Child health : chapter 19

Children have been prioritised in the process of South Africa's transformation. In the health sector, a number of policies and programmes have been formulated in the past five years. Implementation of these policies and programmes has not been uniformly successful. This chapter examines the progress made within the health sector and whether children's health needs have been adequately addressed. Health status indicators for children reflect a mixture of successes and concerns. The majority of areas in the country still have child mortality rates that are much higher than in other countries with comparable levels of income. Immunisation coverage has not improved much in the last 5 years. Yet, there has been a considerable drop in childhood infectious diseases such as measles, polio and neonatal tetanus. The countrywide Integrated Management of Childhood Illnesses has the potential to improve child health significantly. Two problems that have emerged as serious threats to child health and well being are highlighted. These are the rapidly rising rate of HIV-infections, and the scourge of trauma and violence against children. The current organisation and delivery of child health services are not adequately equipped to deal with these emerging problems. The chapter concludes that some important strides have been made in terms of responding to the health needs of children, but that many gaps and challenges still remain.