Children bear brunt of poverty

Malawi has one of the highest child mortality rates in Africa due to deteriorating nutrition levels and falling immunisation coverage, according to children’s rights activists. “In 1992 nearly seven out of 10 one-year-olds in Malawi had been vaccinated by their first birthdays, but this has now dropped to only six out of 10 while six percent of children have no vaccination at all by age one,” a child health specialist told IRIN on Monday. “This drop in immunisation partly contributes to an infant mortality rate of 133 per 1,000 live births, while the under-five mortality rate stands at 234 per 1,000 live births,” among the highest in the sub-Saharan Africa. She added: “The major causes of death among infants and children is malaria and malnutrition,” and estimated that as many as two out of nine children could die before they reach their fifth birthday. The specialist said the situation is aggravated by the limited number of health facilities in rural areas. Currently about 57 percent of Malawian households live more than five kilometres from a health centre. “Two in five people, which is 34 percent of the population, must travel between one and five kilometres to reach a health centre, while less than one in 20 live in a village with a health facility.” According to recent UNICEF figures, 48 percent of all under-fives are stunted or too short for their age, indicating chronic malnutrition. “Half of these children are severely stunted,” said the report. “Localised stunting rates may be as high as 62 percent. Wasting rates are as high as seven percent, and urban areas are more severely affected than rural areas,” the report added. “Severe stunting in the cities almost doubled to nearly one in five during the last three years, from 11 percent to 19 percent,” continued the report. “Urban rates of moderate wasting among under-fives more than tripled between 1992 and 1995, rising to nine percent.” In other words, explained the specialist, while rural malnutrition in general in 1995 was still worse than in Malawi’s cities, the situation in towns was quickly deteriorating. “This is real cause for concern,” said the activist, “as the rate of urbanisation increases especially as unskilled and illiterate families move into the cities in search of nearly non-existent opportunities.” The underlying causes of malnutrition, according to UNICEF, are complex. “These include food insecurity, intra-household maldistribution of food, improper child feeding and weaning practices, disease, and other sociological variables.” The report concludes that micro-nutrient deficiencies are widespread “and it is estimated that these account for 12 percent of all deaths in in-patients, or 18 percent of under-fives”. The AIDS epidemic is also having a devastating effect on the status of Malawi’s children. Official government statistics estimate that 12 percent of the population is HIV positive. “There are currently approximately 88,000 orphans in Malawi, many of whose parents have died from AIDS-related illnesses,” a health ministry official told IRIN. The official added that the ministry’s projections suggest that by the year 2000 the cumulative number of AIDS orphans in Malawi will be over 330,000.