Child Health

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It has been estimated that every minute eight under-five children die in sub-Saharan Africa. Of the 46 countries in the African Region, 36 have under-five mortality rates (U5MRs) of above 100 per 1000 live births; 8 have U5MRs of at least 200 per 1000 live births; 5 countries have had static U5MRs in the past fifteen years while in 9 countries the U5MRs have reversed.

Two thirds of the under-five deaths in the African Region are due to preventable causes. The chief causes of death are neonatal conditions and acute respiratory infections mainly pneumonia, malaria, diarrhoeal diseases, measles and HIV/AIDS (diagram below), most of which are complicated by malnutrition that accounts for one third of all deaths in children under five years. Under-five deaths, most of which occur in the African Region, increased to 43% globally in 2005 from 31% in 1990. According to WHO, an estimated 10.6 million under-five children die each year, 4.6 million of whom die in the African Region.

Food insecurity in Africa threatens the lives of millions of vulnerable people especially displaced persons and people living with HIV/AIDS. Undernutrition is directly or indirectly responsible for 3.5 million child death every year, and at least 35% of the disease burden in under 5 year old children. Sub-Saharan Africa has one of the highest prevalence of low birth weight ranging from 7-42%. Exclusive breastfeeding rate is low and complementary foods are inadequate and inappropriate in the region. Maternal nutrition increases the risk of death of the mother at birth and may be associated with about 20% of maternal deaths.

Annually, almost one million children die from pneumonia, 769 000 from diarrhoea and a further 810 000 from malaria; 600 000 children under five years are infected with HIV each year, mainly through mother-to-child transmission of HIV, and 315 000 die from AIDS.

Although the degree to which indirect determinants of death are expressed varies between countries, malnutrition is a critical risk factor in most countries, and nutrition and food security remains a fundamental challenge to child survival. There are multiple constraints in health systems that hamper effective scaling up of child health interventions. Insufficient human, financial and material resources coupled with limited managerial capability; and out-of-pocket payments are some of the factors that lead to poor service delivery and/or low coverage of interventions. Financial resources for child survival programmes and adolescent health interventions are far from adequate to reach every community in every district with low-cost interventions.