Table of Contents

HK J Paediatr (New Series)
Vol 19. No. 3, 2014

HK J Paediatr (New Series) 2014;19:143-144


The Child Health Issues

GCF Chan

Paediatrics and child health are 2 inseparable entities. Paediatrics focus on the diagnosis and management of diseases processes related to children and adolescents. Child health focus on helping children to grow and develop into healthy adults. A comprehensive child health program should encompass health supervision, developmental surveillance and screening, psychosocial assessment, immunisations, and care coordination (Kuo A.A. Pediatrics 2006). There are concerns that the attention and resources, from both academics and health authority, have been unevenly distributed to "Paediatrics" and leaving the "Child Health" portion behind. It may be true in many countries including the most developed one.

In this issue, a special featured article and 2 other original articles are all on child health related topics. Prof. Shek, the awardee of the Orater for Paediatrics of the Hong Kong Paediatric Society this year, shared with us his researches on how to overcome the psychosocial problems of adolescents. It is known that youth with disadvantaged socioeconomic status together with the background of non-intact or non-harmonious family are often the high risk group to involve in problematic conducts such as drug abuse, delinquency, and anti-social behaviour. In recent years, the non-engaged and hidden youth becomes a newly emerged adolescent problem. Many of these hidden youth are addicted to computer game or web browsing, often with highly violent and sexual contents. We have witnessed how some of these youth subsequent transformed into horrible anti-social killers aboard. Prof. Shek advocates to apply program such as Positive Adolescent Training through Holistic Social program (P.A.T.H.S.) in cultivating the psychosocial competence of youth. By applying this program, adolescents become more emotional stable, pro-social, and with better social and school adjustment. His works also high-lighted the importance of research in child-health related issues. The research can be in the form of "prevention science" by identifying the risk factors and then applying preventive intervention. The other approach is to induce positive inner strength or competence among youth through "positive youth development". He cited successful stories of how "positive youth development" can improve the resilience and self competence of young people. Such approach should be adopted as a model by the Government so a more widespread and sustained effort can be extended to the youth in needed.

The other two articles are about maternal health survey in a province of China and dental health of children with autistic spectrum disorders, both are specific topics within the scope of child health. Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. As we know, good paediatric and child health stems from a healthy pregnancy and perinatal care. Therefore, understanding the maternal health in a locality is vital in identifying the service gap for subsequent improvement. Motherhood should be a positive and fulfilling experience, however, for many women it is associated with suffering and this will compromise the subsequent development of a healthy child.

On the other hand, dental health is another important aspect of child health. It is interesting to show that children with special needs such as autistic spectrum disorders can have better oral hygiene. This is in part due to the extra effort provided by the Government. On the other hand, lower social economic status is associated with poorer dental care and higher dental caries rate. This implies that if we have more resources on dental education and care, the dental health of our children can be improved, no matter they are normal children or children requiring special needs.

In Hong Kong, a child health survey has been done by the Surveillance and Epidemiology Branch Centre for Health Protection, Department of Health in 2005 to 2006. It covered a wide spectrum of child health related issues including general and psychosocial health, physical health, diet and physical activities, risk behaviour, childhood injury, parenting, disease prevention and utilisation of health facilities. The survey report was released in 2009 and revealed that our children population aged 0 to 14 years generally enjoyed good health in the domains that the survey covered. However, areas that require improvement have been identified including myopia, obesity, low activity level and risk taking behaviours. If we carefully look at the details, there are additional areas that raise our concern. Such as almost 25,000 children have smoked and 25% of our children are not routinely taken care by their own parents. And another question is by now, almost 10 years from the last survey, whether there are any changes in all these parameters?

One unique characteristic of child health care is the involvement of multiple non-medical professionals such as experts involve in education, social welfare, psychology, etc. Without each of these components, it can hardly be functioning normally. Therefore, a concerted effort is needed. Currently, many of our professionals under both academic institutions and professional bodies have been engaging in networking with the other professionals to strengthen the development of child health. This is a good trend. However, we have to remember that paediatrics and child health are 2 inseparable entities. While we are promoting one, we should not exclude or ignore the development of the other. Otherwise, we will just shifting our resources and attention from one end to another and triggering a perpetual competition of the 2 important domains of our profession. That is something that we don't want to see and should try our best to avoid.

GCF Chan
Chief Editor

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