Child survival at heart of human progress
Life and hope: A child is carried on his mother's back for a test for sickle cell anaemia in Dakar, Senegal. Unicef's annual flagship report this year focuses on child survival and primary healthcare for mothers, newborns and children. Picture: EPA
Saturday, March 15, 2008
THE United Nations Children's Fund (Unicef) annual flagship report The State of the World's Children this year assesses the situation of child survival and primary healthcare for mothers, newborns and children, showcasing how these issues lie at the heart of human progress.
The global report will be released in Malaysia for World Health Day 2008, held officially on April 7.
With some 26,000 children under the age of five dying each day, and the target date for the Millennium Development Goal (MDG) 4 which aims to reduce child mortality by two thirds between 1990 and 2015 drawing near, critical questions arise, namely: how can momentum on maternal, newborn and child survival be recaptured and progress accelerated in the next eight years?
According to Unicef Malaysia representative Youssouf Oomar, child mortality rates are generally recognised as the best indicators of the wellbeing of a child population and are also an assessment of a country's overall development.
"These issues serve as sensitive barometers of a country's development and wellbeing and as evidence of its priorities and values," he says.
"Investing in the health of children and their mothers is a human rights imperative and one of the surest ways for a country to set its course towards a better future."
In Malaysia, maternal and child health have experienced dramatic improvements throughout the post-Independence era, with levels today close to that of most advanced countries:
Under (age) five mortality rates (U5MR) have declined from 57 per 1,000 live births in 1970 to 22/1,000 in 1990 and 12/1,000 in 2006.
Infant mortality rates (IMR) have declined from 41 per 1,000 live births in 1970 to 16 per 1,000 in 1990 and 10/1,000 in 2006.
Maternal mortality ratio (MMR) halved between 1957 and 1970 when it fell from around 280 to 141 per 100,000 live births. By the 1990s, the MMR declined further and has since levelled to around 33 per 100,000 live births (about 160 reported maternal deaths per year).
Malaysia's remarkable experience in reducing child and maternal mortality has been the result of a synergy of a wide range of policies, strategies and programmes that have addressed access to services through socio-economic, cultural, educational, gender and poverty dimensions.
However, having reached such low levels, recent trends are levelling out while a continued rural-urban disparity is becoming more evident in the country.
The leading causes of death today in Malaysia for children under one year of age are perinatal conditions, while septicaemia and pneumonia are the leading causes of death among children one to five years old.
As for maternal mortality rates, proxy indicators point to slightly higher levels in Sabah as well as among the Orang Asli population in the Peninsula.
At the same time, the country is currently in a stage of epidemiological transition where non-communicable and sexually transmitted diseases such as HIV are increasing, particulary among women.
Based on the lessons of the past decades, Unicef's report illustrates how experts in maternal, newborn and child health are increasingly coalescing around a set of strategic principles for child health and survival.
These principles which could provide the impetus needed to achieve the health-related MDGs, include:
Recognising the need for community partnerships to support families in improving their care practices for children, especially in countries with weak health systems.
Providing a continuum of care for mothers, newborns and children by packaging interventions for delivery at key points in the life cycle.
Strengthening health systems by providing stronger support to developing countries in national planning, policy and budgeting frameworks for the health-related MDGs.
Enhancing ways of working at the national and international levels with a strong focus on coordination, harmonisation and results.
"Health-care provision must be tailored to meet the constraints of human and financial resources, the socio-economic context, the existing capacity of a countrys health system and, finally, the urgency of achieving results," Oomar says.
"An examination of these strategies provides important perspectives on the current situation and helps guide the way forward in the drive for child survival.
"The challenge is to ensure children have access to a continuum of health care, backed by strong national health systems that also involves local communities." Bernama
The global report will be released in Malaysia for World Health Day 2008, held officially on April 7.
With some 26,000 children under the age of five dying each day, and the target date for the Millennium Development Goal (MDG) 4 which aims to reduce child mortality by two thirds between 1990 and 2015 drawing near, critical questions arise, namely: how can momentum on maternal, newborn and child survival be recaptured and progress accelerated in the next eight years?
According to Unicef Malaysia representative Youssouf Oomar, child mortality rates are generally recognised as the best indicators of the wellbeing of a child population and are also an assessment of a country's overall development.
"These issues serve as sensitive barometers of a country's development and wellbeing and as evidence of its priorities and values," he says.
"Investing in the health of children and their mothers is a human rights imperative and one of the surest ways for a country to set its course towards a better future."
In Malaysia, maternal and child health have experienced dramatic improvements throughout the post-Independence era, with levels today close to that of most advanced countries:
Under (age) five mortality rates (U5MR) have declined from 57 per 1,000 live births in 1970 to 22/1,000 in 1990 and 12/1,000 in 2006.
Infant mortality rates (IMR) have declined from 41 per 1,000 live births in 1970 to 16 per 1,000 in 1990 and 10/1,000 in 2006.
Maternal mortality ratio (MMR) halved between 1957 and 1970 when it fell from around 280 to 141 per 100,000 live births. By the 1990s, the MMR declined further and has since levelled to around 33 per 100,000 live births (about 160 reported maternal deaths per year).
Malaysia's remarkable experience in reducing child and maternal mortality has been the result of a synergy of a wide range of policies, strategies and programmes that have addressed access to services through socio-economic, cultural, educational, gender and poverty dimensions.
However, having reached such low levels, recent trends are levelling out while a continued rural-urban disparity is becoming more evident in the country.
The leading causes of death today in Malaysia for children under one year of age are perinatal conditions, while septicaemia and pneumonia are the leading causes of death among children one to five years old.
As for maternal mortality rates, proxy indicators point to slightly higher levels in Sabah as well as among the Orang Asli population in the Peninsula.
At the same time, the country is currently in a stage of epidemiological transition where non-communicable and sexually transmitted diseases such as HIV are increasing, particulary among women.
Based on the lessons of the past decades, Unicef's report illustrates how experts in maternal, newborn and child health are increasingly coalescing around a set of strategic principles for child health and survival.
These principles which could provide the impetus needed to achieve the health-related MDGs, include:
Recognising the need for community partnerships to support families in improving their care practices for children, especially in countries with weak health systems.
Providing a continuum of care for mothers, newborns and children by packaging interventions for delivery at key points in the life cycle.
Strengthening health systems by providing stronger support to developing countries in national planning, policy and budgeting frameworks for the health-related MDGs.
Enhancing ways of working at the national and international levels with a strong focus on coordination, harmonisation and results.
"Health-care provision must be tailored to meet the constraints of human and financial resources, the socio-economic context, the existing capacity of a countrys health system and, finally, the urgency of achieving results," Oomar says.
"An examination of these strategies provides important perspectives on the current situation and helps guide the way forward in the drive for child survival.
"The challenge is to ensure children have access to a continuum of health care, backed by strong national health systems that also involves local communities." Bernama
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