Essential messages

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1. The health of women1 and children can be significantly improved when births are spaced at least two years between the birth of the last child and the beginning of the next pregnancy. Health risks increase for both the mother and the child when pregnancy occurs before age 18 or after age 35. Both men and women, including adolescents, need to know about the health benefits of family planning so they can make informed choices.

2. All pregnant women should visit a trained health worker for prenatal and post-natal care, and all births should be assisted by a skilled birth attendant. All pregnant women and their families need to know the warning signs of problems during and after pregnancy and the options for seeking assistance. They also need to have plans and resources for obtaining skilled care for the birth and immediate help if problems arise.

3. Children learn from the moment of birth. They grow and learn best when they receive attention, affection and stimulation, in addition to good nutrition and proper health care. Encouraging girls and boys equally to observe and express themselves and to play and explore helps them learn and develop socially, physically, emotionally and intellectually.

4. Breastmilk alone is the best food and drink for an infant for the first six months of life. After six months, infants need other nutritious foods, in addition to breastfeeding up to two years and beyond, to meet their growth and development needs.

5. Poor nutrition during the mother's pregnancy or the child's first two years can slow a child's mental and physical development for life. Children need a well-balanced diet that includes protein and energy foods as well as vitamins and minerals, such as iron and vitamin A, to ensure good health and development. From birth to age 1, children should be weighed every month and from age 1 to age 2, at least every three months. If a child does not appear to be growing, the child should be seen by a trained health worker.

6. Every child should complete the recommended series of immunizations. Immunizations during a child's first year of life and into the second year are especially important for early protection against diseases that can cause poor growth, disability or death. All women of childbearing age, including adolescent girls, need to be protected against tetanus for their own benefit and for their future babies. Over time, five doses of tetanus vaccine are recommended for lifelong protection. A booster should be given during pregnancy if the woman has not yet received five doses.

7. A child with diarrhoea needs plenty of the right liquids — breastmilk and ORS (oral rehydration salts) solution – and, if older than 6 months, other nutritious liquids and foods should be added. Zinc should be given to reduce the severity of the diarrhoea. If the diarrhoea is mixed with blood or is frequent and watery, the child is in danger and should be taken to a trained health worker for immediate treatment.

8. Most children with coughs or colds will get better on their own. But if a child with a cough and fever is breathing rapidly or with difficulty, the child is in danger and needs to be taken to a trained health worker for immediate treatment.

9. Many illnesses can be prevented by good hygienic practices: washing hands with soap and water (or a substitute, such as ash and water) after defecating or cleaning a child who has defecated, using clean toilets or latrines, disposing of faeces away from play and living areas and water sources, washing hands before handling food, using water from a safe source, disinfecting drinking water if its safety is in question, and keeping food and water clean.

10. Malaria, which is transmitted through mosquito bites, can be fatal. Wherever malaria is present, people should sleep under insecticide-treated mosquito nets; any child with a fever should be examined by a trained health worker for treatment and sponged gently with cool (not cold) water; and pregnant women should take antimalarial tablets as recommended by a trained health worker.

11. HIV (human immunodeficiency virus), the virus that causes AIDS (acquired immunodeficiency syndrome), is preventable and treatable, but incurable. HIV is transmitted through unprotected sex with an HIV-infected person; transmission from an HIV-infected mother to her child during pregnancy, childbirth or breastfeeding; and blood from HIV-contaminated syringes, needles or other sharp instruments and transfusion with HIV-contaminated blood. Educating all people on HIV and reducing stigma and discrimination should be part of the information, education and communication on HIV prevention, testing and care. Early diagnosis and treatment of children and adults can better ensure their survival and a longer and healthier life. Children and families affected by HIV should have access to child-friendly health and nutritional care and social welfare services. All people living with HIV should know their rights.

12. Girls and boys should be equally protected within their family, school and community. If these protective environments are lacking, children are more vulnerable to violence, abuse, sexual exploitation, trafficking, child labour, harmful practices and discrimination. Living with family, birth registration, access to basic services, protection from violence, a child-friendly justice system based on child rights, and children's active engagement in developing their knowledge and skills to protect themselves are important building blocks in constructing protective environments in which children can develop and fulfil their potential.

13. Many serious injuries that can result in disabilities or death can be prevented if parents or other caregivers watch young children carefully, keep their environment safe and teach them how to avoid accidents and injuries.

14. Families and communities must prepare for emergencies. In disasters, conflicts, epidemics or pandemics, children and women must be the first to receive attention, including essential health care, adequate nutrition, support for breastfeeding and protection from violence, abuse and exploitation. Children should have access to recreation and learning opportunities in safe, child-friendly schools and spaces that give them a sense of normalcy and stability. Children should be cared for by their parents or other familiar adults, so that they feel secure.

1Throughout this publication, references to pregnant women include pregnant adolescents.