Family Health Assessment

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Child Development Programme in Singapore—Lai Yun Ho

Child Development Programme in Singapore 1988 to 2007
Lai-Yun Ho,1-3MMed (Paed), FAMS, FRCPCH

Abstract
Early childhood intervention programmes can shift the odds toward more favourable outcomes in development, especially for children at risk. However, there is no quick fix in the world for early childhood interventions. Programmes that work are rarely simple, inexpensive, or easy to implement. Each country must decide its own model and strategies and develop its resources based on existing infrastructures. Since its independence to become a sovereign nation in 1965, Singapore has undergone significant socio-economic changes. The infant and under-5 childhood mortality rates are among the lowest in the world. A number of “new morbidities” have been identified to pose major challenges to child health in the next decades. They are chronic medical illnesses, developmental disabilities, learning problems, injuries and neglect, behavioural disturbances and disorders, sequelae associated with unhealthy life-styles, and social and emotional disorders. The need for a comprehensive child development programme is therefore obvious. The main objectives are identification and treatment of children with developmental and behavioural problems so as to correct developmental dysfunctions, minimise the impact of a child’s disability or of prevailing risk factors, strengthen families, and establish the foundations for subsequent development. A child development programme has evolved in Singapore over the last 20 years. The programme is multi-disciplinary, community-based, family-focused, and childcentric, with partnership and integration between government and voluntary community organisations.

Ann Acad Med Singapore 2007;36:898-910
Key words: Children with special needs, Developmental problems, Early childhood intervention

The Basis of a Comprehensive Child Development
Programme
Singapore is a small country without natural resources.
Children are our nation’s most important resource and they are the future of our society. Since its independence in
1965, Singapore has enjoyed economic success and this is
due primarily to the fundamental principle that Singapore’s continued prosperity depends largely on its people to
maintain its competitiveness. The Singapore family size is
small and its population is ageing. As such, great importance must be placed on health and well-being of the next
generation.
In UNICEF’s report on “The State of the World’s Children 2007”,1 Singapore was ranked first, together with Japan,
Sweden and Switzerland, for the lowest infant mortality
rates and under-5 mortality rates in the world in 2005.
Childhood mortality rates in Singapore have fallen to very
low levels and are now mainly associated with conditions

that modern medical care cannot affect. These include
stillbirths of unknown cause, serious congenital
malformations and genetic disorders, extreme low birth
weight, serious accidents and cancers. This means that
death rates are no longer adequate indices of medical care,
particularly the traditional perinatal and infant mortality
rates in relation to obstetrics, neonatal and general maternity care. Other population-based indices must be developed to
enable proper evaluation of “how we are doing” as a
community in the provision of holistic care to mothers and
children. Furthermore, relative good health by usual
statistical criteria may mist the awareness of subtle and soft issues that interfere with quality of life, especially for
children. We must therefore guard against complacency
and unawareness, which may deflect services and support
away from the special needs of children and families,
diffusing services and running into the risk of diluting or
diminishing standards.

1

Department of Neonatal and Developmental Medicine, Singapore General Hospital, Singapore Child Development Unit, KK Women’s and...
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