the case of integration of environmental and social interventions?

J Ehiri and J Prowse
Previously Centre for Occupational and Environmental Health, Faculty of Health and Community Studies, De Montfort University, Leicester, UK; Current address: International Health Division, Liverpool School of Tropical Medicine, Liverpool, UK

In spite of improving epidemiological knowledge in relation to child health, the challenge of promoting the survival and quality of life of infants and children in most parts of the developing world remains an abiding public health problem, for both the countries and the international agencies involved. Current infant and child health programmes largely reflect western style medical care, with emphasis placed on reducing mortality, and the preventive aspects confined mainly to immunisation, improved nutrition, provision of micro-nutrients, promotion of breast-feeding and birth spacing. In contrast, environmental and social factors which underpin the proliferation of disease agents are receiving minimal attention. This paper presents a critical review of current strategies for promoting child health in developing countries, and examines the environmental, social, and political factors that influence child health. Presenting a specific example of infant and childhood diarrhoea, the authors argue that in order for a real reduction in mortality, and improvements in quality of life to be sustained, attention needs to be focused equally on the environmental and social factors that underlie much of the childhood diseases in the developing world. This will involve the adoption of a broader strategy aimed at reducing childhood diarrhoea, using the hazard analysis critical control point (HACCP) system in combination with other methods.
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