Question

1. (chapter 13) Chapter 13 identifies 9 themes in Maternal and Child Environmental health. Summarize five of those themes (20 points)

2. (chapter 14) Summarize the history of hunger in the United States? What current programs are in place to address hunger? (10 points)

3. (chapter 14) Summarize the primary barriers to breastfeeding in the United States.

4. (chapter 14) Summarize the prevalence and incidence of obesity in the United States.

5. (chapter 15) Summarize the developmental stages of children’s oral health covered in the text.

6. (chapter 15) Describe the three major oral health problems of childhood covered in the text.

7. (chapter 15) Summarize the dentally healthy diet, tooth brushing at different developmental stages, and the importance of fluoride. (10 points)

8. (chapter 16) Describe how childhood mortality (age birth -5) has changed in the past few decades. What has led to that change?

9. (chapter 16) What impact does HIV/AIDS have on maternal and child health according to the text?

10. (chapter 16) Summarize three of the inequalities in global maternal and child health covered in the text. (10 points)

Answer 1

1.

a.Opportunity to end preventable deaths among all women and children and to greatly improve their health and well being:

Improve the health literacy of the of the mother and as well as the society and public,thus they get good awareness regarding the preventable diseases thus we can prevent the deaths among the women and children.Thus gaining the knowledge they can improve their health and well being and leads a healthier and burden free life with out any disease or complications

b.Access to essential quality health services and education

The economic and social case for investing in women,children and adoloscents is clear and evidence-based.We have access a standardized care and access to care who ever needs.While giving health services and education that should maintained in an highest standards and in quality and should be effective.

c.Clean air and water and adequate sanitation

Adequate access to clean water and sanitation is essential for human development by primary toilet type used by house hold and house hold water treatment.Poor water quality and sanitation will give negative and adverse effects to these vulnerable groups such as mother and child.We have to promote the steps to minimize the air pollution by sound manangement of chemicals and allwasres through their life cycle

d.Nutrition

*We have take proper measures to asses the protein - energy malnutrition affects the growth pattern of children.We have to determined by using certain anthropometric indicators

*Measures to assess micro-nutrient deficiencies

*Measures to asses the early diagnosis of iron deficiency anemia among the women

*Measures to asses earlly detection of iron deficiency disorders

*Early detection of vitamin A deficiency

e.Reducing maternal,infant and child mortality rate

*We have to take a great efforts to improve family planning,safe abortion should be done only at the designated hospitals,and integrated maternal health services

*The infant and child mortality rate can be minimized by taking the measures to improve sanitation,access to clean drinking water,immunization against infectious diseases etc.

2.When coming to the history of hunger in United States 1 in 6 people in United States face hunger.The main reason for this is due to "food insecurity".Most of the people in the United States struggle to put food on the table.The main reason for the hunger is not caused by lack of food,but the fact is due to the prevalence of poverty.

*The current programs to address hunger are:

$\rightarrow$ Supplemental Nutritional Assistance Program

$\rightarrow$ The emergency Food Assistance Program

$\rightarrow$ The Commodity Supplemental Food Program

$\rightarrow$ The Child Adult Care Food Program

$\rightarrow$ The National School Lunch Program

$\rightarrow$ The School Breakfast Program

$\rightarrow$ The Summer Food Service Program

$\rightarrow$ Women,Infants, and Children

Most of the programs are targeted to the particular types of citizens.

3.The reasons for the primary barriers of breast feeding in the United States are :

Most of them are concerned with full time working for job,busy schedules,lack of awareness regarding the importance of breast feeding till first 6months,more concerns giving to the body image than breast feeding their baby/lack of health literacy

4.When discuss regarding the obesity prevalence and incidence in United States more than 50% of African Americans women are obese.The overallprevalence of obesity was 39.8%among adults and 18.5% among youth (2015-2016)The prevalence of obesity was higher among the adults aged 40-59 year when comparing among the adults aged 20-39 year.Any way we can say that the obesity we can see in both genders.

5.Provide preventive interventions to pregnant women and the new parents regarding the developmental stages of children's oral health."Lift the Lip"of children 0-5 years to examine the upper front teeth and look for early signs of tooth decay and existing cavities.Assess the child's level of risk for oral disease.Advise the parents to reduce the frequency of sugar intake by limiting night time on-demand feeding after 6 months.Advise the parents by maintaining good oral health themselves and by not placing food,utensils,dummies or teats in to the mouth.Provide adequate oral hygeine.Provide information on teething to new parents.provide an oral health assessment to a child at one year of age.Refer children at high risk for tooth decay to an dental hospital/oral health service.Advise the parents to talk to their children about dental visits in a positive way.

6.

*Dental Caries: Dental caries is otherwise called as tooth decay.Approximately 21% of children have had untreated dental caries in their primary teeth.We can prevent this condition involces a range of population and individual- based strategies such as water fluoridation,topical fluorides,dental sealants,education and dietary interventions.

*Cleft lip and palate are facial and oral malformations that occur very early in pregnancy.The cleft lip is a physical split or the seperation of the two sides of the upper lip and apperas as a narrow opening or gap in the skin of the upper lip.The cleft is usually treated with surgery.Other treatments include speech therapy or dental care.

*Tongue Thrusting :The infant swallow by placing their tongues at the top of their mouths behind their front teeth in amethod called tongue thrusting.As they grow they abadon this method as they learn how to swallow properly.If however the child continues to tongue thrust it can damage the teeth and change the shape of the mouth to need a dental consultation

7.Only offer milk at meals and in a cup

*Wean from the night time bottle by replacing the milk with warm water

*Brush the teeth twice a day with a fluoride tooth paste

*Limit the amount of sweet foods and drinks,or eat them only with or immediately after the meal

*Drink only water in between meals

*Eat a greater variety of food including cheese and fruit

*Administer sugar free medicine according to the physiacians order

*Fluoride plays a key role in the prevention of dental caries by adjusting fluoride levels in public water supplies

*The use of fluoride tooth paste for the prevention and control of dental caries is safe and highly effective in the prevention of dental caries

*Drinking water especially flourinated tap water is beneficial for rinsing food particles from the mouth and reducing the levels of acids in the mouth

8. There is a progress in reducing the child mortality has been accelerated in the 2000-201q7 period compared with the 1990's.There is a annual rate rediuction in the global under-five mortality rate increasing from 1.9% in 1990-2000 to 4.0% in 2000-2017.There is a global progress in reducing child mortality over the past few decades.

*The changes or decline in the child mortality rate has been acheived byimproving the health literacy of the population.

Through the health literacy we can create awareness among the parents and ending preventable child deaths can be acheived by immediate and exclusive breat feeding,improving access to skilled health professiopnals for antenatal birth,and postnatal care,improving access to nutrition and micronutrientsimproving access to water,sanitation and hygeine,taking timely immunizations.

9.The HIV positive pregnant women are more likely to die during pregnacy,delivery or post partum than HIV negative pregnant women.The HIV positive pregnant women are at increased risk for life threatening infections such as sepsis and opportunistic infections.

They have go for timely check ups and get adequate treatment to prevent the most severe complications and mortality.

The infants born to HIV postive mother are have a 30% probability of being infected by the HIV virus.and goes to a stage of dying with AIDS with in one to two years.

The pediatric HIV can be treated by newborn with nevirapine or other programmes to prevent mother -to- child transmission.

HIV infected children residing in communities where infectious diseases are common and the back ground of death rate is already high.

The estimated infant mortality rate to the child with these background is thought to be atleast two-to- three fold higher.

The children have more frequent infections are less likely to recover and have higher rates of associated failure of thrive.

10.Inequallities are detriment of women,infants and children.

All are cosidering these groups as an disadvantaged population sub-groups ie;means poorest,least educted and those residing in rural areas had lower health intervention coverage and worst health outcomes.

The largest gaps in health coverage/inequality is between the richest and poorest,the most and least educated,urban and rural areas.

The inequalities an be exhibited as lack of skilled birth attendants and skillled personnel,inequalities in antenatal health coverage and lack of other maternal interventions.

Globally we can see some low levels of sex-related inequalities in immunization coverage between boys and girls

The under five mortality is high among the poorest when comparing with the richest due to lack of health coverage,poverty,lack of economy,lack of education and health literacy

The prevalence of stunting in children underfive years of age is presented according to mother's educational level