Decision Making and Children Health

Decision making referred to a choice reached after verifying available options to pursue a specific cause –which carried consequences (good and bad). It was as a result of a cost-benefit analysis of having children that a prospecting parent made, rather than making decisions based on urges or feelings because they (urges or feelings) did not think apart from causing excitement.

Attachment denoted the nature of the bond between the mother and the child while level of attachment implied the degree of the existing bond between the mother and the baby or child. And circumstances at conception were merging issues during, or at conception while for environment, experts attribute the term environment to virtually everything visible, invisible, practiced, imagined, or reasoned and about life processes –including man himself, or her self –and all interacting and relating in a certain way with each other.

Children in Uganda have been most marginalized with child-friendly health services only limited to referral hospitals. Elsewhere in the country children share facilities and health care services with adults –an indiscriminate administration of health, yet special care for them was paramount. Direct, structural and institutionalized violence too claims the lives and right morals of children. Domestic violence does not only take the life of one of the parents, but also is psychological violence –moreover the worst a human being can experience that, now, becomes a children affair to deal with or shared experience upon observing parents fight.

Cultural environment –which is discriminative according to gender; never recognizes the rights of children –and the reproductive health rights of women have turned out to be a huge and overwhelming social cost –inclusive of HIV spread and under-development. It becomes a way of life that suffocates the rights of women and children as men behave the way they want as suggested by their cultures.

The economic environment disables parent’s ability to further children’s education, or not even at all affording it, yet it is through child education that the future a community is secured with a productive citizenry. The cycle continues from children dropping out of school and opting to marry or succumbing to wrong and untimely choice to conceive, then the burden becomes a product to be handed over from one generation to another –rendering the talk of children rights a dream.

Now, that way of life is one that begins to dictate the quality of life of a children, level of attachment –where insecurities and future behavioral problems begin, irresponsible parenthood, reckless and risky behaviors of a parents as children observe, low or no health seeking as there will be no money and, ultimately, no motivation to adopt a healthy lifestyle –even when health guidelines are issued –which in turn affects children health, leads to broken family situations, or broken marriage relationships –and which as the saying goes, “if elephants fight it is the grass that suffers,” the consequences accruing from broken-family situation hit children hardest as all the anger gets projected to them in form of abuse and neglect.

And in bid to come out of poverty traps using the much respected cultural or traditional remedy systems, children, still, are the soft target like commodities (without life) to offer to the gods. These are innocent children: why all that? What about the plight children in areas once ravaged by war in northern and north eastern Uganda? How about those affected by annual floods and, in recent years, the landslides? Is our scope of children health catering for that? It is from such grounds that families and communities face accountability for in the child’s teen or youthful years. No shall we have a moral fabric in society, violent free generations because society simply ignores the root causes of structural violence –whose origin is quality of care of children right from conception. And who should save the children of Uganda?

Parenting is, thus, a responsibility one finds himself or herself under voluntarily or involuntary. During adolescence, gradual changes that may be cognitive, emotional, biological, physical and social or environment occur. The qualities of changes are influenced by how well decisions are made at different levels of interaction (cognition, instinct or biology, emotional, social and/or natural environment) in relation to one’s sexuality. It all begins at conception –through important stages of birth, special care of newborns, weaning, and child in playful stage, socialization and learning, gender roles or interests, young stardom, youthful period and adulthood.

Becoming a parent was not only an urge, or by accident as some young women say, but an issue to think about critically before making a decision, not even pressure from elders or traditions counted. It was important to look at children as human capital of the future –through integrating health care, nutrition, and early child care services for young children in developing countries. Problems faced by children in early years, such as stunted mental and physical development and lack of preparation for school set the stage for low academic achievement, high drop out, functional illiteracy, lack of productivity in the work force –and even delinquencies and dependency on society (Young M., 1996).

It did not matter what age of pregnancy, but from the time of conception. But for the purposes of this submission care had to start from the time one started developing feeling to become mother or father, because ultimately the quality of decisions made counted in determination child health. Brain studies demonstrated that early years were critical in the development of intelligence, personality, and social behavior before the age of three. Environment, thus, dramatically affected how the infant brain developed –moreover the impact of early childhood programs on personality and behavior became significant and long-lasting. Indeed childhood education reduced social costs, juvenile delinquencies and drug use (Young M., 1996).

Under difficult or challenging parenting environments, HIV/AIDS emerged as an environment problem as young people and parents were pressured to adopt risky behaviors as means to “survive.” According to Tigawalana D. (Sunday Monitor Sept. 19, 2010), Young people between the ages of 15 and 24 constituted young women as most vulnerable –unexplainable by biological factors, but gender inequalities that existed in African society.

More than 5000 women still died every year in child birth across the globe –with the majority of deaths occurring in developing countries –where health systems were weak or non-functional –and health workers scarce (Lirri, Sunday Monitor July 31, 2010).

In the review on orphans and vulnerable children policy, ministry of gender, labor and social development (2004), 38 of the population lived in absolute poverty –constituting 62% of children. And the number of children living below the poverty line was likely to rise due to high fertility rates, HIV/AIDS, other preventable diseases and insecurity. The causes of poverty included limited access to productive assets (especially women), limited utilization of improved production technologies, large families, alcoholism, unemployment, lack of markets, inadequate opportunities for education and lack of information.

“…so many children in need of education but numbers are so overwhelming. If there’s any support your organization can give us, that’s welcome. Government has given due attention to basic education resulting into substantial increase in enrollment. Unfortunately, there has been decline in primary school retention in the past few years due to high drop-outs."

Geoffrey Muzusa,
Community Development Officer, Jinja

Child care was a cost the prospecting parents needed to think about long before deciding to conceive. In fact, child care began at conception. Pregnancy as physiological stress when various body functions of the mother underwent strain, need an excellent died to keep replenishing the body. With ante natal requiring time, rural areas were located several distances from health centers, so it was less likely that affected parents would visit ante natal clinic as advised.

Yet because of the need for PMTCT, to help the mainly teenagers to conceive safely, and those with height related defects (short parents) associated to difficulty delivery as well as to receive counseling on issues related to physiological reactions of the mother, appropriate dressing of mother and child, appropriate diet, preventive measures against malaria, handling of sibling rivalry and children discipline (Ebrahim G.J., 1971).

While appreciating Ebrahim G.J. (1971) understanding of pregnancy as a physiological reaction, one important component ought not to be underestimated –the psychological implications (e.g. anxiety and depression). Successful child care ought to put that into consideration, otherwise the psychological implications potentially turned out to be the most damaging to the child, or baby. Cumberbatch CJ Eta l (2005) revealed that conditions that were, themselves, psychosocial: anxiety disorders (GAD, OCD, panic disorder, PTSD), mood disorders, and schizophrenia, all of which were a background for a disturbed pregnancy would complicate pregnancy denominated high risk for some other reason.

25% of adolescents became pregnant at 19 as by 2006. Fertility was high at 6.9 children per woman (2001). Contraceptive prevalence rate was at 22.8% in 2001 and 23.7% in 2006. Only 14% of the people were employed in wage employment and the rest in self employment in the informal sector. Females constituted majority of the population at 51%, 32% females at the age of 10 were illiterate, 36% reached primary level, and 18% secondary (National Population Policy for Social Transformation and Sustainable Development, 2008). It was, however, impressive to note improvement in decision making by adolescents as by 2006 could conceive at 19 years. With wage employment at 14% and contraceptive use at 23.7%, the situation was getting better. If decision makers embarked on developing the education sector to have more children complete secondary and train in skills formation, then Uganda would be in a pole position to not only improve livelihoods but make child care as a right real.

Broken-family events are a result of extended family system to stand the test of times (twentieth and twenty first century new world order). As the urge to have children arose as traditionally demanded from the ages of 18 and above or less, the new order, instead, required productivity of prospecting parents before, at all, they decided to have children. Having children is thus no longer fashionable, nor marrying until one’s decision was in agreement with the new order.

Those who are there even when economically liberated will tell you that things are not really good while gaining confidence that God will provide. The question of sustainability of care and love within a family set-up is ignored yet critical. It is, therefore, important that policy makers embark on massive gender-conscious literacy or education program intertwined with aspects that address reproductive health concerns, impart life skills, or vocational skills –all of which empower communities with tools of rightful decision making that go as far as influencing health children development, or for that make transform children rights talk from theory to practice. When structural change is registered, no more shall see Bukedde news paper pictures of sacrificed children or domestic violence, among other concerns.

Jacob Waiswa

Graduate Peace and Conflict Studies Program
Makerere University
P.O. Box 7062,
Kampala-Uganda
jwaiswa@arts.mak.ac.ug