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Last Updated: Thursday, 13 September 2007, 13:55 GMT 14:55 UK
Child mortality in Malawi, Vietnam and India
Figures compiled by the UN's children agency, Unicef, show a worldwide drop in under-five child mortality rates. The BBC News website has spoken to Unicef representatives to find out which factors have contributed to the decline in Malawi, Vietnam and India.

AIDA GIRMA, MALAWI

The factors that have contributed to the rapid decline in child mortality in Malawi include the achievement of relatively high rate of interventions such as immunisations - immunisation coverage right now is at 86%. Vitamin A supplementation has reached over 90% coverage. Exclusive breast-feeding up to six months has also gone relatively high... to over 56% right now.

File photograph of a Malawian woman and her grandson at an emergency nutrition centre in Malawi
Malnutrition is a major cause of childhood death in Malawi

Safe water, for instance, has reached about 74% of households and currently over 50% of households own at least one insecticide-treated net.

Of course, one has to sustain these interventions and also accelerate them, because even though there has been a decline, one in eight children still die of easily preventable diseases. So there has to be an acceleration if Malawi is to achieve the millennium development goals.

The other thing in Malawi, which has not really changed since the 1990s, is nutrition indicators. Malnutrition is still a big problem and still the underlying cause of almost 50% of child deaths.

CAROLINE DEN DULK, VIETNAM

Under-five mortality rates in Vietnam have dropped from 58 per 1,000 live births in 1990, to 17 per 1,000 in 2005. This is enormous progress over a short period of time.

Immunisation levels are almost at full coverage, at around 95-100%. There is a lot other countries can learn from Vietnam about eradicating polio and measles. It is definitely a success story. The government has been very committed.

We have been working with the health ministry to support them in training health workers, who administer the immunisations, and raise awareness among people of when to bring their children in to be immunised, and when to seek medical help.

But what we see growing within the country is geographical areas where progress has not been made, where malnutrition rates are still relatively high.

This is in rural areas, where there are large numbers of ethnic minorities. They are lagging behind in access to services and in health-seeking behaviours.

IMAR BARR, INDIA

Under-five infant mortality rates in India have fallen to 73 per 1,000 live births in 2006, from 94 per 1,000 in 1990. That's a 22% decline, which is extremely good news, although it still represents 1.9 million deaths.

The decline has been due to a number of factors. The public health system has improved, although India being such a large country, certain states are better off than others.

A young child in India receives a dose of the oral polio vaccine
Increased immunisations have saved lives in India

Measles vaccination coverage has risen over the years and stands at 65%, which is good but not good enough - we would like it to be at least at 80%. Again, the figure masks the disparities among the country's states. The southern states tend to be better off, whereas the poorer states such as Uttar Pradesh and Bihar have poorer facilities.

Another thing that has helped is breast-feeding, which helps decrease incidents of disease and diarrhoea, which is a killer among young babies. The rate in India is just over 50%. Frontline support workers are helping to support mothers at antenatal clinics, hospitals and in villages.

India's success in bringing mortality rates down is due to putting a large percentage of its budget into the health and social sector, and investing in the health sector, facilities and frontline health workers.




SEE ALSO
Child mortality 'at record low'
13 Sep 07 |  Health



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