Update on Child Health in India - World Immunization Week April 24 - 30 2015

Dear Colleagues,

Greetings! You are an important advocate for child health in India and it is with great pleasure that we are writing to you. This is the second of a series of periodic emails through which we would like to share research, media, and other efforts ongoing in India around child health and disease prevention. We hope that you will share these updates with your colleagues and networks, and that they will be useful tools as you continue addressing the urgent child health needs in India.

Government Launches Mission Indradhanush

As 2014 came to a close, the Ministry of Health and Family Welfare (MoHFW) announced the launch of Mission Indradhanush – a campaign to vaccinate all unvaccinated and partially vaccinated children and pregnant women by 2020 under the Universal Immunization Programme (UIP). Mission Indradhanush is focusing on interventions to expand UIP coverage to more than 90% of children, up from 65%.

The Government has identified 201 high focus districts across the country, where it will organize special catch-up campaigns to rapidly increase full immunization coverage to help reduce morbidity and mortality due to vaccine-preventable diseases. These diseases include: diphtheria, whooping cough, tetanus, polio, tuberculosis, measles, and hepatitis B. Read more.

You can join the movement by tweeting #FullyImmunizeEveryChild and sharing this graphic with your network. For updates, follow @Vaccinate4Life.

The Value of Vaccines

Vaccines are considered to be one of the most cost-effective solutions in the history of health and development. In 2012, some of the world’s leading health economists ranked childhood

immunization among the top three most cost-effective solutions to advance human welfare.

Importantly, vaccines don’t just save lives. They also prevent illness, hospitalization, disability, and unnecessary human suffering. They provide indirect benefits to individuals and society, including improvements in cognitive development, educational attainment, and labor productivity.

We created a new brochure, for use in your advocacy efforts, about the power of vaccines in India.

National Health Policy

The Draft National Health Policy, recently shared by the MoHFW on its website includes several points that may impact new vaccine introduction. Key among them are the need for a national epidemiological evidence base for decision-making and monitoring, better reporting of Adverse Event Following Immunization (AEFI), and evaluating compensation for AEFI cases. The MoHFW solicited comments on the draft policy though the end of February.

Upcoming Child Health and Immunization Events

&#8226                       Harnessing Power of Immunization: Opportunities & Challenges for New Vaccines

25-26 April, 2015 in Kochi, India

&#8226                       World Immunization Week (Next Week!) 24-30 April, 2015

&#8226                       ASVAC 2015 - Asian Vaccine Conference 12-14 June, 2015 in Hanoi, Vietnam

Continuing the Momentum

The Government of India’s continued commitment to child health is inspiring. Each great stride helps save more lives and prevent illness. Your voice plays an important role in demanding that the same level of momentum and commitment remains. Through advocacy YOU can become a champion.

Here are 10 ways you can advocate during World Immunization Week (24-30 April):

1                                            Brief a state or district level government official, elected representative, political leader or other key stakeholder

2                                            Write an Op-Ed or an article

3                                            Speak to a journalist

4                                            Write a letter to a policymaker to call for new vaccines and/or investment in strengthening the system

5                                            Organize or participate in a child health or immunization event

6                                            Build awareness amongst colleagues and friends

7                                            Use social media to promote immunizations at a local and/or global level (e.g. #vaccineswork)

8                                            Educate families, students, and others about risks of disease and what can be done

9                                            Share success stories with this advocacy network

10                                        Display advocacy materials illustrating value of vaccines prominently at your practice or place of employment

Thank you for your dedication to child health and survival in India.

Dr. Mathuram Santosham

Professor, Johns Hopkins Bloomberg School of Public Health (JHSPH)

Senior Advisor, JHSPH International Vaccine Access Center (IVAC)

A 5 year old child swallowed a coin - now in stomach on X ray - what to do?

Q: A 5year old boy has just been rushed to my OPD with a swallowed coin. The child is playful & active, and the coin was swallowed 1-2 hours back. An xray reveals that the coin has reached the stomach. How to proceed?

Guest Answer - Posted at Docpelxus by Dr Kirthy Proamd R.

Hi,

Coin ingestion in children is very common. Most paediatric surgeons at institutions see atleast around twenty coin ingestions a year. They all pass out in the stool. There is no necessity to give laxatives too, as this can cause the FB(foreign body to get stuck at some kink in the bowel. If an ingested coin remains in the stomach for more than 72 hrs in an xray, then u may consider endoscopic extraction. many ppl even wait upto seven days for spontaneous passage in stool. ofcourse parents need to check the stool for passage of FB, so as to avoid unnecessary xrays. urgent removal of coin is necessary when its stuck in esophagus and causing retching. many occasions when a coin is stuck in the esophagus and child is ASYMPTOMATIC, overnight waiting for it to spontaneously pass to stomach and confirming on xray is sufficient as it then passes out.

Most foreign bodies pass out on their own... seen large clips(hair clips-even fla ones) triangular glass pieces, lockets, safety pins all come out on their own.

In sharp foreign bodies dangerous is foreign bodies with both ends sharp.. like a needle...

one edge pointed and other broad end objects do not cause problem...courtesy fluid dynamics...when the flowing liquid has to take a foreign body along, its always the broad end that moves forward...physics...

in non-sharp foreign bodies... dangerous is button batteries.... try n get them out as quickly as possible... endoscopy or paeglec flush therapy in hospital... this is because the button-battery has a rubber seal holding the the metalic round plates together with dangerous chemicals like mercuric chloride inside... the older the battery the faster the rubber ring melts in the gastric acid and chance for the the button battery to open up and cause havoc of multiple perforations in the intestines.....

Magnets also may come out many times if small but sometimes there is a risk of two powerful pieces of magnet getting attracted through different bowel loops and then causing slow necrosis of intervening bowel walls.. seen one case

So most often it is just "Masterly Inaction and Careful Follow-up"

Sorry if this is little exhaustive to your question.... but sure will help u get an overview

Seen all these personally during my training under my teachers and my practice of Paediatric Surgery in the last ten years

Thank you

What is the ideal age of surgery for common pediatric surgical conditions?

Inspite of advances in pediatric surgery, anesthesia and good pre and post operative care, still many a times, babies are referred quite late for surgery, just because the referring doctor & the parents are not updated about the age at which a particular pediatric condition is corrected.

For parents, there baby is always small, and they avoid operations as much as possible, but it is our duty as doctor to guide them properly, as the age of operation matters in many pediatric surgical conditions.

Some commonly seen anomalies and their ideal age of operation.

Inguinal hernia- as soon as diagnosed.Congenital hydrocele- wait n watch till 1.5 to 2 yrs age, if doesnot resolve, needs surgery.Umbilical hernia- after 3 yrs , if no signs of irreducibilty before.Undescended testis- 6 mths... must complete orchiopexy by 6 mths age.Phimosis- if physiological , wait till at least 3 yrs, treat with steroids and then possible surgery if recurrent infections only.Hypospadias- between 6 mths to 15 mths is ideal age for repair.Tongue tie- between 10 mths to 1 yr.Cleft lip- 3 mthsCleft palate- 10 mthsPolydactyly - if with pedicle/ stalk- at birth to prevent gangrene n complications.Antenatally diagnosed anomalies- conselling by pediatric surgeon from antenatal period helps prevent postnatal panic,and parents are prepared mentally and financially for the treatable anomalies.