Historical Development of child Care at National and international Levels

The country's health was much worse many centuries ago, with much higher death rates and a far shorter average lifespan. Children were treated as a commodity at that time (as an additional hand to help families with household work and farm work). Crowded living circumstances, insufficient and unsanitary food (e.g., contaminated milk), a lack of childhood vaccinations, and severe working conditions all contributed to the prevalence of infectious illnesses (including child labor). Children are particularly vulnerable to the devastating effects of epidemics such as smallpox, diphtheria, scarlet fever, and measles. This perspective shifted as public schools were founded and children's health became a greater public concern.

As the nineteenth century came to a close, doctors and scientists made significant advancements in their ability to identify and treat diseases at their source. With this information, public health initiatives like the fight for a tastier, safer milk supply may be prioritized (pasteurization of milk). During this time period, mandatory vaccination programs were introduced.

Nutrition, sanitation, bacteriology, pharmacology, medication, and psychology all benefited from the fresh information that emerged around the start of the 20th century. During this time, several important tools in the fight against contagious illnesses were developed, including penicillin, corticosteroids, and a rise in the number of vaccines available. As a result, by the end of the twentieth century, accidental injuries had surpassed infectious diseases as the main cause of mortality for children aged one and above.

By the century's conclusion, technological progress had a major effect on every aspect of health care. Child survival rates have improved as a result of these tendencies. However, many kids who beat deadly diseases end up with permanent impairments. Extremely preterm newborns, for instance, did not survive due to lung immaturity before the 1960s. Mechanical ventilation and the use of medications to foster lung development have led to higher survival rates in premature infants, but those who do make it often suffer from a variety of long-term complications, including chronic lung disease (bronchopulmonary dysplasia), retinopathy of prematurity, cerebral palsy, and developmental delay. As a result of people living longer, chronic diseases have become a far bigger reason for hospitalization and death than acute diseases.

Technology and biology have made great strides in recent years. As a result, there's been a shift toward identifying and treating health problems at their earliest stages. Additionally, many genetic abnormalities are being found at an early stage, allowing for earlier counseling and treatment.

Multiple domestic and international groups have emerged in recent years to safeguard children's rights, complementing the advances in technology and biology. Violence and abuse, child labor and soldiering, juvenile justice, child immigrants and orphaned children, and abandoned or homeless children are all areas that these groups seek to address. When a kid's rights are restored and respected, the youngster has a better chance of a healthy and productive life.

Though there has been progress in the field of child health, this improvement has not been shared equally among all children. Children from low-income households are more likely to suffer from and experience the worst symptoms of health problems such as malnutrition, obesity-related illnesses, lead poisoning, and asthma.

In the 21st century, obesity, environmental toxins, allergies, drug abuse, child abuse, and neglect, and mental health problems are among some of the key issues that endanger children's health.

Development of Child Health in Nepal

In 1983, Nepal launched the Control of Diarrheal Disease (CDD) Program as the country's first initiative aimed at ensuring the survival of its youngest citizens. Also starting in 1987 was the attempt to reduce the spread of acute respiratory infections (ARIs). After combining ARI intervention and CDD in 1997/98, the resulting program was called CBAC (Community Based- ARI and CDD program), and a year later, nutrition and vaccination were included as additional components. Mahottari district became a test site for the Integrated Management of Childhood Illness (IMCI) program in 1997. Community-Based Integrated Management of Childhood Illness was officially established in 1999 after the government of Nepal merged the CBAC with IMCI (CB-IMCI). In its infancy, the CB-IMC program served children from 2 to 59 months old and focused on the treatment of major childhood killers such pneumonia, diarrhea, malaria, measles, and malnutrition. Nationwide implementation of CB-IMCI was completed in 2009.

A effective public health initiative, Nepal's National Immunization Program (or "Expanded Program on Immunization") first began in 2034 BS. Nepal is polio free since 2010 and Nepal was awarded as polio free country on 27th March 2014. The eradication of maternal and neonatal tetanus in Nepal has been sustained since 2005. The rates of measles and rubella, as well as Japanese encephalitis, have decreased. The neonatal death rate in Nepal was quite high since there were no specific interventions for infants, despite the country's enormous success in reducing under-five and infant mortality up until 2005. Birth defects, infections, hypoxia, and low body temperature were the leading causes of infant death. The government of Nepal created the "National Neonatal Health Strategy" in 2004, the "Community Based Newborn Care Program" (CB-NCP) was developed in 2007 using the strategy, and a pilot program for the CB-NCP was implemented in 2009.

The Ministry of Health (MOH) made the decision to merge CB-IMCI and CB-NCP into a single program known as CB-IMNCI on 2071/6/28 (October 14, 2015). (Community Based Integrated Management of Neonatal and Childhood Illness). Children ages 0-5 are the primary focus of the CB-IMNCI program. Essential newborn care and management of newborn problems such as birth asphyxia, neonatal sepsis, jaundice, hypothermia, low birth weight, and preterm conditions, as well as breastfeeding guidance, are all part of the child-survival interventions for infants from birth to 2 months of age. Diseases including pneumonia, diarrhea, malaria, measles, and malnutrition, which are leading causes of death in children under five, are comprehensively addressed in this program for infants and toddlers aged two to five years. me.

Pediatric hospital and education in Nepal

Prior to 1963 A.D., there were no specialized pediatric hospitals in Nepal. While the Bir hospital did have a tiny pediatrics unit, neither a physician nor pediatric nurses were on staff. Therefore, in 1963, for the treatment of children, a 50 bedded general hospital was created in Maharajgunj, which was later extended to 100 bedded and turned into a full-fledged children's hospital in 1970, today known as "Kanti Children Hospital." This hospital is the only government facility in Nepal devoted exclusively to the care of children, and it serves as the country's only tertiary referral center. The hospital has grown from a 100-bed facility to a 300-bed facility that provides comprehensive treatment for children of all ages, including medical, surgical, emergency, and outpatient care; intensive care unit care (NICU, PICU, SICU); cancer care; and cardiology care. In the present day, a variety of additional institutions, both public and private, offer pediatric care. Health care for newborns (from birth to 28 days) is now provided free of charge at all public hospitals, and this includes NICU treatment.

This is combined with an increase in nursing services, with an emphasis on childcare. Graduate and post-graduate programs in pediatric nursing are available at both public and private medical schools.