Majority of under-five deaths preventable - UNICEF

Most deaths of children under five are preventable or treatable in Myanmar, according to the UN Children’s Fund (UNICEF).



The Under 5 Mortality Survey (2002-2003), conducted by the government and UNICEF, reported the main causes of early death as acute respiratory infection (21.1 percent), brain infection (13.9 percent), diarrhoea (13.4 percent), septicemia (10.7 percent) and prematurity (7.5 percent).



About three-quarters of all deaths occurred in the first year.



"Over two-thirds of child deaths could be prevented by inexpensive but proven high impact services like immunisation, better case management with antibiotics, insecticide-treated bed nets, supplementation of Vitamin A and other micronutrients," Osamu Kunii, chief of health and nutrition at UNICEF, told IRIN in the former Burmese capital, Yangon.



As part of its Millennium Development Goals (MDGs), Myanmar has pledged to reduce its under-five mortality rate by two-thirds by 2015, from 130 per 1,000 live births in 1990 to 43.



"To achieve the goals we need more internal efforts and external supports, especially resource mobilisation such as funding," Kunii said, emphasising the importance of better collaboration and coordination between government, UN and NGO partners before 2015.















Photo: Lynn Maung/IRIN
A woman in Yangon waits to have her child vaccinated

Greater awareness



But while the government and its partners work to expand health services to remote areas of the country, the public should also seek better healthcare for their children.



"We also have to put more focus on [the] behaviour change of families, and change the community towards supportive, healthy and hygienic environments for children and women,” he said, explaining that without parents’ cooperation, any initiative would be ineffective in reducing child mortality.



That applied to using treated mosquito nets, for example, as malaria is a major cause of infant death, and changing women’s diet. According to health personnel, traditionally many women avoid certain foods during pregnancy as well as during lactation in the belief they may harm the baby.



“Many women here avoid some foods which are in fact good for their babies, but eat other foods [that are] bad for babies. For instance, as a result of Vitamin B1 deficiency, so-called infantile beriberi occurs. It has been the major cause of infant deaths in this country," the UNICEF specialist said.



According to the State of the World's Children 2009, about 15 percent of infants are low birth-weight in the country. "Making mothers healthy is very crucial for saving children and making children healthier," Kunii said.



Importance of breastfeeding



He also suggested women should be encouraged to breastfeed exclusively as it is the simplest but most effective intervention to fight malnutrition and infectious diseases during the first six months of a child’s life.



However, only 15 percent of infants in Myanmar are exclusively breastfed. According to global research, increasing breastfeeding could reduce child mortality by 13 percent.



“We could save more children by mothers’ behavioural changes for infant and young children’s feeding practices.



“Just providing knowledge and raising awareness hardly changes people’s behaviour. To reduce individual risk behaviours, people need support from their family, peers, community and experts. We need to help communities create such environments to change individuals’ risk behaviours and protect children and women,” Kunii said.



In an effort to reduce the risk of child deaths, UNICEF is working with the government and other partners on immunisation drives, providing essential drugs and other supplies, Vitamin A supplementation and de-worming, the prevention of mother-to-child HIV transmission, capacity building for basic and community health workers, and other critical child and maternal health activities.



“The emergency response to Cyclone Nargis has made us confident that all the partners can work together to achieve the same goals with the same vision. I’m sure we can do the same in achieving MDGs 4- for saving [a] child’s life,” Kunii said.



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