Singapore Government Press Release

Media Division, Ministry of Information and The Arts,

36th Storey, PSA Building, 460 Alexandra Road, Singapore 119963.

Tel: 3757794/5

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Speech By Dr Aline Wong, Senior Minister Of State For Health at the Opening Ceremony Of The Workshop On "Children, The Family and Health" 18 Feb 99, 7 PM, YWCA Fort Canning Ballroom

 Theme: Towards Better Health For Our Young Children

Introduction

 I am happy to be here this evening to officiate at the opening of the Workshop on "Children, The Family and Health", organised by the Singapore Council of Women’s Organisations on behalf of the Pan Pacific South East Asian Women's Association (PPSEAWA). I would also like to extend a very warm welcome to all our local and overseas participants who will, over the next few days discuss the state of health of younger children in our region, as well as establish ways to improve their health conditions. We hope that our overseas friends will find some time to savour the sights and experiences which Singapore has to offer.

It is indeed fitting to have a workshop on Cchildren , as they are our most important and vital assets who will influence the future of our society. A healthy child will grow into a healthy adult. Good health combined with a stimulatory environment can help ensure that the full potential of our children is achieved.

Health in Children – The Size of the Problem

On a worldwide scale, it is reported that about 12 million children die each year before the age of five years. This occurs mainly in the developing countries. Nearly three-quarters of these childhood deaths are caused by one or more of five common, preventable and treatable conditions, namely pneumonia, diarrhoea, measles, malaria and malnutrition.

Around the world, the leading cause of death in children under five years of age is acute respiratory infection. More than two million children die of pneumonia annually. Diarrhoeal diseases, which are often caused by consumption of contaminated food and water, account for more than another two million childhood deaths each year. Measles is another the third major killer responsible for infecting over 40 million children and killing more than 800,000, children under the age of five every year.followed by Malaria malaria which claimsclaims the lives of 600,000 children. each year. Another very important cause of childhood deaths Iin certain parts of the world, is malnutrition continues to be the main cause of ill health and even childhood death. This is due not only to a lack of food, but also to poor feeding practices, poor knowledge on the type and range of food to feed the child, and unattended illnesses, and child neglect.

Alarming and sad though it is, it has been predicted that these five conditions will continue to be the major causes of childhood mortality in the year 2020, if efforts are not made to prevent and control them now. We cannot afford to let this tragic scenario happen. We must do something to prevent these diseases from claiming more innocent young lives in the developing world.

Although each country in each region has to work under its own set of unique circumstances, there is much we can share in terms of ideas and experiences.

Maintaining good health in our very young children

In Singapore we have learned that disease prevention and health promotion are the best strategies to combat illness and all the costs and suffering that illness brings to individuals, families and the community. Investing in hospitals, clinics, drugs and equipment to treat the sick is necessary, but this can never be enough because, like all other countries, our resources are limited. Thus, we place a great deal of emphasis on disease prevention and health promotion. This applies to both the young and the adult population.

About 16% of our resident population are below the age of 10, and about 8% are below the age of five. Aleven though our infant mortality rate at 3.6 per 1,000 live births (1997) is one of the lowest in the world, we have not been complacent. my Ministry takes child health seriously. We provide a systematic and comprehensive schedule of immunization and child health surveillance for young children. Our immunization programme has been very successful, as 90% and more of our very young pre-school children are immunized against the nine major infectious diseases (These are: TB, hepatitus B, diphtheria, whooping cough, tetanus, polio, measles, mumps, rubella). For school-going children, my Ministry also provides health screening, immunization and health education through school and clinic based programmes. In this way, health problems can be detected early, communicable diseases prevented, and good health habits inculcated.

My Ministry takes child health seriously. We provide a systematic and comprehensive schedule of immunisation and child health surveillance for our young pre-school children. For school-going children, my ministry also provides health screening, immunization and health education through school and clinic based programmes. In this way, health problems can be detected early, communicable diseases prevented, and good health habits inculcated in our children.

We value highly the health and development of all our children. With the elimination of the major communicable diseases among our our children, the leading causes of morbidity and mortality among our children in Singapore are congenital abnormalities, although the numbers affected are very small. We have set up a system to screen all newborn babies. Blood tests are routinely done for all newborns to detect two very important conditions, namely G6PD deficiency and congenital hypothyroidism. All pregnant women have access to antenatal care. Genetic counselling is available for those who have history of genetic conditions such as thalessemia. In many hospitals, birth defects clinics have been set up to manage children with birth defects. My Ministry has set up a National Birth Defects Registry to help monitor the trend of common birth defects so that appropriate attention can be given. As a result of all these measures, the number of children with severe congenital abnormalities has remained low.

As the child grows, my Ministry continues to monitor his physical and social development, through child health screening or surveillance programmes at our Government clinics. These programmes have been implemented since the start of the 1970's in all our Government clinics. They are regularly updated and improved upon with the latest major revision in 1998, to ensure ensure early detection of any developmental abnormalities, so that early intervention can be introduced. These programmes are provided free of charge and are offered into all immunization visitsat regular intervals, coinciding with the child’s clinic attendance for immunization. This has ensured that the coverage response rate of children in to our developmental screening programme is nearly 80% of all children.

Our School Health Service also provides school-based medical screening, vaccination and health education to students. The medical screening includes growth and development, eyesight and spinal screening at critical stages of the child's development. Where necessary, the child is referred for specialist care at the Student Health Centre.

I might have given you the impression that all that needs to be done to ensure good child health is to have good screening programmes and good child health services provided by the Government. This is not true. Apart from the role of the Government, parental involvement is most important to the success of any child health surveillance revised programme. Parents are ultimately responsible for ensuring the child's health. The Government can only provide the environment, the resources and the facilities for ensuring child health. Parents have to take the initiative to make use of such resources to protect their own child's health. Immunization may be offered free of charge and parents receive reminders to bring their young child for immunization at the required intervals. It is the parents who have to bring the child to receive the immunization. Thus, parents' education is a very important component of our child health surveillance programmes. For example, during the immunization visits, the child’s health and development are assessed and reviewed with parents. A questionnaire on various aspects of the child’s health and development is also given to parents when the child reaches specific ages. This is particularly useful as parents are in constant contact with their children, and any problem noted by parents can be identified quickly and highlighted to the doctor. The results of the questionnaires are reviewed during the child’s periodic health checks by the polyclinic doctor.

Apart from parental involvement, we have learnt that community participation is also important for disease prevention and health promotion. Community participation is effective in spreading knowledge, skills and attitudes about child health issues. Thus, my Ministry regularly and frequently holds educational talks on child care and nutrition demonstrations for children of various ages. These are conducted not only at our government polyclinics, but also at community centres throughout the island. One particular community activity that has been found to be attractive to participants from the community is healthy baby competitions. These invariably draw crowds and enthusiastic participants from among mothers, grandparents, caregivers and so on. These are good occasions to spread the right messages on health and nutrition for infants and young children. On a more serious note, my Ministry organises health talks and roving health education exhibitions that go around the community centres at every possible opportunity provided by community organisations.

We also have a large variety of brochures and print materials on child health which are available to the public.

To conclude, one of the most important aspects in child health management includes improving practices in the family as well as health awareness in the family.is a healthy environment. A healthy home and living environment is essential in the healthy development of a child. Improved Good hygiene and good feeding practices should be practised rigorously at home, in the nursery, and in school. Parents and guardians have a duty to provide a healthy home and to ensure that children get prompt medical care when required, receive proper immunizations, and undergo child health checks regularly. All these will go a long way in achieving continuous good health for our children.

The Role of Workshop Participants

All the participants here have been working with children. Whether you are a teacher, a community worker, a social worker or a parent, you have an important role to play in the development of good health in our children. Over the next 3 days yYou will have the opportunity to identify, discuss and share your experiences in tackling health problems in children of their respectivethe Pan Pacific South-East Asian countries. I hope the workshop will prove to be enlightening and fruitful for all participants and observers.

On that note, I would, with greathave the pleasure, to officially open the Workshop on "Children, The Family and Health".