Prävention und Behandlung von Kinderkrankheiten in Entwicklungsländern – Halbzeit für die Millenniumsentwicklungsziele

Weltweit sterben jährlich fast 10 Millionen Kinder unter 5 Jahren. Das 4. Millenniumsentwicklungsziel fordert bis zum Jahre 2015 eine Verminderung der Kindersterblichkeit um 2 Drittel bezogen auf 1990. Die Haupttodesursachen – Pneumonie, Durchfall, Malaria, Mangelernährung, Masern und Neugeborenenprobleme – könnten durch entsprechende Prävention und Behandlung leicht verhindert werden, allerdings scheitert es in vielen Ländern an der mangelnden Umsetzung entsprechender Maßnahmen. Die Weltgesundheitsorganisation WHO hat Richtlinien entwickelt, um den wirksamen Einsatz von Vorsorge– und Behandlungsmaßnahmen auf Gemeindeebene, in primären Gesundheitseinrichtungen sowie im Krankenhaus voranzutreiben. Im Rahmen des „Integrated Management of Childhood Illness” wurden Richtlinien entwickelt, die für die Behandlung von Kindern in primären Gesundheitszentren mit geringen Mitteln angemessen sind. Das ”Pocket Book of Hospital Care for Children" fasst Grundsätze für die adäquate Krankenhausversorgung für Kinder in Entwicklungsländern zusammen. ”Community IMCI" verbreitet Präventionsbotschaften über Ernährung, Stillen, Hygiene und Luftverschmutzung. Ohne eine Ausweitung bewährter Behandlungs– und Präventionsansätze und systematische Investitionen in Gesundheitssysteme werden weiterhin jedes Jahr Millionen Kinder unnötigerweise sterben.

Globally, almost 10 million children under 5 die annually. Millennium development goal 4 calls for a two thirds reduction in child mortality by 2015 with reference to 1990. The main causes of childhood deaths – pneumonia, diarrhoea, malaria, measles, malnutrition and neonatal problems – are easily preventable and treatable, but the implementation of preventive and curative interventions is often insufficient in many countries. WHO has developed guidelines to promote the implementation of these interventions at the community, primary healthcare facility and hospital level. The Integrated Management of Childhood Illness (IMCI) allows for the adequate treatment of common childhood illnesses at peripheral health facilities. The ”Pocket Book of Hospital Care for Children” provides guidelines for the management of common illnesses with limited resources at the hospital level. Community IMCI promotes preventive messages on feeding, hygiene, and air pollution. Unless proven approaches to prevention and treatment are scaled up and accompanied by systematic investments in health systems millions of children will continue to die in vain every year.

Key words

child survival - millennium development goals - IMCI - quality improvement

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