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Regional Child Survival Strategy: WHO and UNICEF

Regional Child Survival Strategy: WHO and UNICEF

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Subject: FCM III
Topic: Regional Child
Survival
Strategy
WHO/UNICEF
Shifting /Date: August 1, 2008
Trans group: Paolo Paraiso
Learning Objectives
By the end of this session, the students will be able
to:
(1) describe the overall health status of children
in
the Western Pacific Region;
(2) explain the underlying causes and other
related factors against child survival; and
(3) enumerate the essential

package of interventions applicable for counties of varying levels of child health status

Trend in Infant Mortality Reduction Towards
Target 2015 MDG, WPR
Under-five Mortality Rates of Countries in the
Western Pacific Region, 2004 WHO

Immediate Causes of Deaths Among Underfive Children In High and Middle Mortality Areas (WPRO:2000-2003)

Immediate Causes of Death
in Underfive
Children, WPR
Immediate Causes
\ue000deaths in perinatal and neonatal periods

dominate the U5MR; the perinatal period is also associated with the highest number of disabilities; highest risk is in the first day of birth;

\ue00040 - 80% of neonatal deaths are associated
with low birth weight;

MARY YVETTE ALLAIN TINA RALPH SHERYL BART HEINRICH PIPOY TLE JAM CECILLE DENESSE VINCE HOOPS CES XTIAN LAINEY RIZ KIX EZRA GOLDIE BUFF MONA AM MAAN ADI KC
PENG KARLA ALPHE AARON KYTH ANNE EISA KRING CANDY ISAY MARCO JOSHUA FARS RAIN JASSIE MIKA SHAR ERIKA MACKY VIKI JOAN PREI KATE BAM AMS HANNAH MEMAY PAU
RACHE ESTHER JOEL GLENN TONI

Subject: FCM III
Topic: Regional Child
Survival Strategy
Page 2 of 6
\ue000malnutrition remains the highest attributable
causal factor of all childhood deaths in
children under 5;
\ue000most important immediate causes of death
from
communicable
diseases
remain
diarrhoea and ARI
Predisposing Factors
\ue000Inadequate Care for Women:
-currently, most women seek antenatal care
(ANC) in the 2nd or 3rd trimester
\ue000High fertility, poor birth spacing:
- 2.5 times chance of surviving infancy if >3
years interval;
\ue000Community and environment:
-indoor, outdoor and personal hygiene are
major
contributors
to

ARI/CDD; parentless/orphans are 6-7 times greater chance of dying in infancy

\ue000Improper infant and young child feeding:

- the transition between intrauterine and extrauterine life; infants not breastfed have 6- fold increased chance of dying in first two months; protection against infections

\ue000Lack of access to safe water, sanitation:

- WPRO/ EAPRO has 3 of the 10 countries \u2018worst off\u2019 for water safety (Cambodia, PNG, Laos); Cambodia worst off in toilet sanitation; 1 billion people in the region live without adequate sanitation = 305,000 metric tons of fresh excreta deposited outside each day

\ue000Lack of access to basic social services:

- pockets of poor immunization rates, poor access to appropriate management of diarrhea and pneumonia

Underlying Causes:
A. Undernutrition
\ue000conditions interfering with nutrient absorption
that lead to deficiencies prior to and
throughout
pregnancy
(e.g.,
malaria,
hookworm, Tb, UTIs, HIV/AIDS, etc.)
\ue000Low Birth Weight:
\ue001significantly increased mortality risk
in the neonatal and early infancy
period;

\ue001cognitive function impairment;
\ue001predicts underweight later in life;
\ue001risk for adult diseases.

B. Poor Intrauterine Nutrition
\ue000Stunting:
\u2022 persists into adulthood;

\u2022 intergenerational effect: associated with an increase in surgically assisted births, and birth of LBW babies;

\u2022 associated with poor cognitive and
motor development
C. Others
\ue000Increasing inequity:
- the poor being marginalized in the delivery
of health care;
\ue000Policy Environment:
- lack of supportive laws or poor
implementation of the laws;
\ue000Constraints Financing for Child Survival.

- public spending in health is only 1.9 % of GDP in comparison to global average of 3.2 %; policies not driven by concepts of public goods, or of human rights based approaches;

\ue000Human resource constraints:
-underpaid, demotivated health workers;
inequitably distributed;
\ue000Social norms and Gender issues:
-women are underfed, poorly educated,
overworked.
Subject: FCM III
Topic: Regional Child
Survival Strategy
Page 3 of 6
Essential Package of Child Survival Interventions
Essential Package of Child Survival Interventions
\u2013 WHY?
\u2022
Skilled attendance. during pregnancy,

childbirth and the immediate postpartum would prevent approximately 13% of child deaths

\u2022
Exclusively breastfeeding for six months,
and adequate and safe complementary

feeding from six months onwards with continued breastfeeding and micronutrient supplementation

would
prevent
approximately 20% of child deaths
\u2022
Vaccination
against
common
vaccine
preventable
diseases
would
prevent
approximately 3% of child deaths
\u2022
Case management of diarrhoea would save
approximately 21% of child lives
\u2022
Case management of pneumonia and
neonatal sepsis would prevent an estimated
12% of child deaths
\u2022
Use of insecticide treated bed netsand
prompt treatment of malaria would reduce
child mortality by approximately 13%
Child Survival Actions by Country Group
Group 1
\u2022
Essential package for
child survival
\u2022

Deworming of children 6- 59 mos. and pregnant women

Group 2
\u2022
Essential package for
child
survival
w/
geographic
targeting
in underserved areas
\u2022

Institutional deliveries w/ comprehensive newborn care

\u2022

Deworming of children 6- 59 months, and pregnant women

\u2022
Promotion of childhood
safety
\u2022

Introduction of new or underused vaccines (HiB, rotavirus,

conjugate
pneumococcal vaccine)
Group 3
\u2022
Essential package for
child
survival

with targeting of the socio- economically

underprivileged
and
marginalized
\u2022
Institutional
deliveries
with newborn care
\u2022
Promotion of child safety
\u2022

Introduction of new or underused vaccines (HiB, rotavirus,

conjugate

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