The present article identifies, for children living in developing countries, the major causes of ill-health that are inadequately covered by established health programmes. Injuries and noncommunicable diseases, notably asthma, epilepsy, dental caries, diabetes mellitus and rheumatic heart disease, are growing in significance. In countries where resources are scarce it is to be expected that increasing importance will be attached to the development and implementation of measures against these problems. Their control may benefit from the application of elements of programmes directed against infectious, nutritional and perinatal disorders, which continue to predominate.
PIP: This study evaluates the major causes of ill health that are not covered by global health programs among children in developing countries. Assessments are based on a set of death and disability estimates for 1990-2020. Causes of death are classified as 1) infectious, maternal, perinatal and nutritional conditions, 2) noncommunicable diseases, or 3) injuries. Disability-adjusted life years (DALYs) are used in estimates of disease burden. Childhood disease burden in 1990 among regions, age groups, and sex are compared using DALYs per 1000 population and presented in table form. Among childhood disease burdens, infectious, perinatal and nutritional disorders ranked first (72%), followed by noncommunicable diseases (15%) and injuries (13%); these values are significantly higher in developing countries than in developed regions. Furthermore, injuries and noncommunicable diseases--particularly asthma, epilepsy, dental caries, diabetes mellitus, and rheumatic heart disease-- are increasing in prevalence. It has been estimated that in the next two decades the disease burden of injuries will equal or exceed of infectious diseases. This study suggests that strategies used in programs directed against infectious, nutritional and perinatal disorders should be applied to the control of injuries and noncommunicable diseases; it stresses the importance of community involvement, family education, and social marketing in the formulation and implementation of these control measures.