I recall an anecdote that Dr. M. Ramaswamy, my professor of Paediatrics, often shared with many paediatric residents because it demonstrated the lasting impact healthcare providers can have on society.
I, 1982, A six-year-old child suffering from fever for three weeks was referred to him from a village near Udamalpet. The local physician wanted an expert opinion. Rightly so, as a week later, the evaluation revealed that the child was suffering from leukaemia. Though appropriate treatment was started, the child died in 18 months.
While the family was still in mourning, they did something very moving, one that has a lesson for healthcare providers and society combined. They brought in a generous donation of Rs.25,000 and requested for more of the same appropriate and compassionate care for other children. For all the time they had spent in Dr. Ramaswamy’s office, they ahd been confident their child was getting the best care.
Nearly three decades later, this is the same confidence all parents want to experience — adequate, appropriate and compassionate care for their children.
But why do we still think of health in the context of disease and acute illness? Isn’t it time for us to think of how to harness the preventive health interventions to prevent disease? We know much more about the socio-economic determinants of health today thus giving us a chance to modify them positively in favour of health.
But the key question is: can we give our children a healthy start to life? Yes, this is possible today given the expanding health service infrastructure both in the government and in the private sector. In addition we have a global pool of public health knowledge and practice. One approach to realising this goal is to ensure a well-child outreach, which is to work systematically with a child or a community of children in times of wellness and during the critical phases of child development.
A well-child outreach has tremendous potential to build healthy communities today. Proven and cost-effective public health solutions like age-appropriate growth and development assessment, immunisation, micro-nutrient supplementation are widely available today.
We must take proactive steps to keep children healthy. A well-child clinic — whether in a hospital or in a community setting — should include a doctor to check the child’s all-around health. While all visits include some standard evaluations such as nutrition, growth, development, vision, anaemia checks and vital signs, each visit is tailored to the child’s needs. If there specific concerns about any child’s growth, behaviour or development, the parent can bring it up. Often, during this time, parents and providers identify concerns that require screening. For older children and teenagers, regular well-child visits with the doctor can help identify and educate them around certain high-risk behaviours and life skills.
At Shanti Ashram, successful community outreach interventions for children include: Innovation in child health practice; extended immunisation; referral linkages and care for children living in poverty; care and support programmes for children living with HIV; studying the prevalence of anaemia among adolescent rural girls and empowering them with information and iron supplements; well-child outreach; and health-promoting schools initiative.
Regularly scheduled well-child outreach is a core part of developing trusting relationships between the family, the child and healthcare providers. This simple intervention is an essential part of a child’s long-term health as well as a concrete roadmap for children to live healthy lives, every day.
The writer is the Director of Shanti Ashram