What We Do   Community Health Care Centers   Specialized Services   Mobile Clinics & Outreach Programs   Lending Centers   Health Education   School Health Program   School of Community Health   Emergency Response Program   Community-Based Rehabilitation   Chronic Diseases Program   Well-Baby & Child Health Program   Women’s Health Program   Community Mobilization Programs   Advocacy & Public Awareness	Well-Baby & Child Health Program Child Well-Being Children are entitled to the highest attainable standard of health. UPMRC believes that in order to reach this standard, health must be viewed in a holistic, comprehensive manner, which includes all facets of child well-being. Child development is multi-dimensional including physical, cognitive, emotional and social dimensions, and child well-being exits when a child is able to realize his or her potential vis-?-vis each of these components. Child health reflects more than physical well-being; it also necessarily includes mental and social health. These different aspects of development are integral to one another and continuous throughout life. Thus childcare programs must address all aspects of child development comprehensively and continually in order to ensure child well-being. The basic needs of development go beyond protection, food, and health care to include the need for affection, interaction and stimulation, security provided through consistency and predictability, and play allowing exploration and discovery. Child Health Context Despite the fact that more than half of the population of Palestine is under the age of 18, there is no comprehensive child health program to meet the developmental needs of the nation's children. Poverty is one of the principal problems connected to child health in Palestine. About one out of every four children in Palestine is poor. Palestine is in a stage of epidemiological transition, which the characteristic disease profile of children in a situation of underdevelopment (diarrheal and respiratory diseases compounded by malnutrition), are combined with concerns more typical of developed countries, such as accidents, psychological problems, abuse and neglect. [1] For instance, particularly in the refugee camps, diarrhea and intestinal parasites are highly prevalent due to poor environmental conditions. However, the leading cause of death for children under the age of five is accidents. Palestinian Child Health Statistics from the Palestinian Central Bureau of Statistics   From 1995-1999 the average Infant Mortality Rate in Palestine was 25.5 per 1,000 live births.   Low birth weight, congenital malformations and respiratory infection are by far the leading causes of infant       mortality.   The average under-5 child mortality rate was 28.7 per 1,000 live births from 1995-1999.   In 1996, 36.8% of the disabled were below the age of 14. Of particular concern is the fact that children between the age of 15 months and 6 years in general fall off the health radar screen-they do not attend regular check-ups, are not monitored or screened for health defects and they are only brought to clinics when they are ill. Until the age of 15 months, parents bring their babies into government, private or NGO-run clinics on a routine schedule in order to completely the baby's course of vaccination. However, between the ages of 15 months and six years, children only come to clinics when they are ill, and they do not receive any screening except for growth monitoring. While some organizations run Well-Baby clinics which function through outreach to screen and treat babies, they are not systematic, and do not engage in monitoring or community based rehabilitation. At the age of six, children enter school where they receive systematic health screening. This situation leads to many child health problems. The crucial time to screen children for health defects and abnormalities is before the age of three. Thus, it is highly problematic that there is no systematic screening of children between the ages of 15 and 36 months. Because health problems are not detected at this age, they go untreated, and are often aggravated by behavior that would be avoided if the condition were known. Furthermore, children's health records are short and incomplete because they do not attend regular check-ups. Child Health and the Intifada The child health situation has become even graver since the start of the Intifada in September 2000. Not only have children suffered direct health consequences from Israeli violence, but they have also suffered from collective punishment measures. Since the advent of the Al Aqsa Intifada, poverty rates have dramatically increased, directly effecting the health situation for Palestinian children. Now more than two million Palestinians (60.8% of households) live below the poverty line, and since the Intifada, about half of Palestinian households have lost more than 50% of their usual income[2]. The Palestinian Central Bureau of Statistics conducted a survey on the impact of Israeli measures on the economic conditions of Palestinian households and found that more than 58% of households reported that they have faced problems accessing health resources because they are not able to pay the treatment costs. [3] Furthermore, worsening economic conditions have directly affected the nutritional behavior. Almost 40% of households have less food, and more than 55% have lesser quality food. The excessive use of force by the Israeli occupation forces has left serious and negative consequences to the psychology of the child. In an opinion poll conducted by the Development Studies Program, 89.4% of Palestinians reported that the Israeli violence created psychological disorders and neuropathy among their children. School Health Program During the past three years, UPMRC implemented a school health program. The program was first conceived out of a need to organize and coordinate the outreach activities that UPMRC implements in schools and kindergartens. The main activities included physical screening of children and health education lectures. As the program evolved, additional activities were included such as First Aid, life skills training and school health committees. The development in the program came from an evolution of the approach towards youth from recipients of services and health information to principal actors in their own and other's health. The program aimed to broaden the scope of its work so that it would incorporate in addition to the needs of this group, their potential as agents of change in the health of others. Training youth on First Aid empowers them and provides them with skills that encourage them to assume leadership roles especially in the current political situation. The life skills training extended to other areas beyond their physical health to include strategies of coping with stress, peer pressure and decision making, that they can take charge of themselves. Groups of students trained in First Aid, formed health and environment committees in their schools to oversee activities in these areas and maintain the quality of environment for themselves and fellow students. The school health program was not exclusive to children but was also extended to groups of teachers and parents who were trained on health education and promotion issues that concern their students and children. Towards a Comprehensive Child Health Program UPMRC seeks to develop a comprehensive child health program that builds upon the work already done in the area of child health at the organization. Currently, UPMRC offers numerous child health services through a variety of programs such as the Well-baby clinics, General Clinic services, School Health, Women's Health, and Community Based Rehabilitation. The services provided are linked to one another vertically. Integrating and unifying these services into a more systematic program will allow the organization to focus on improving specific aspects of child health for particular age groups. In particular, UPMRC sees the need to focus on screening and prevention services for children ages 15 months to 6 years. Children of this age group often do not receive regular check-ups, due to a relative lack in targeted services. Children ages 15 months to 6 years generally do not come to health centers for regular physical and developmental screenings. The Ministry of Health provides vaccination for children aged 0-15 months. UPMRC in cooperation with the ministry is providing these services in 8 of its clinics. Once children are fully vaccinated at age 15 months, parents generally seek health services for them only when they are sick. Beyond age 6, children are targeted with screening services through the School Health Program. Age 15 months to 6 years is a crucial growth period, and many developmental problems manifest themselves during this time. Early detection leads to early intervention, which leads to better quality of life for children and a healthier overall population in the long run. UPMRC seeks to promote the health of all children, with an emphasis on gaps in service provision. The lessons learned from the school health program have prompted UPMRC to organize and coordinate the health services provided to children through the different programs. The experience gained from addressing the overall needs of school age children's well- being is a reason for the organization to extend this approach to younger children ages 0-6. Thus the new Child Health program will incorporate both the existing school health program and an additional component that focuses on the younger age group. The program will also focus on the Jerusalem area where the Ministry of Health has no authority. UPMRC through its school health and youth programs is providing screening and health education services in 26 of the Jerusalem's schools. ------------------------ [1] UNICEF [2] Palestinian Central Bureau of Statistics, 2001. Impact of the Israeli Measures on the Economic Conditions of Palestinian Households (3rd Round: July-August, 2001). [3] Palestinian Central Bureau of Statistics, 2001. Impact of the Israeli Measures on the Economic Conditions of Palestinian Households (3rd Round: July-August, 2001).