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Vifo vya watoto wachanga mathalani walio chini ya miezi sita

Discussion in 'JF Doctor' started by neggirl, Jun 2, 2011.

  1. neggirl

    neggirl JF-Expert Member

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    Jun 2, 2011
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    wadau nimekuwa nikiguswa sana na vifo vya watoto wachanga wenye umri kati ya siku moja hadi miezi sita, naona pia kama vifo hivi vinazidi kuongezeka. Kila wakati ukiwa na ndugu au rafiki mjamzito akijifungua mtoto akipona ni mara chache sana. Tatizo liko wapi na nini kifanyike?
     
  2. s

    shayo New Member

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    Jun 2, 2011
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    Vitendea kazi mahosipitalini havitoshelezi na ni duni,wataalam wachache na umasikini pia
     
  3. Dr.Chichi

    Dr.Chichi JF-Expert Member

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    Its true,vitendea kazi pamoja na upatikanaji wa dawa ni moja ya sababu kubwa ya vifo hivyo.WHO walianzisha imci ambayo ndani yake kuna jinsi ya kugrade ugonjwa wa mtoto ili wale walio serious wahudumiwe as an emergency na pia serikalini watoto chini y miaka mitano wanatibiwa bure ila hospitali nyingi wamezembea hapo kwenye emergency treatment ndo maana unasikia wengi wao wanafariki kwenye msululu wa kumuona daktari.also maspecialist wengi hawataki kuhama dar.huku mkoani hata hospitali iwe kubwa vipi utakuta madaktari hawapo au kiwango cha elimu hakitoshelezi
     
  4. Riwa

    Riwa JF-Expert Member

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    Jun 3, 2011
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    Neggirl....hapo kwenye nyekundu sio kweli, vifo hivyo vinapungua tena significantly! Ukilinganisha na mwaka 2005 ambapo ilifanyika survey ya kutathmini viashirio vya kiafya (TDHS 2005) vifo vya watoto chini ya mwaka mmoja (Infant Mortality Rate) vilikuwa 71 kwa kila watoto 1000 walizaliwa hai, na vifo vya watoto chini ya mwezi mmoja (Neonatal Mortality Rate) vilikuwa 30 kwa kila watoto 1000 walizaliwa hai!

    Majibu ya tathmini kama hiyo ambayo hufanyika kila baada ya miaka mi5 kwa mwaka 2010 (TDHS 2010) yalizindiliwa wiki iliyopita na waziri wa afya, na yanaonyesha vifo hivyo vimepungua na sasa IMR ni 51 kwa kila watoto 1000 waliozaliwa hai, na NMR ni 26 kwa kila watoto 1000 waliozaliwa hai.

    Ni ukweli unauma sana kuwa vifo hivi vinatokana na matatizo makuu ma4 ambayo yanazuilika...1. Matatizo ya vitoto vichanga (35% ya vifo vya watoto) kama kuzaliwa njiti (premature), kuzaliwa na uzito mdogo (low birth weight), maambukizi hasa ya kitovu (umbilical sepsis), mtoto kushindwa kupumua baada ya kuzaliwa (birth asphyxia) etc. 2. Malaria (16% ya vifo vya watoto) 3. Pneumonia (14% ya vifo vya watoto) 4. Diarrhoea/kuharisha (11% ya vifo vya watoto)...hiyo ni jumla ya 76% ya vifo vyote vya watoto.

    Wizara ya Afya mwakani itaintroduce chanjo kwa ajili ya kinga ya Pneumonia (Pneumococcal vaccine) na kuharisha (Rotavirus vaccine) ambazo zitaccelerate kupunguza vito vya watoto kwa magonjwa hayo mawili na labda kufikia lengo la milenia. Chanjo dhidi ya malaria inaendelea na majaribio ambayo yanatoa majibu mazuri, lakini mpaka iweze kuingia kama sera ya taifa na kutumika itachukua miaka.

    Ukiachana na chanjo....magonjwa yote hayo yanazuilika kwa kubadili tabia tu (behavioural change)...sidhani kama kuna mtu hafahamu jinsi ya kujikinga na kukinga mtoto dhidi ya malaria (leading killer), labda kidogo kujikinga dhidi ya Pneumonia, lakini kuharisha pia usafi wakati wa kuhudumia watoto hasa unapoandaa chakula chao na kuwalisha kila siku unasikia hizo kampeni! Kuna program chungu mzima za kugawa vyandarua kwa watoto na kina mama wajawazito, lakini watu wanabeza..kuna mpango wa hati punguzo, kampeni za kugawa vyandarua kwa watoto..watu wanajitokeza kuchukua vyandarua lakini havitumiki ipasavyo kwa watoto. Dawa za mseto watu hawataki kutumia siuji vidonge vingi sijui siku 3 lakini ni best kwa kutibu malaria kwa sasa, watu wanakatisha dose usugu unatokea tunabaki kubadilisha dawa kila siku na kulaumu serikali!

    Kila siku unasikia kelele kuhusu kunyonyesha mtoto maziwa ya mama tu kwa miezi 6 ya kwanza..faida zake ni kuondoa hatari hiyo ya magonjwa ya kuharisha na pia kumpatia mtoto kinga ya mwili dhidi ya magonjwa meengi tu ikiwemo Pneumonia. Kila siku unasikia kelele kuhusu umuhimu wa kupima VVU/HIV wakati wa ujauzito ili kama mama ameathirika basi awekwe kwenye mpango wa kutumia dawa ili kupunguza uwezekano wa mtoto kuambukizwa na mama yake, and this really work...kuna kina mama ambao positive wanazaa watoto wasio na maambukizi lakini bado watu wagumu kupima. Ukimwi unachangia 8% ya vifo vya watoto.

    Lishe bora kuanzia maziwa ya mama tu kwa miezi 6 ya mwanzo na baadae kuendelea na vyakula vinavyoshauriwa kutokana na umri na ukuaji wa mtoto, elimu hii inatolewa clinic za watoto lakni watu hawahudhurii! Tanzania sasa in watoto 43% wamedumaa (stunted) ikionyesha wana lishe duni, huku 5% wakiwa na utapia mlo mkali wakati vyakula vimejaa...tulime! Huitaji chipsi kuku au vyakula vingine ghali kuzuia utapia mlo kwa mtoto

    Tanzania kuna mpango wa chanjo dhidi ya maginjwa 7 yanayozulika kwa chanjo...coverage ya nchi ni 80 - 85%, lakini watoto wengi hawamalizi chanjo..mpaka sasa watoto wetu bado wanakufa kwa surua (measles) ni aibu!

    NB: Mfumo wa afya una mapungufu tena makubwa tu na yanachangia kwa vifo vya watoto wetu..lakini na sisi tuangalie mchnago wetu katika kuua watoto wetu wenyewe! Kubadilika tabia kwetu tu na kufuata tabia za kiafya kama zinvyoshuriwa kila siku kunaweza kupunguza saaaana vifo vya watoto wadogo kabla hata hatujaanza kuangalia huko mahospitalini na zahanati kuna nini!
     
  5. Riwa

    Riwa JF-Expert Member

    #5
    Jun 3, 2011
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    Dr Chichi naomba kutofautiana nawe kidogo kimtazamo katika mambo yafuatayo:

    1. IMCI ilikuwa evaluated na katika miaka 7 tu ambayo ilikuwa implemented Tanzania ilishusha vifo vya watoto wadogo chini ya miaka mi5 kwa 13%..lengo lilikuwa 40% lakini kulikuwa na mapungufu katika implementation as a whole package especially the community component (cIMCI) and district health system strengthening...but it is one of the best strategy to cut off child deaths!

    Lakini IMCI ilifocus kumuassess mtoto as whole (assess hata vitu ambvyo mama hajacomplain in the context of 6 major kilers of children), kumgrade (ainisha) na kumpa matibabu yanayotakiwa kabla hajawa na serious illness, na ndio maana package yake ni kwa ajili ya zahanati na vituo vya afya, na unapomuassess akiwa na dalili ya hatari (Danger sign) basi apatiwe matibabu ya mwanzo na haraka apewe rufaa kwenda hospitali...our referral system unaijua.

    Mpaka sasa referral completion rate is 28%! Ukisubiri mtoto awe na serious illness ili umpeleke kwa specialist...anakufa kabla hajafika huko. Hapo ndio unakuja umuhimu wa community component cIMCI ambao ulikuwa unaddress early ercognition of childhood illnesses and apropriate and early care seeking behaviour!

    2. Maspecialist sio watu wa kucut down child deaths...bado hatujafika kwenye stage ya kuhitaji kupunguza vifo vya watoto kwa kuinvest kwa maspecialist. Nurse katika zahanati, community health worker anyefanya kazi kijijini kwenye community, a clinical officer hawa wanaweza kucut child deaths nyingi na significantly than a specialist can! Tatizo ni kuwa na system strong yenye kuweza kuaddress hayo magonjwa ma4 makubwa yanayotuulia watoto wetu toka ngazi ya household/community (through CHWs) ambao watafanya kazi on the ground wakiwa na rejesta wakijua watototo na kina mama wajawazito katika vijiji vyao vya kazi, kuwatembelea, kuwapa elimu ya afya na kujikinga na magonjwa ya maambukizi, kuwasses, na kurekodi taarifa zao.

    Then link CHWs na health facility kwa taarifa za kina mama wajawazito na watoto kuhusu kuhudhuria clinic za ujauzito na maendeleo ya mtoto pamoja na chanjo, home treatment, rufaa kwa wanaokuwa na dalili za magonjwa kwenda health facility...train health workers hata lower cadres kama nurses na nurse assistances to deliver a simple standard package of reproductive and child (especially newborn/neonatal) care...results will be massive, hapo sijaona umuhimu wa specilist bado.

    3. Huhitaji hospitali kubwa na wafanyakazi wenye elimu kubwa kupunguza vifo vya watoto wadogo, sisemi kuwa hatuhitaji hospitali kubwa na wafanyakazi wa afya wenye elimu na ujuzi wa kutosha, na kutumia teknolojia kuokoa watoto wetu. Ila kwa interventions cheap tu wala zisizo fancy tunaweza cut significantly vifo hivyo.

    Kwa sababu kabla hatujafikiria hayo, tuangalie vitu basic na standard vya kufanya ambavyo ni cost effective kupunguza hivi vifo mpaka stage ambayo tutaanza kufikiria fancy things kuboresha zaidi huduma na client satisfaction.

    Ni mtazamo wangu tu.
     
  6. Dr.Chichi

    Dr.Chichi JF-Expert Member

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    Jun 3, 2011
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    To Riwa, it's a really good assesment, IMCI kweli imeokoa maisha ya watoto wengi. Uwepo wa specialist ni muhimu coz kuna case ambazo hata sisi ma medical officer zinatushinda au tunakuwa haturidhiki na maendeleo ya mtoto, so its better to get a specialist assistance.

    Kuna kauzembe katika kuimpliment IMCI ndo maana vitoto vinakufa senselessy although study insha vifo vinapungua.

    Its very true kumtibu mtoto hauhitaji hospitali kubwa but ukiritimba wa nchi hii unakwamisha mengi, yaani medicine imejaa politics tupu.
     
  7. Dr.Chichi

    Dr.Chichi JF-Expert Member

    #7
    Jun 3, 2011
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    To Riwa,ita a really good assesment na shukran for correcting me.imci kweli imeokoa maisha ya watoto wengi.uwepo wa specialist ni muhimu coz kuna case ambazo hata sisi ma medical officer zinatushinda au tunakuwa haturidhiki na maendeleo ya mtoto so its better to get a specialist assistance.kuna kauzembe katika kuimpliment imci ndo maana vitoto vinakufa senselessy although study inaonsha vifo vinapungua.....its very true kumtibu mtoto hauhitaji hospitali kubwa but ukiritimba wa nchi hii inakwamisha mengi,yaani medicine imejaa politics tupu
     
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