Health and nutrition problems in preschool children

It is becoming apparent that treating health and nutrition problems in preschool children (< 5 years old) is important for two reasons. First, these children account for more than 50% of the global gap in mortality between the poorest and richest quintiles of the world's population and second, they bear 30% of the total burden of disease in poor countries. There are an estimated 600 million preschool children worldwide [3] and they have several-fold higher case fatality rates for many infections, therefore keeping them healthy gives them a better survival rate in childhood and adulthood.

Out of 100 children born in each year, 30 will most likely suffer from malnutrition in their first 5 years of life, 26 will not be immunized against the basic childhood diseases, 19 will lack access to safe drinking water and 40 to adequate sanitation and 17 will never go to school. In developing countries, every fourth child lives in abject poverty, in families with an income of less than $1 a day. As a consequence nearly 11 million children each year - about 30 000 children a day - die before reaching their fifth birthday, mostly from preventable causes. Of these children, 4 million die in their first month of life. Of the 10.5 million children that died in 1999, 99% were from developing countries and of these 36% were in Asia and 33% in Africa. In many of the world's poorest countries, child mortality rates have either not changed or else they have worsened. In sub-Saharan Africa, child mortality averages 173 deaths per 1000 live births, and in South Asia 98 deaths per 1000 - many times the industrialized country average of 7 deaths per 1000. More than 50% of all child deaths (< 5 years old) are due to five communicable diseases, which are treatable and preventable. These are pneumonia, diarrhea, measles, malaria and HIV/AIDS.

For those who survive, poor health and nutrition has an impact on their lives, which is less apparent but which nonetheless has serious implications for their development and their education. This impact is considered in the following section.

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