CHILD WELFARE

Dominion, Volume 14, Issue 192, 10 May 1921, Page 3

CHILD WELFARE

CAMPAIGN IN BRITAIN THE FALLING DEATH-RATE The British Minister of Health (Dr. Addison) contributed an. article to the Loijdon "Observer” of February 13, in which he replied to criticisms directed against the Ministry of Health and the service for which it was responsible. Among other things, he said: — On November 30, the .Budget estimate for the year 1020-21 was stated to be «£1,423,600,00Q. Bow much of the whole of this prodigious and alarming sum was required in respect of maternity and child-welfare services for England and Wales? The figure is <£1,100,000. This represents somewhat less than onefifth of a penny out of each «£ in the Budget, so that, if the most enthusiastic reactionary had his way and the whole service were wiped out,* including not only those developments of it for which the Ministry of Health is responsible, but the whole service—lock, * stock, and barrel —the relief to the taxpayer would bo one-fifth of a penny out of every -k of taxation. Mother and Child.

What are the particular services which we have sought specially to develop? We have had to consider first the health of the mother before, during, and after confinement, and. secondly, the welfare of the infant and little child. The maternal mortality due to child-birth is still high. From four to five mothers die per 1000 children born, and many more arc injured permanently or temporarily. There is thus a loss to the nation of about 3500 young women every year, a loss which should largely be prevented and which we aim nt reducing as much as possible. We are trying to do this by supervising the health ' of the expectant mother, by improving the midwifery service, and by providing small maternity homes where women whose home conditions are. unsatisfactory, can be attended at child-birth under cleanly conditions by skilled workers. There is no question as to the value of these homes or as to the growing demand for maternity beds. We rely on two chief methods for promoting the welfare of the little child, namely, health visiting and the development of infant welfare centres. The object of both is education—the health visitor advises and teaches the mother in her own home. At the centre the mother is advised by the doctor how to bring up her baby and how to keep it in good health. The intention is to train the mother to keep the baby wall and to prevent it from falling sick. We have means of assisting the mother with the ailing child, too, but our primary business is to prevent illness and injury to health, which can be avoided. During the past few years, I am happy to say, there has been a substantial increase in the number of maternity and child welfare centres, especially in our industrial districts where they were sorely needed. It was clear to me, after a special investigation of the work throughout the country, that we needed in many places an improvement in the quality of the services relating to maternity and child welfare, and we, therefore, set going schemes for improving the training and position of health visitors, nurses, midwives, and others associated with this work. I am quite certain that the efficiency of the services provided by local authorities and voluntary agencies has greatly improved.. Everyone knows that the infant deathrate constitutes one of the most reliable and valuable indices of health and social progress. Many of the weaknesses and disabilities which figured so prominently in our recruiting stations during the war have their origin in conditions affecting the earlv months or years of child life. It is with a view to avoidance or prevention of these things, apart from the mere preservation of life, that , a study of 1 the infant mortality statistics is of value.

Encouraging Figures. i We have recently,been confronted with some of the mos’. encouraging and important health statistics ever ‘put out by any nation. For years previous to the war we struggled hard to get the infant death-rate down to 100, but in the five years 1911-15 it averaged 110, although in the last three years of that period it had been below that figure. In the three following years, even at a time when the birth-rate was low and conditions in many ways unfavourable, it fell well below 100, varying from 91 in 1916 to 96 in 1918. Last year, however, for the first tijne. it ‘is low as 89, and the year 1920 has shown a most remarkable drop. The figure for that year is 80, and in London has fallen as low as 75. I noticed that some of our hostile critics showed a really extraordinary promptitude to suggest that, although this most remarkable decline had occurred during the past two years the Ministry of Realth could not in any way claim any share in having assisted towards the result. Far bo it from me to put forward high claims, but there is an almost ostentatious unfairness in criticism of that sort.

The improved health conditions of infant life during these past two years, especially during the past year, are, of course, due to a great many circumstances. The Local Government Board and the Board of Education laid tne foundations of the system of maternity and child welfare work which the Ministry of Health have developed and extended. For many years voluntary agencies have laboured to educate public opinion in the rules of health and the need for good "mothercraft.” The awakening which the war has caused as to the vital necessity for the preservation and care of the child life of the. nation is another most important contributory factor. Increased wages and better fowling of the mother are others. To pretend that the improved measure of co-operation and effort in all directions of the local authorities and voluntary agencies which have been encouraged by the Ministry of Health, together with a much greater measure of common guidance and help and the sustained efforts which all have made to improve the quality of the service available have not. had an important share in producing the improved result, is to ignore the truo facts of the situation. Examine where we will, I am confident that there is no branch of public expenditure which has given a bettor return to the nation than this, and equally is it certain that to return to the conditions of the decade 1901-10 in which the average infant mortality rate was 128, would be a waste of life and happiness and effort which no sane economist could justify by any reason.