Reducing Childhood Mortality And Morbidity

Children are a precious human resource any country can boast of and it is in the children that any country has it future.

As the saying goes, "a forest without young trees today will never be a forest tomorrow" it is imperative therefore that children born today should survive, grow and develop to their fullest potential in order for us to have a prosperous nation in future.

But to the contrary, increased levels of poverty, food insecurity and various forms of abuse and deprivation are causing untold suffering to our children.

This situation has been worsened by lack of proper knowledge in recommended child caring practices that are essential for child survival growth and development.

To make matters worse the HIV/AIDS pandemic has also ravaged families leaving behind a large number of orphans and making others vulnerable because the capacity of the families and communities to cope with the impact has been weakened.

It is against this background that a childhood policy aimed at fighting disease burden dubbed Integrated Management of Childhood Illnesses (IMCI) Policy was recently put in place by government to assist in recognising the importance of child development so that they should not only survive but also grow into productive citizens that would contribute to national development.

Through the use of IMCI approach, the policy aims to significantly scale up simple and low cost effective interventions such as immunization, Vitamin A supplementation, promotion of exclusive breastfeeding and insecticide treated nets (ITN) in order to reduce child deaths by two - thirds by the year 2015.

United Nations Children Fund (UNICEF) Country Representative Aida Girma says deaths of children aged 0 - 5 years is a major public health concern in Malawi and all the developing countries.

She said that though there have been improvements in child survival due to effective public health interventions and better economic and social performance world wide, globally, every year, 10.5 million children die before their fifth birthday out of which 4.4 million of these deaths occur in sub Saharan Africa.

"The majority of under five deaths are due to a small number of common, preventable and or treatable conditions. Recent studies have shown that approximately 63 percent of child deaths could be prevented by achieving universal coverage of low cost, high impact interventions," she emphasised.

She noted that though the country has made significant strides in the last few years to improve child survival the situation is still sad as every year one in eight children under the age of five still dies of a few but easily preventable and or treatable diseases.

Girma also emphasized the need to address the persistent problem of malnutrition among the children in Malawi and according to the UNICEF representative accounts for more than 50 percent child deaths in the country.

" Maternal mortality also remains very high at 982 per 100,000 live births, contributing to the high mortality among new borns while malnutrition rates have not improved since the early 1990s and close to 30,000 new borns are infected every year through the mother to child transmission of HIV," she explained.

Andrina Mchiela, Principal Secretary for Women and Child Development expressed sadness at the pace of child survival and development interventions being undertake by the country.

" The pace of implementation has not been commensurate with the deteriorating child survival indicators and deprivation the children are experiencing today. The slower we move in the implementation of our activities, the greater the number of children who are deprived of the much - needed services. Children are missing out, they are missing parental care, they are missing childhood, a future, medical care, protection and most importantly, they are missing you. In this situation, can we afford to do business as usual?" Mchiela queried.

Mchiela decried the HIV/AIDS crisis saying has made a family unit which is regarded as the best environment for child growth, care and protection very dysfunctional forcing over 8000 children resorting to seek refuge in the streets.

The principal secretary calls for concerted efforts to minimise the problem.

" Messages on child caring practises we advocate to the communities can only be reinforced and sustained if they are accompanied by a reliable service. We cannot continue to advocate drinking of safe water when safe water itself is not available. The support we provide to the communities should be based on their needs and more so building on their strengths and capabilities," she added.

You will agree with me that families and communities are already doing something to ensure that their children do survive, grow and develop into productive adults but we know that alone they cannot succeed because they need resources, support and technical assistance for them to come up with interventions for child survival and development programmes."

Implemented through components, by 2005, the IMCI strategy, adopted in Malawi in 1998 was being implemented in 18 districts and so far, only 11 districts have implemented component 3 in 39 Traditional Authorities (T/As) out of a total of 161 in the districts.

Statistics say inadequate financial resources to implement the package as a whole in all districts, acute shortage of staff at health facility level, inadequate referral and communication systems, frequent stock outs of essential drugs and supplies and inadequate coordination and inequitable allocation of resources resulting from lack of interest by partners are some of the main challenges facing dodging the programme.