Birth defects, also
known as congenital anomalies, are growing public health problems which cause structural
and functional disorders that result in malformations, malfunctions or
syndromes that may present in-utero or after birth. Birth defects cause
significant morbidity and mortality with increase in health care expenditure
and psychosocial problems for the child and family throughout life. It is the
leading cause of infant mortality and occurs worldwide with about 3% live
births. In general, different birth defects are existent in different rates in
different parts of the world probably due to differences in distribution of
risk factors.
In the early 1940s,
scientists thought that genetic factors, which are out of the control of health
workers, were the only predisposing factors to birth defects. However, the
discovery that German measles affecting pregnant mothers led to birth defect
showed that relevant public health measures could be put in place to reduce these
disorders and defects. Shortly afterwards, it was also observed that the use of
the sedative drug- thalidomide, by pregnant women led to increase in Amelia in embryos
while the anti-acne drug, isotretinoin commonly known by its trade name
Accutane causes oro-facial clefts. These findings showed that drugs could also lead
to birth defects. Subsequently, the number of agents that cause birth defects-
known as teratogens, continued to increase due to widespread surveillance,
monitoring and observation. Other infectious causes include protozoans e.g.
toxoplasmosis; bacteria e.g. syphilis; and viruses e.g. HIV. Besides drugs and
infectious agents, birth defects can also be caused by exposure to
environmental teratogens such as radiation and heavy metals or issues with
maternal health such as obesity, diabetes, pregnancy before 18 years or after
35 years, smoking and substance abuse especially alcohol which causes foetal
alcohol syndrome.
Although many birth
defects, especially those of genetic origin, are difficult to treat or prevent,
public health has focussed more on educating the public through awareness
programmes on those that can be prevented. Several research studies worldwide have
unequivocally demonstrated that increased folic acid intake (above the given
FDA range) reduces the risk of neural tube defects. Public health officers also
partner and work with the FDA to ensure that there is a black box warning
against use of potential teratogens. More so, awareness is continuously created
for other causes of birth defects such as radiation and poor hygiene or
sanitation practices. Most awareness campaigns are targeted towards the prevention
of infection and have proven to be effective in addressing some causes of birth
defects. Screening and advanced testing such as karyotyping or PCR are essential
to the diagnosis of genetic defects like Down syndrome as well as to counsel parents
on what to expect. Stem cell research and gene therapy, on the other hand,
continues to give hope to families of children with genetic disorders.
Family planning is a significant part of healthcare, and
is important to not just the family unit but also the community, state, and
nation. Generally, it presents far reaching effects that cut across social, financial
and political dimensions of the society. Family planning is particularly a
problem in poorer families, low income groups and developing parts of the
world. It is also an integral part of maternal health, basic human right to
choose and women empowerment in general. According to WHO, family planning
allows individuals and couples to anticipate and attain their desired number of
children as well as the spacing and timing of their births. This is achieved by
the use of contraceptives, whether traditional ones like withdrawal and rhythm
methods or modern contraceptive methods which may involve birth control pills, condoms,
insertion of a diaphragm or an IUD and castration or vasectomy. Even though
these methods are aimed at avoiding pregnancy, post conception ways and acts of
terminating pregnancy such as abortion are not part of family planning. Despite
being legal in many countries, including Canada, the 1994 United Nations summit
in Cairo still rules out abortion as part of family planning.
As an important public health issue, it is pertinent
that doctors, nurses, midwives and other health care workers educate the public
and provide necessary expert advice on the contraceptive options available. The
importance of family planning cannot be overemphasized because the right to
choose birth times allows women to be free to pursue their career or academic goals
which in turn improves their feeling of wellbeing, empowers them to make better
choices about how to plan and live their lives as well as increases their economic
significance to the society. Families may also choose to have a particular
number of children or even temporarily delay childbirth if there are important
financial stressors which would actually improve the quality of life. Also, contraceptives
like condoms are an integral part of safe sex practices which have helped
reduce the incidence of AIDS and STIs among sexually active people like
teenagers or extramarital affairs that are not considered to be planning a
family.
Evaluations have revealed a decline in infant
mortality and adolescent pregnancies in areas with better family planning
access, awareness and education. On a larger scale, some governments mandate family
planning for national planning and population control like China’s One Child Rule
policy. Family planning, despite all its merits has met some stubborn
challenges. Several issues influenced by maternal age and health such as the
risk of down syndrome and other chromosomal disorders, tumours, gestational
diabetes and even emergency life threatening conditions like eclampsia have
been identified. Additional issues reported include deficiencies with the
method of contraception such as irregular periods and infections from implant. There
are also cultural and religious hindrances to virtually all forms of modern
contraceptive use especially in communities with more cultural and religious
influence on individuals. Perhaps the most modifiable limitation of family
planning is coverage and accessibility which healthcare providers and
governments can tackle by creating more awareness through outreach and
educational programmes to promote, emphasize and nail in its importance.
Children like
every human have basic human rights and child maltreatment in all its forms
violates this right. Child maltreatment involves child abuse, child neglect, manipulation
or trafficking by the supposed care giver .Child abuse could be physical like
inflicting wounds or sexual like oral sex, fondling of genitals, voyeurism and
other sexual acts or emotional use words to hurt a child feeling. Child neglect
is physical- when a caregiver fails take care of the child; medical- when
medical needs are not taken care of; and emotional- when the emotional needs of
the child are not met. Children who are particularly at increased risk of
maltreatment include: children born into broken homes or those born to mentally
ill parents. The fact remains, child maltreatment is a global and public health
problem given that one in every four adults report experiencing some kind of
abuse or maltreatment as a child.
The consequences of child maltreatment may be immediate death of the child during the process or injury. Long term results such as psychological issues like depression, anxiety, schizophrenia, suicide or emotional brokenness are equally devastating to both the child and the society. There could be physical deformations in cases of physical abuse or extreme sexual behaviors, abnormal sexual cravings and other psycho-sexual disorders in cases of sexual abuse. Medical neglect may lead to complication of an otherwise benign disease while physical and emotional neglect could result in poor emotional understanding and awkward responses even in adulthood. Abused children may grow up to become involved in crimes, substance abuse, violence to cope with their past, and may even abuse other children setting up a vicious cycle that worsens the problem in the society
The public health sector has perhaps the most important role in tackling this problem. There are already education and awareness programs where children are taught, for example, to understand sexual cues like good touch and bad touch, rights as individuals over their bodies. Awareness programs also help train health workers and the general public on ways to recognize physically abused children like children with multiple bruises, especially bruises in unusual areas of the body like the cheeks, ears and back. Physically neglected children may be generally untidy and wear dirty clothes to school while medically neglected ones have an obvious medical condition that’s not attended to. Victimized children tend to be distrustful and withdrawn so it is especially challenging to reach out to them however, their fears should be addressed and they should be assured that they would be properly taken care of. Public officers should be sent more to areas with higher reports of abuse and there should be reliable access to public health services through a phone. They should work with the judiciary to take control of the child as quickly as possible as the child runs the risk of further abuse or even death. Children with psychological problems from abuse should be referred to psychiatrists to assess and help them to find coping mechanisms. Government also has important roles like instituting laws such as serious jail terms for children abusers and proper funding of social and health care services that help fight child maltreatment.
Child maltreatment is not just a problem for public health and the government, it is every ones problem and we must do what we can to protect, guide and save these innocent creatures for posterity sake.
Air quality can be
defined as the state of the air within our surrounding environment in relation
to its appearance and composition. Air quality is measured by the extent to
which air is clean, clear and free from impurities such as smoke, chemicals,
particles, mists, dust and smog. The quality of air can be determined by
measuring and assessing a series of quality indicators such as amount of
impurities, rate at which these impurities are released into the atmosphere and
how long they are trapped in air. The WHO Air Quality Global Guidelines, which
was published in 2005, provides an assessment of the health effects of poor air
quality as well as thresholds values for harmful impurities.
Good air quality is
important to balance and sustain the existence of human, plant and animal life,
and to preserve natural resources and the environment at large. Consequently,
all life and resources are threatened when impurities and chemicals exceed
threshold concentrations in the atmosphere. Air quality can be depraved through
either natural or man-made means- natural processes that depreciate air quality
are volcanic eruption and windstorm dust while man-made processes include
contamination by vehicles exhausts, toxic gases from industries, coal powered
plants, landfills and burning wood or other material in open air. Both natural
and manmade causes of poor air quality can significantly affect overall air
quality resulting in severely negative health problems for humans, animals,
plants and the environment as a whole.
Human activities emit
a wide range of contaminants which depreciate air quality on a daily basis.
These contaminants are classified into different categories that include Sulfur
Dioxide, particulate matter, Hydrocarbons, volatile organic compounds, Lead,
Carbon Dioxide, Carbon Monoxide, Nitrogen Oxides and Smog. In most parts of the
globe, substances that visible reduce air quality include smoke, dust, particles,
some gases, soot and smog from factories, power plants, automobiles, and
smelters particularly in urban and industrial areas. In general poor
environmental air quality also affects indoor air quality. Specific indoor air contaminants
include cigarette smoke, mould, dust mites, pet dander, formaldehyde, volatile
organic compounds and radon gas. Certain conditions like light winds and high mountains
that tend to constrain air movement may preserve and increase contaminants and
perpetuate poor air quality in an area.
Despite many efforts
by various organizations, including WHO, to improve air quality, the situation
has worsened. Many people across the world die annually due to the damage done
to their bodies by the gradual, yet daily and consistent inhalation of toxic
gases present in the atmosphere. Health consequences of poor air quality are
difficulty breathing, irritation of lungs and airways and aggravation of
already existing chronic diseases such as heart disease, chronic bronchitis,
emphysema and asthma.
Certain ways to
promote and improve air quality for this, and the coming generations include:
reducing traffic and vehicle emissions by encouraging public transports;
managing industrial waste and emissions; and establishing effective policies
that embrace clean air action plans. However, these require collaborative
effort and long-term team work, partnerships and commitment from individuals,
businesses, companies, facilities, national governments and international
organizations.