The paper analyses the existing constraints in the delivery of adequate health services to children. A strategy for containing the infant mortality due to neonatal causes, diarrhoeal diseases and respiratory infections is presented: suggestions are given for better training of manpower for child health services, continuous supply of drugs and equipment and adoption of the "at risk" approach for identification of children likely to die, without intervention.
PIP: The question of the adequacy of health services for children in India is examined. Focus is on the constraints--- budget, quantity and quality of manpower, drugs and supplies, and unrealistic work schedules -- and the leading causes of death. The funds that have been allocated for children are not in proportion to the seriousness of their diseases or the weight of their numbers. This situation can be corrected by specified allocation to some programs which require organization. The shortage of personnel and the inadequacy of their training in child health also needs correction. The budget provided to primary health centers for drugs and supplies is markedly inadequate, so that for long periods the primary health center staff can only offer advice or prescription. Finally, the work schedules of some categories of workers seem unrealistic. Good antenatal care is essential, and the treatment of anemia of pregnancy and immunization against tetanus appears to be critical. Natal and postnatal care in the hands of a trained birth attendant lowers both maternal and infant mortality. Reduction of mortality from diarrhea can be achieved by concentrating on the education of the public regarding what is clean water and food and the availability of oral rehydration mixture to the community health workers and his or her training in its use. If community health workers begin referring to physicians all infants with a respiratory rate in excess of 50 per minute, few cases would be missed. In that most of the deaths occur in grade 3 or grade 4 malnutrition, the community workers and multipurpose workers need to be trained to identify such cases during their routine home visits.