Reducing Birth Defects Meeting the Challenge in the Developing World (2003) / Chapter Skim
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Executive Summary
Executive Summary
Pages 1-10
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From page 1... ...
Congenital rubella syndrome can be prevented through the immunization of children and women. And public health education and preventive health care services can reduce the incidence of Down syndrome by discouraging childbearing in women over 35 years of age and can address the in Hero effects of alcohol by discouraging its use during pregnancy.
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Several developing countries are making progress toward reducing infant mortality. A smaller number of developing countries with more comprehensive health care systems are also making significant progress in the prevention and care of birth defects.
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To explore this knowledge, the committee enlisted experts with recent research experience in developing countries; these experts made workshop presentations or provided information through technical consultations. This combination of sources, the committee believes, accurately represents the current state of knowledge regarding the epidemiology of birth defects; their prevention, treatment, and rehabilitation in developing countries; and the capacity of local health care systems to undertake similar programs.
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FINDINGS AND RECOMMENDATIONS Where resources are scarce, policy makers face difficult choices in allocating limited funds for health care. Effective strategies to address birth defects in developing countries must take into account the competing needs for resources and social, economic, and other factors that constrain health care resources.
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Basic reproductive health care services an essential component of primary health care in all countries should be used to reduce the impact of birth defects by providing: · Effective family planning, · Education for couples on avoidable risks for birth defects, · Effective preconceptional and prenatal care and educational campaigns to stress the importance of such care, and · Neonatal care that permits the early detection and best care locally available for management of birth defects. Recommendations 2 to 8 propose specific interventions that can be considered by health ministries in conjunction with their own health care priorities and implemented within the national framework of public health education and basic reproductive care.
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Ministries of public health, in collaboration with other government departments in developing countries, should establish regulations to reduce occupational exposure to teratogens such as mercury and other pollutants and create programs to raise public awareness of the health risks, including birth defects, associated with these substances. The burclen imposed by birth defects justifies wiclespreaci implementation of these cost-effective interventions.
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Education policies at the national and local levels should ensure that all children, including those with birth defects, receive appropriate schooling. Genetic Screening to Further Reduce the Impact of Birth Defects Once countries have implemented the basic, highly effective strategies of reproductive health care to reduce neonatal and infant mortality outlined above, further reductions can be accomplished by addressing genetic risks for birth defects.
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From page 8... ...
Depending on the infant mortality rate, the capacity of the health care system, and the resources available, countries should incrementally develop the following: · National demographic data on neonatal and infant mortality and morbidity, · Data on causes of death, · Documentation of birth defects using standardized protocols for diagnosis, and · Ongoing monitoring of the common birth defects in a country or region. National programs of basic reproductive health should set uniform standards for training and performance; collect, interpret, and act on surveillance data; and foster communication among health care providers, researchers, and policy makers.
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From page 9... ...
Each country should develop a strategy to reduce the impact of birth defects, a framework of activities by which this can be accomplished, and the commitment of health leaders to accomplish these goals. National programs of basic reproductive health should collect and interpret surveillance data, set uniform standards for the training and performance of health care providers, and foster communication among health care providers, researchers, and policy makers.
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