Paediatrics—I: Infancy and early childhood

摘要

Children born in the last decade of the 20th century have been healthier, and will be longer lived, than ever before. Recent advances in paediatrics have seen national infant mortality rates fall below 5.0 per 1000 live births. The countries in which this has been achieved—Hong Kong, Taiwan, and Japan—have thus set benchmarks for the century ahead, In the context of world medicine, all who care for children rejoice in the momentum of advanced technology, which is saving hitherto unsavable individual children; yet we are seeing the failings of delivery of health systems whose principles have been proved for decades. The major killers of the 13 million children who die annually before their fifth birthday remain pneumonia, gastroenteritis, malaria, measles, and trauma. The potentiating effects of malnutrition contribute to more than 80% of child deaths from infectious disease. One of the signal advances in paediatrics is the recognition that children's safety and health, indeed the very existence of whole races of children is a responsibility for all who practise in a contracting world.