***DISCLAIMER***:
*** Join and/or use any materials at "www.uhscambodia.ucoz.org" at your own risk.***!
*** Materials contained within "www.uhscambodia.ucoz.org" do not represent UHS.***!
*** The creator and administrators of "www.uhscambodia.ucoz.org" are not responsible for any harm and/or damages and/or mislead done by materials taken from this website.***!
*** "www.uhscambodia.ucoz.org" is not the official website of UHS nor the logo below.
By Marwaan Macan-Markar BANGKOK, Sep 21 , 2010 (IPS) - Cambodia’s partial success in reducing child mortality rates
has exposed a fault line of inequity, one that underscores the
advantage that the country’s urban population has had over the
rural poor.
Yet the South-east Asian kingdom, 35 percent of whose 14
million population live below the poverty line, is not alone
in having this mixed record of reducing child mortality, say
child rights experts.
Some of the other countries in the region reflect a
similar trend 10 years after world leaders committed to meet
a set of eight targets to help the world’s poor by 2015. The
fourth of the eight U.N. Millennium Development Goals (MDGs)
seeks to achieve a two-thirds reduction in child mortality
rates by 2015.
"To be fair to governments in South-east Asia, child
mortality rates are going down everywhere," said Ben
Phillips, director of strategy at the Asia office of Save
the Children, a British-based humanitarian organisation.
"But the rate of decline is less than the rate they
committed in 2000."
"In South-east Asia, child mortality rates have almost
halved from 2000 levels," he told IPS. "But the region is
substantially behind from meeting the two-thirds target,
which is five years away."
A recent report by Save the Children, entitled ‘A Fair
Chance At Life’, shows that Cambodia has seen a 32 percent
drop in child mortality figures among the country’s "richest
20 percent", but only an 18 percent reduction in child
mortality among the "poorest 20 percent".
Indonesia, the region’s giant where 16 percent of its 225
million people live below the poverty line, has recorded
"equitable progress," noted the 37-page report. The poorest
20 percent has seen child mortality figures drop by 29
percent, while the richest 20 percent has witnessed a nine
percent decline.
Military-ruled Burma, also known as Myanmar, lags behind
all with the worst child mortality figures. It reportedly
has 104 children under five years dying for every 1,000 live
births. Cambodia, by contrast, has 82 deaths of children
under five years of age per 1,000 live births. Laos, the
third of this region’s poorest countries, has 75 deaths per
1,000 live births.
Child rights groups have hailed Thailand, Malaysia and
Vietnam as being well on course to meeting the 2015 targets.
The region’s richest country, the city-state of Singapore,
has been singled out in a study by ‘The Lancet’, a British
medical journal, as leading all countries in the world in
child mortality rates, having reduced it by 75 percent since
1990.
The inequity in child mortality rates in countries like
Cambodia and the Philippines, which has 32 deaths per 1,000
live births, is "partly an urban-rural divide," said
Phillips. "There is no conscious discrimination, but a
natural tendency for nurses and doctors to work in cities."
At times, the distance to a health care is a day away,
making it costly and time consuming for a family to take a
newborn to treat illnesses that lead to child deaths, such
as pneumonia, diarrhoea and sepsis.
"If you live more distant from a health centre, you will
be reached later unlike those who live closer to health care
workers," said Basil Rodriques, regional adviser for your
child survival and development at the Asia office of the
United Nations Children’s Fund (UNICEF). "The MDGs saw the
‘low hanging fruits’ reached first."
To address this trend, countries in the region are being
urged to strengthen community health initiatives in rural
areas, including by tapping trained midwives who live in the
villages they grew up in. "This is what is going to make the
difference," Rodriques said in an interview. "Governments
are looking at how to train workers who grow up and return
to live in their communities."
Early diagnosis of diseases like pneumonia is key to
saving a child’s life, adds Rodriques, pointing to
achievements in Indonesia. "There is a growing recognition
of a community-focused approach, since community health
workers are trained to see the problem and offer prompt
care."
Vietnam’s success with a similar community health care
programme across its rural regions is also being held up as
another model for the region. Its record of child mortality
is 17 deaths for 1,000 live births.
"It is really hard to divorce equity from the development
paradigm," said Rodriques. "The MDGs have, in a sense, acted
as accelerator for governments in South-east Asia to invest
more."
Save the Children’s Phillips estimates that the entire
Asian region needs two million health workers, ranging from
midwives, nurses and obstetricians, to meet the 2015 targets
on child mortality. "India will need one million of them and
South-east Asia will need a third," he said.
"This requires a dramatic shift in policy and resources
made available to strengthen rural health care systems," he
explained. "If you are not focused on equity, the outcome
will be inequitable."
"Health workers don’t just cure; they also prevent," he
said. "Governments need to be putting more people through
nursing schools."
(END)
