Monday October 15, 2018

A Majority of Children Die Due to Lack of Basic Healthcare Facilities: UN

For children everywhere, the most precarious time is the first month of life

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A malnourished child lies in a bed waiting to receive treatment at a therapeutic feeding center in a hospital in Sana'a, Yemen, Jan. 24, 2016. (VOA)
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An estimated 6.3 million children died before their 15th birthdays in 2017, or one every five seconds, mostly due to a lack of water, sanitation, nutrition and basic healthcare, according to report by United Nations agencies on Tuesday.

The vast majority of these deaths – 5.4 million – occur in the first five years of life, with newborns accounting for around half of the deaths, the report said.

“With simple solutions like medicines, clean water, electricity and vaccines” this toll could be dramatically reduced, said Laurence Chandy, an expert with the U.N. children’s fund UNICEF. But without urgent action, 56 million children under five – half of them newborns – will die between now and 2030.

Globally, in 2017, half of all deaths in children under five were in sub-Saharan Africa, where one in 13 children died before their fifth birthday. In high-income countries, that number was one in 185, according to the report co-led by UNICEF, the World Health Organization and the World Bank.

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UN: A Child Dies Every Five Seconds, Most Are Preventable Deaths. Pixabay

It found that most children under five die due to preventable or treatable causes such as complications during birth, pneumonia, diarrhoea, neonatal sepsis and malaria. Among older children – aged five to 14 – injuries become a more prominent cause of death, especially from drowning and road traffic.

For children everywhere, the most precarious time is the first month of life. In 2017, 2.5 million newborns died in their first month, and a baby born in sub-Saharan Africa or in Southern Asia was nine times more likely to die in the first month than one born in a high-income country.

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Despite these problems, the U.N. report found that fewer children are dying each year worldwide. The number of under five deaths fell to 5.4 million in 2017 from 12.6 million in 1990, while the number of deaths in five to 14 year-olds dropped to under a million from 1.7 million in the same period. (VOA)

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The Woes Of Indonesia’s Children

According to Flint, Indonesia’s “reasonably high average income conceals a fair amount of underlying inequality.

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Two sick children wait for treatment after being admitTed to a hospital in Agats, Asmat District, after the government dispatched military and medical personnel to the remote region of Papua to combat malnutrition and measles, Indonesia. VOA

Despite its middle income status, Indonesia is dealing with what experts say are unexpectedly high rates of childhood stunting. Now, its government – starting with the the president – is declaring war on the issue and committing to boost its response to the challenge following a World Bank publication that says 37 percent of Indonesia’s children were stunted in 2013, a rate on par with some far more impoverished nations of Sub-Saharan Africa.

Stunting is the medical condition that the World Health Organization defines as “impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.”

While Indonesia’s health ministry and other agencies have been battling to address the problem for years, the administration of President Joko “Jokowi” Widodo has now elevated the issue to be a national priority, making it a point to include it in last year’s Independence Day address.

“Before he mentioned it in the speech, I doubt it has ever been mentioned by a president in Indonesia,” said Claudia Rokx, a lead health specialist at the World Bank and one of the authors of the landmark book released last month.

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“If you’re malnourished during that first thousand days, the likelihood is that you would have suffered from irreversible brain damage,”

First 1,000 days

Health experts emphasize that the first 1,000 days of a child’s life are vital for preventing stunting, requiring adequate breastfeeding and nutrition, stimulation and activity, clean water and sanitation, and timely treatment of conditions like diarrhea and malaria.

With more than one in three Indonesian children being stunted, this means around 9 million children in Southeast Asia’s most populous country are suffering from developmental limitations.

Nusa Tenggara Timur, an impoverished province of eastern Indonesia, has the highest rate of stunting in Indonesia at 52 percent. Fifi Sumanti is a midwife on Komodo Island, known for its famous dragons and home to just 2,000 people. It is arid and most food must be brought in from other islands.

“Mothers here aren’t used to giving their children enough vegetables and fruit. They’re happier to give instant food to the children,” Sumanti told VOA. Hygiene awareness and access to clean water are also major problems, she said.

While the poorest parts of Indonesia suffer the highest rates of stunting, even among the richest proportion of Indonesians stunting is as high as 29 percent.

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Health experts emphasize that the first 1,000 days of a child’s life are vital for preventing stunting. Pixabay

Dr. Brian Sriprahastuti, a senior advisor to the office of the President of Indonesia on the issue of stunting, said the reasons for Indonesia’s stunting problem today go beyond the traditional factors of poverty and limited access to public services. “Now we have another hypothesis that behavior is the main problem of this stunting issue,” Sriprahastuti said.

Sumanti, the midwife, agrees.

“We need to speak with [mothers] more about what stunting is and give greater care from the time mothers are first pregnant until they give birth, until the time the child is three years old,” she said.

“If you’re malnourished during that first thousand days, the likelihood is that you would have suffered from irreversible brain damage,” said Simon Flint, a donor with the Asian Philanthropy Circle, a Singapore-based charity. It is thus, Flint said, “critically important” to prevent stunting to ensure “any intervention or expenditure on education,” adding it “could be so much more effective later on in a person’s life.”His group plans to launch a $10 million 1000 Days Fund by this March to support anti-stunting programs in Indonesia.

A new commitment

In the forward to the World Bank publication, the Indonesian president called current stunting rates “unacceptable” and pledged to prevent two million children from being stunted by 2021. “Eliminating stunting is therefore a main priority for our Government,” he wrote. “The Government is fully committed to do whatever it may take to achieve this goal.

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“I doubt it has ever been mentioned by a president in Indonesia,” said Claudia Rokx, a lead health specialist at the World Bank. Pixabay

Jim Yong Kim, President of the World Bank Group, said the government is investing in what he said are “evidence-based interventions” across 100 districts, to be expanded to the country’s 541 districts by 2021. “This initiative marks a decisive step up in the ambitions of the world’s fourth-most populous nation to tackle stunting as part of its commitment to sustained, inclusive economic growth,” he wrote.

According to Flint, Indonesia’s “reasonably high average income conceals a fair amount of underlying inequality. Just for example, according to government figures, in 2016 around 30 million Indonesians were still living on less than a dollar a day. There’s obviously a huge problem of inequality and lack of access among the poorest people.”

Sriprahastuti of the President’s Office said that the government was adopting a human rights-based approach. “For all pregnant women in Indonesia, everywhere, for all children under two, everywhere, we have to support them.”

Also Read: A Majority of Children Die Due to lack of Basic Healthcare Facilities: UN

“They know they have a huge problem, they’ve recognized it now. They are ready to do something about it. They’ve thrown a lot of money into it. They have the highest-level commitment, and they know it can be done in Indonesia as well,” said Rokx.

“Everything is in place for them to do it well, they just have to coordinate better, be persistent and make sure that these kids get the best start in life they can get.” (VOA)