A new report from UNICEF has highlighted the huge child survival gap between the richest and the poorest children by focusing on pneumonia and diarrhoea – the two primary killers of children under the age of five.
The new UNICEF report, Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children, identifies the tremendous opportunity to narrow the child survival gap within and between countries if proven and cost-effective interventions for pneumonia and diarrhoea are scaled up to reach the most disadvantaged children.
“We know what works against pneumonia and diarrhoea – the two illnesses that hit the poorest hardest,” said Anthony Lake, UNICEF Executive Director. “Scaling up simple interventions could overcome two of the biggest obstacles to increasing child survival, help give every child a fair chance to grow and thrive.”
East Asia and Pacific countries have had tremendous success in reducing child mortality over the past 20 years. The total number of under-five deaths decreased in from 2.2 million in 1990 to close to 700,000 in 2010. Pneumonia and diarrhoea accounted for nearly one-third of those deaths, most of which are among the poorest children.
The prevention and treatments for both diseases often overlap, and include such basic steps as encouraging breastfeeding and hand-washing with soap; expanding access to decent sanitation; and disseminating oral rehydration salts to children with diarrhoea and antibiotics to children with bacterial pneumonia.
From 2006–2010, one third of children under 5 in the region with suspected pneumonia infections were not taken to an appropriate health care provider. Nearly half of children under-five with diarrhea did not received oral rehydration and continued feeding, signalling a failure to deliver one of the tried and true child survival interventions.
Most of the countries in East Asia and the Pacific have sophisticated health care systems. But, across the region the poor are less likely than the wealthy to receive simple life-saving interventions for pneumonia and diarrhoea often because they live in rural or remote areas and do not have easy access to health care facilities.
“Where a child lives definitely impacts their access to health care, but there are still easy and affordable solutions for treating pneumonia and diarrhoea which could save lives, but require government commitment and action,” said Nabila Zaka, Maternal and Child Health Specialist, UNICEF East Asia Pacific Regional Office. “Most countries in the region do not allow community health workers in remote areas to provide critical antibiotics to children with suspected pneumonia. In fact, only seven countries in East Asia and the Pacific have a national policy supporting community treatment of pneumonia with antibiotics despite the strong evidence it saves lives.”
Countries like Thailand, Mongolia and Malaysia, which support this approach, are examples where access to this simple intervention has reduced the risk of dying from pneumonia among children living in rural or hard to reach communities.
Another simple and effective way to safeguard babies from disease is exclusive breastfeeding. Yet fewer than 30 per cent of infants younger than six months of age in East Asia and the Pacific are exclusively breastfed, depriving them of this critical protection.
Access to decent sanitation also continues to put millions of children at risk of contracting diarrhoeal diseases. In East Asia, an estimated 134 million people who resort to open defecation and over one third of people do not use sanitation facilities hygienic enough to prevent excreta related diseases such as diarrhoea.
“Child deaths from pneumonia and diarrhoea can be significantly reduced by tackling these problems and focusing efforts on the poorest communities,” said Zaka. “Through this, the tremendous progress in reducing the number of child deaths each year in East Asia and the Pacific can be accelerated, saving even more lives.”
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