Learning: Space your Babies! Wash your Hands! Protect your Children!

This week there is a Global Child Health Conference at work, and I've been attending some of the lectures. Really interesting stuff - and, of course, totally up my alley :)

The new information, constant images and personal accounts have definitely re-invigorated me and provided inspiration to go out and save the world one child at a time! I cannot wait to be able to do so - med school let me in!! Anyway, definitely a much appreciated break from the usual routine and med school waiting game.

Some of the most interesting lectures I've heard have been about:
1. Birth Spacing
2. Sanitation, Water and Hygiene
3. Child Trafficking

Parasitic infections and gross worm pictures have also been pretty awesome. Well "awesome" for those of us who enjoy that sort of fine line between totally interesting and gross clinical voyeurism :) I digress...

First, Birth Spacing.

Why do we care?

The risk of death from pregnancy and child birth is 1 in 22 in Sub Saharan Africa, and 1 in 75 in Asia. There is a huge disparity between rich versus poor countries. Can you imagine the outcry if those were the stats and risk involved in the US? In addition, if these "poorly-spaced" children do survive, i.e born less than 2 years after their mother had her previous child, there is a much higher risk that the second child will be stunted and underweight (among other problems). The mother has less time to breastfeed and recover herself and often suffers from other health issues.

So why do many mothers (and fathers), particularly in poorer countries, often decide to have or end up having many many children so close together? It's a complex issue to say the least. With so many cultural, religious, and other factors, "family planning" is multifaceted and must be presented and analyzed differently depending on the audience in the particular country. In some countries, where there is much labor to be done, families want more children to tend to that. Families are often uneducated about the risks and benefits of spacing, there are conscious decisions not to use contraception for various religious or cultural reasons, and there is low supply for contraception in many developing countries even if people desire to have it.

Result?

Common Chain of Events: Unmet need for family planning (for the above reasons) --> unwanted pregnancies --> unsafe abortions, fistulas, maternal and child deaths, etc.

However, providing education as well as resources and tools like cycle beads and other options for contraception has led to a lot of progress already. Family planning and fertility awareness-based methods are being taken to many developing countries with promising results. But, there is still a long way to go...

Next - Sanitation, Water and Hygiene!