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"21,000 children die every day from preventable causes"
WHO, September 2011
Anup Shah,
Today, 21,000 children died around the world - Global Issues,
Updated: September 24, 2011
The silent killers are poverty, hunger, easily preventable diseases and
illnesses, and other related causes. Despite the scale of this daily/ongoing
catastrophe, it rarely manages to achieve, much less sustain, prime-time,
headline coverage.
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UN Declaration of the ...
Rights of the Child
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photo
unicef india |
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I told my husband that
if Shah Jahan could build the Taj Mahal to honour Mumtaz,
why can’t you build a toilet for me?
Village woman in Maharashtra, India
India, where more than 65 percent of people lack a toilet and 500,000
children die each year from diarrhoeal illnesses. |
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Fact
File on Health Inequities
In developing countries, one child in 10 dies before reaching their fifth
birthday, compared with 1 in 143 in high-income countries.
Today, there is a 36-year gap in life expectancy between countries. A child
born in Malawi can expect to live for 47 years while a child born in Japan
could live for as long as 83 years. (1) In Chad, every fifth child dies
before they reach the age of 5, while in the WHO European Region, the
under-five mortality rate is 13 out of 1000. (2) There is no biological or
genetic reason for these alarming differences in health and life
opportunity.
Causes of Child Deaths
According to UNICEF, of the 8.1 million child deaths (under-5s) in 2009,
most (and 70% in developing countries) result from one the following five
causes or a combination thereof: acute respiratory infections,
diarrhoea, measles, malaria and
malnutrition.
Two-thirds of deaths are preventable.
Malnutrition, which weakens the body's resistance to illness, and the
lack of safe water and sanitation contribute to half of all these children’s
deaths. Millions more survive only to face diminished futures, unable to
develop to their full potential. Research and experience show that most of
the children who die each year could be saved by low-tech, evidence-based,
cost-effective measures such as vaccines, antibiotics, micronutrient
supplementation, insecticide-treated bed nets, improved family care and
breastfeeding practices,
and
oral rehydration
therapy. In addition to providing vaccines and antibiotics to children,
education could also be provided to mothers about how they can make simple
changes to living conditions such as improving hygiene in order to increase
the health of their children. Mothers who are educated will also have
increased confidence in the ability to take care of their children,
therefore providing a healthier relationship and environment for them.
An Urgent Need for Health Education
Many of these deaths can be avoided if parents and caregivers understand
what to do when illness strikes and how to recognize the danger signs that
signal the need for medical help.
Facts for Life presents, in simple language, the most authoritative
information about practical, effective and low-cost ways to protect
children's lives and health. Everyone has the right to know this
information.
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Focus
The aim of HETV is to establish and promote health educational programs that
will provide rapid and long-term capacity-building to improve health and
quality of life, and will give mothers and communities more control over
their health status. Health gains associated with safe drinking water can be
achieved by providing people with simple, affordable technologies, such as
chlorination, filtration, solar disinfection and improved storage in their
homes. Worldwide, surveys have shown that hand-washing alone reduces the
instance of diarrhoea by as much as 43 percent.
Partnered with national and state governments, we work to assist in
educating mothers and children, teachers and students, doctors and village
health workers, and a variety of community leaders, in the targeted areas of
health, water, hygiene, and sanitation.
The Long-Term Effects of Childhood Poverty
Most poor children achieve less, exhibit more problem behaviours, and are
less healthy than children raised in more-affluent families. Looking beyond
these well-known correlations between poverty and negative outcomes in
childhood, recent studies have assessed the effects of childhood poverty on
later attainment and health. Experiencing poverty early in childhood may
prove harmful later in life, and can be linked to adult outcomes such as
earnings and work hours as well as obesity and other health conditions that
impair productivity. The evidence suggests that prenatal and early childhood
poverty have a substantial negative association with adult earnings, work
hours, and certain health conditions, but not with behavioural outcomes such
as out-of-wedlock childbearing and arrests.
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 Taking
care of a baby at home after birth: What families need to do
Download
pdf
This flipbook, released in Nov. 2011, contains key messages that pregnant
women and their families need in order to plan care of an infant at home
right after birth. It focuses on essential actions families can take both to
prevent newborn death and illness and to promote healthy newborn
development.
This material encourages use, whenever possible, of skilled birth attendants
and clinical services and, where that is not realistic, provides some
information on what families can do for pregnant women and care of the baby
at birth.
Even where mothers deliver with a skilled birth attendant in a health
facility, they are often sent home within 6-12 hours of delivery. This
material can also be used with women going home soon after delivery in a
health facility. It highlights danger signs in the infant that require
immediate attention and referral.
This tool was developed by CORE Group, in collaboration with Save the
Children, the American College of Nurse-Midwives, and MCHIP.
This material is meant for outreach to pregnant women and their families
with poor access to health services. These communities may also have
low-literacy levels and/or poor access to health information. It is
important to test the material with outreach workers and community members
to be sure the messages are understood and acceptable. For guidance on
adapting or testing this material, please email
contact@coregroupdc.org.
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 Why
Is Breastfeeding So Important?
Download
.pdf 17.5 mb.
Breastfeeding provides the perfect nutrition for your baby and provides many
health benefits for both mother and baby.
- Initiating breast feeding within the first hour and exclusive
breastfeeding can prevent under two mortality.
- Breastfeeding: Exclusive breastfeeding
- Colostrum - Gift of a protective cover from the mother
- We believe all mothers know how to feed their child. But do they?
- Myths and facts about breast milk
- Complimentary feeding
- Role of media in promoting proper young child feeding: Media should focus
on and promote measures that are required to be taken urgently to ensure the
survival of children
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Respectful Maternity Care: Every Childbearing Woman's Right
Download Poster pdf
 In
every country and community worldwide, pregnancy and childbirth are
momentous events in the lives of women and families and represent a time of
intense vulnerability. Imagine the personal treatment you would expect from
a maternity care provider entrusted to help you or a woman you love give
birth. Naturally, we envision a relationship characterized by caring,
empathy, support, trust, confidence, and empowerment, as well as gentle,
respectful, and effective communication to enable informed decision making.
Unfortunately, too many women experience care that does not match this
image. Pregnant women seeking maternity care instead too often receive ill
treatment that ranges from relatively subtle disrespect of their autonomy
and dignity to outright abuse: physical assault, verbal insults,
discrimination, abandonment, or detention in facilities for failure to pay.
Disrespect and abuse of women during maternity care is a problem that has
been obscured by a "veil of silence".
NO MORE.
Through the USAID Health Policy Project, partners from the research,
educational, clinical, human rights, and global and national advocacy
communities are working collaboratively to establish a growing community of
concern determined to address the issue of disrespect and abuse during
maternity care. This month we are pleased to launch the RESPECTFUL MATERNITY
CARE CHARTER: THE UNIVERSAL RIGHTS OF CHILDBEARING WOMEN and new advocacy
materials, based on this rights framework, that convey the message
RESPECTFUL MATERNITY CARE is every woman's right.
Now we are calling on you to join us by learning more and engaging your
communities to speak out and break the silence.
Useful links:
Respectful Maternity Care
Respectful Maternity Care Charter: the Universal Rights of Childbearing
Women
Companion brochure and
Poster based on this rights framework.
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Eliminating health inequities - Every woman and every
child counts
Download pdf
The International Federation of Red Cross and Red Crescent Societies (IFRC),
in partnership with the Partnership for Maternal, Newborn and Child Health
Health inequities are affecting the life and future of all vulnerable groups
of society across the world, creating systems of social injustice. By
dismantling the barriers to health services and resources, we reduce the
burden of disease that affects the future of children, impoverishes entire
families and passes social injustice on through the generations. In this
report, we focus on women and children not only because many of them suffer
undue hardship, but also because women are instrumental in improving the
health of their children, families and communities.
This report provides evidence that health inequities can and need to be
addressed through a holistic approach. Health inequities, and the resulting
social injustice are closely linked with other issues such as poverty,
gender inequality and human rights violations which in turn, have an impact
on education, transport, health, agriculture, and overall well-being. Our
interventions should therefore be multi-sectoral, going beyond health to
address social and economic determinants - malnutrition, alcohol abuse, poor
housing, indoor air pollution and poverty, among others.
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Featured Resources:
WHO Reproductive Health Publications
Sexual and reproductive health - Maternal and perinatal health -
Publications
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Managing
newborn problems: A guide for doctors, nurses and midwives
This guide, based on the latest available evidence, provides up-to-date,
authoritative clinical guidelines that are relevant to a facility with basic
laboratory facilities, selected essential drugs and supplies, and the
capability to provide safe blood transfusion. In some settings, the guide
will be relevant to large health centres that provide childbirth care and
have the capacity to care for sick or small newborn babies.
More
information/full text |
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Managing complications in pregnancy and childbirth
A must for midwives and
doctors at the district hospital who are responsible for the care of women
with complications of pregnancy, childbirth or the immediate postpartum
period, including immediate problems of the newborn. Both physicians and
midwives will find this manual essential for promoting and assessing the
quality of health services, in the training of providers and in supporting
quality services through supervision and performance feed-back.
More information/full text
Español
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Français |
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Guidelines for the management of sexually transmitted infections
Sexually transmitted
infections (STIs) remain a public health problem of major signifi cance in
most parts of the world. The incidence of acute STIs is believed to be high
in many countries. Failure to diagnose and treat STIs at an early stage may
result in serious complications and sequelae, including infertility, fetal
wastage, ectopic pregnancy, anogental cancer and premature death, as well as
neonatal and infant infections. The individual and national expenditure on
STI care can be substantial.
More information/full text
Español
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Français
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Portuguese |
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 Institute
for Reproductive Health at Georgetown University
Since its founding in 1985, IRH has been recognized
as a leader in the effort to improve reproductive health worldwide. The
Institute’s strengths are its quantitative and qualitative research skills,
its focus on critical needs in reproductive health, and its
research-to-practice strategy that includes working with partners to build
capacity for sustainable services. The Institute collaborates with a wide
variety of organizations from central to community levels to implement
evidence-based service delivery programs in countries worldwide.
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 Health
Workers Count: The World Needs More Health Workers, Better Supported
No Child Out of
Reach: Time to end the health worker crisis -
Download pdf
The current shortage of over 3.5 million doctors, nurses, midwives and
community health workers means that millions of children do not receive the
health care they need, and risk an early death from preventable causes. We
cannot achieve the goal of saving 15 million children’s lives by 2015 unless
a health worker – with the right skills, equipment and support – is within
reach of every child.
The new report sets out the scale and the causes of the crisis, and
recommendations for how it can be overcome. Progress will require political
action at the global level, backed by strong national efforts in every
country with a critical shortage of health workers.
Increased long-term investment is needed to recruit and train more health
workers, with a balance across different cadres. At the same time better use
of the existing workforce must be made by ensuring they are equitably
deployed, receive a fair living wage, and are well supported, trained,
equipped and motivated. Tackling the health worker crisis will also require
governments and donors to spend more, and spend more smartly, focusing on
areas that will have the greatest impact on children’s health.
More Health
Workers
The world is suffering from a massive gap of more than 3.5 million health
workers. Join with hundreds of organisations who have already signed up to
our urgent call for more health workers, better supported.
click here
Scaling Up, Saving Lives - download pdf
Task Force for Scaling Up Education and Training for Health Workers, Global
Health Workforce Alliance
Health workers are the cornerstone and drivers of health systems. And yet
the world is facing a serious shortage of health workers – a shortage that
is identified as one of the most critical constraints to the achievement of
health and development goals.
This crisis is impairing the provision of essential, life-saving
interventions such as childhood immunization, safe pregnancy and delivery
services for mothers, and access to treatment for HIV/AIDS, malaria and
tuberculosis.
New and innovative initiatives are urgently needed to increase the numbers
of trained health workers. This requires scaling up investment in education,
skill mix and remuneration of the workforce as laid out in the Kampala
Declaration and Agenda for Global Action, endorsed in March 2008 at the
First Global Forum on Human Resources for Health.
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Infographic: How Community Health Workers Save Lives in the Developing World
Imagine if pregnant women and their kids in developing countries could be
given simple, lifesaving health care, even when miles away from a hospital
or doctor. Community health workers—trained practitioners who provide health
care for pregnant women, assist in childbirth, and treat newborns—provide
just that service. Without community health workers, pregnant women and
newborn babies in the developing world are at risk for disease. More than
350,000 women die in childbirth and pregnancy each year, and almost 3.6
million babies die before they are a month old. Even small complications can
be deadly for people living so far away from hospitals. Community health
workers are saving lives by
using a very basic—but very important—set of solutions and techniques.
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Child
mortality rate drops by a third since 1990 - UNICEF •
Levels & Trends in Child Mortality - The Lancet
download
report September 2011
24
pages - 3.6 mb
Report 2011 - Estimates Developed by the UN Inter-agency Group for Child
Mortality Estimation
Only four years remain to achieve Millennium Development Goal 4 (MDG 4),
which calls for reducing the under-five mortality rate by twothirds between
1990 and 2015. Since 1990 the under-five mortality rate has dropped 35
percent, with every developing region seeing at least a 30 percent
reduction. However, at the global level progress is behind schedule, and the
target is at risk of being missed by 2015. The global underfive mortality
rate needs to be halved from 57 deaths per 1,000 live births to 29—that
implies an average rate of reduction of 13.5 percent a year, much higher
than the 2.2 percent a year achieved between 1990 and 2010.
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 Global
strategy for women's and children's health
Each year, millions of women and children die from
preventable causes. These are not mere statistics. They are people with
names and faces. Their suffering is unacceptable in the 21st century. We
must, therefore, do more for the newborn who succumbs to infection for want
of a simple injection, and for the young boy who will never reach his full
potential because of malnutrition. We must do more for the teenage girl
facing an unwanted pregnancy; for the married woman who has found she is
infected with the HIV virus; and for the mother who faces complications in
childbirth. »
more
UN launches $40bn woman and child health plan
The UN has launched a $40bn health initiative aimed at saving the lives of
16 million women and children over the next five years. About eight million
under-fives die every year and more than a third of a million women lose
their lives during pregnancy or childbirth.
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 image:
Countries with the greatest number of rotavirus-related deaths
25 October 2011 -
2008 estimate of worldwide rotavirus-associated mortality in children
younger than 5 years before the introduction of universal rotavirus
vaccination programmes: a systematic review and meta-analysis
The Lancet Infectious Diseases, Early Online Publication -
download pdf
Rotavirus remains a major killer of children under
five years of age worldwide, taking the lives of 453,000 children in 2008
according to the latest estimates, published today in the Lancet Infectious
Diseases journal. This translates into the staggering fact that more than
1,200 young children will die from rotavirus diarrhea each day.
Rotavirus-related deaths accounted for 37% of all diarrheal deaths and 5% of
all deaths in children under five years of age. One of every 260 children
born each year will die from rotavirus diarrhea by their fifth birthday.
Tragically, approximately 95% of rotavirus deaths occurred in countries that
are eligible to receive GAVI-support to introduce rotavirus vaccines. Five
countries–India, Nigeria, Pakistan, Democratic Republic of Congo, and
Ethiopia–all GAVI-eligible, accounted for more than half of all rotavirus
deaths globally.
Introduction of effective and available rotavirus vaccines could
substantially affect worldwide deaths attributable to diarrhoea. Our new
estimates can be used to advocate for rotavirus vaccine introduction and to
monitor the effect of vaccination on mortality once introduced.
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Tanzanian lessons in using non-physician clinicians to scale up
comprehensive emergency obstetric care in remote and rural areas
by Angelo S Nyamtema, Senga K Pemba, Godfrey Mbaruku et al.
Human Resources for Health 2011, 9:28 (9 November 2011) 26 pp. 537 kB:
http://www.human-resources-health.com/content/pdf/1478-4491-9-28.pdf
A new study from Tanzania has shown that 'Tanzanian assistant medical
officers, clinical officers, and nurse-midwives can be trained as a team, in
a three-month course, to provide effective comprehensive emergency
obstetrical care and anaesthesia in remote health centres'.
'In Tanzania, 47% of pregnant women deliver in health facilities and only
46% of deliveries are assisted by skilled personnel. The met need for
emergency obstetric care, at 15-30%, and the caesarean section rate (CSR) of
3% are still below ideal levels and constitute the lowest rates in the
world... Considering that most Sub-Saharan countries are already off-track
in their attempts to achieve the MDGs for maternal and perinatal survival,
evidence resulting from the current training programmes calls for urgency to
scale up the application of the concept of 'task shifting' with the use of
NPCs for CEmOC services provision and anaesthesia.'
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Good health at low cost - 25 years on. What Makes a successful
health system?
Editors: Dina Balabanova; Martin McKee; Anne Mills - London School of
Hygiene & Tropical Medicine LSHTM - 2011
full book PDF
- 399 pages 5.6Mb |
mirror copy
'Why do some low and middle income countries manage to achieve good health
outcomes while others fail? What factors drive improvements in the health
system and in access to primary health care? How can we act on the social
determinants of health in cash-strapped economies?
These questions are as relevant today as they were in 1985 when the
Rockefeller Foundation published what was to become a seminal report - Good
health at low cost. The report explored why some low and middle income
countries achieved better health outcomes than others, making Good health at
low cost essential reading for health systems decision- and policy-makers
alike.
This new edition of Good health at low cost 25 years on draws on a series of
new case studies from Bangladesh, Ethiopia, Kyrgyzstan, Tamil Nadu and
Thailand providing fresh insights into the role of effective institutions,
innovation and country ownership in catalysing improvements in health.
New challenges such as increasing urbanisation, a growing private sector and
an upsurge in non-communicable diseases suggest that both learning from the
past and new thinking are required to strengthen health systems. This
edition provides both and is a vital resource for academics, policy-makers
and practitioners grappling with how to improve health in low and middle
income countries..'
The authors emphasise the need for a 'systems thinking approach that
understands the relationships between different health system components,
the context in which the systems exist, and the sequencing of actions'. In
their conclusion, the authors say: 'The key message of this book is that
success in improving health and delivering health care is facilitated by
capacity, both individual and institutional, continuity, or the ability to
maintain a course even when all around is changing, catalysts, or the
ability to seize windows of opportunity, and sensitivity to context, so that
policies that are adopted take account of the circumstances in which they
will be implemented'. Their 'Pathways to Improving Health and Access to
Care' include 'Political commitment... Collaboration... Flexible use of
health workers... Building health system resilience... Economic factors...
Social development'.
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UN reports progress towards poverty alleviation, urges increased support
for the poorest -
Download
pdf
7 July 2011 – Some of the world’s poorest countries have made impressive
gains in the fight against poverty, but the least developed countries still
lag in efforts to improve living standards, the United Nations said today in
a report showing significant overall progress towards achieving the global
targets against extreme poverty.
Giving examples of achievements, the
Millennium Development Goals
(MDGs) Report – prepared by the UN Department of Economic and Social Affairs
(DESA) – says that Burundi, Rwanda, Samoa, Sao Tome and Principe, Togo and
Tanzania attained or are nearing the goal of universal primary education,
one of the targets. |
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Malnourishment in India
More than 5,000 Indian children below five years
die every day due to malnourishment or lack of basic micronutrients
like Vitamin A, iron, iodine, zinc or folic acid.
Overall, India hosts 57 million - or more than a third - of the world's 146
million undernourished children. 45.9 per cent of India's under-three kids
are underweight, 39 per cent are stunted, 20 per cent severely malnourished,
80 per cent anaemic while infant mortality hovers at 67 per 1,000. 440
million people languish at the bottom of the economic pyramid in India and
about 500,000 children are born deformed each year due to vitamin/mineral
deficiencies.
National Family Health Survey, India 2005-2006 - NFHS-3
"Malnourishment severely retards a child's cognitive, physical and emotional
growth and has a cascading effect on his/her productivity in adult years."
-- Dr Suresh Kasana, New Delhi
"India should be worried." Experts reiterate that child malnutrition
is not only responsible for 22 per cent of India's disease burden -
and for 50 per cent of the 2.3 million child deaths in India -- but
is also a serious economic hazard.
Neeta Lal reports. |
25% of all Global Maternal Deaths are in India.
WHO defines maternal mortality as the death of a woman during pregnancy or
in the first 42 days after the birth of the child due to causes directly or
indirectly linked with pregnancy.
Globally, every year over 500,000 women die of pregnancy related causes and
99 percent of these occur in developing countries.
- The Maternal Mortality Ratio (MMR) in India is 254 per 100,000 live
births according to Sample Registration System (SRS) Report for
2004-2006. This is a decline from the earlier ratio of 301 during
2001-2003.
- In the region, the MMR in China stands at 45, Sri Lanka at 58,
Bangladesh at 570, Nepal at 830 and Pakistan at 320 in 2006.
- Wide disparities exist across states in India. The MMR ranges from
95 in Kerala to 480 in Assam.
- MMR has a direct impact on infant mortality Babies whose mothers die
during the first 6 weeks of their lives are far more likely to die in the
first two years of life than babies whose mothers survive.
- Only 47 per cent of women likely in India have an institutional delivery
and 53 percent had their births assisted by a skilled birth attendant. As
many as 49 percent of pregnant women still do not have three antenatal
visits during pregnancy. Only 46.6 percent of mothers receive iron and folic
acid for at least 100 days during pregnancy.
Key Issues
- About half of the total maternal deaths occur because of hemorrhage
and sepsis. A large number of deaths are preventable through safe
deliveries and adequate maternal care.
- More than half of all married women are anaemic and one-third of
them are malnourished
 Maternal
Mortality in India: Using International and Constitutional Law to Promote
Accountability and Change
The Center for Reproductive Rights - 2008 pdf
The Government of India has a legal obligation to ensure that women do not
die or suffer complications as a result of preventable pregnancy-related
causes. The staggering scale and continuing occurrence of maternal deaths
and morbidity in India reveals the Government’s failure to protect women’s
rights and comply with international law.
As the nation leading the world with respect to the number of maternal
deaths, the Indian government has an immediate obligation to take meaningful
steps to dramatically reduce maternal mortality by fully implementing
national policies on maternal health and holding those responsible for the
failure of its policies accountable.
This report is intended to serve as a resource for those interested in using
international and constitutional legal norms and mechanisms to establish
government accountability for maternal deaths and pregnancy-related
morbidity through public interest litigation and human rights advocacy.
India Statistics - Women - UNICEF
Estimates of
Maternal Mortality Ratios in India and its States - A Pilot Study
pdf
Institute for Research in Medical Statistics, Indian Council of Medical
Research - July 2003 |
All information on this web site is for
educational purposes only.
For specific medical advice, diagnoses, and treatment, kindly consult your
doctor.
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