Disparities threaten Viet Nam’s progress in child survival
Ha Noi, 25 January 2008 – Despite tremendous progress in under-five mortality, an average of three children still die every hour in Viet Nam, particularly in ethnic minority and mountainous areas of the country, according to figures released by the UN Children’s Fund (UNICEF). In total, an estimated 28,000 children die every year in Viet Nam before seeing their fifth birthday, most from preventable causes.
The State of the World’s Children 2008 report was jointly launched today in Ha Noi by UNICEF, the World Health Organization (WHO), the Ministry of Health (MOH), Ministry of Labour, War Invalids and Social Affairs (MOLISA), and Save the Children USA. The report assesses the significant progress made on child survival and primary health care for mothers, newborns and children over much of the world, while calling for concerted action to reach the millions of children still lacking access to simple interventions and affordable care that could save their lives.
At the launch Viet Nam was congratulated on already reducing its child mortality rate by more than half since 1990, a figure which the report calls a sensitive indicator of a country’s development and telling evidence of its priorities and values.
“Viet Nam has made impressive progress in improving the survival rate and health of children over the past two decades, and the country is on track to meet Millennium Development Goal 4 to reduce the under-five mortality rate by two-thirds by 2015,” said John Hendra, UN Resident Coordinator in Viet Nam. “However, there are significant disparities within the country, and further progress will require extending health services and care to all pregnant women and mothers, newborns and young children -- especially the poor and those living in remote areas.”
Dr. Tran Chi Liem, Vice Minister of Health, noted that the Government is addressing these challenges through continuing and extending interventions that have proven successful in recent years. These include immunizations and Vitamin A supplements for both mothers and children, as well as the use of oral rehydration therapy, among others.
“These interventions have contributed to a decline from 53 under-five deaths for every 1,000 live births in 1990 to approximately 17 per 1,000 in 2006, according to the State of the World’s Children report,” said Dr. Liem. “The country has maintained high childhood immunization coverage and effective strategies to reduce micronutrient deficiencies nationally.”
Viet Nam still faces many challenges in child survival, however, and current trends may not continue if these challenges are not tackled. “We need to pay more attention to improve policies and care for mothers during pregnancy, and improve neonatal care and quality services to ensure that children’s rights to survival and development are guaranteed,” said Vice Minister of Labour, Invalids and Socials Affairs Dr. Dam Huu Dac.
Progress has been slow in reducing the neonatal mortality rate, or the number of children dying in the first month of life. Newborn deaths now represent more than 50 per cent of all child deaths. This can only be tackled with improved pregnancy and delivery care, and improved essential newborn care. Another major emerging issue is inequity, as despite great progress, the mortality rate of children in mountainous and rural areas and of poor families is still three to four times higher than that of children in lowland areas or of families that are better-off.
According to the United Nations, programmes in many other countries prove that an integrated approach where children are reached with a package of interventions can avert the majority of child deaths.
The report’s overall analysis reveals that more needs to be done to increase access to treatments and means of prevention, in particular ensuring that what’s known as a “continuum of care” is provided for all mothers, newborns and young children, extending from the household, to the local clinic, to the district hospital and beyond.
In Viet Nam, neo-natal care, exclusive breastfeeding, better nutrition and adequate sanitation and hygiene are priority issues. Viet Nam has a low rate of exclusive breastfeeding: only 58 per cent of newborns are breastfed within the first hour after birth and 17 per cent of them are exclusively breastfed for the first six months of their lives. Child and maternal under-nutrition rates also remain unacceptably high. Some 30 per cent of children less than five years old are considered stunted while 37 percent of pregnant women are anemic.
In addition, the majority of rural households lack adequate sanitation and do not practice appropriate hygiene behaviors, major factors leading to worm infection and diarrhoea, which contribute to child deaths.
Viet Nam also needs to tackle its persistently high neonatal mortality rate by assuring universal access to pregnancy and delivery care for mother and newborns, and essential care for newborns. This will also require improvement in the quality of the current services.
The good news is that the relatively simple and affordable interventions needed to save the lives of thousands of Vietnamese mothers and children are now well known. The challenge is to reach those that are not currently receiving the full continuum of care. This will require everyone’s participation, from mother and fathers, to local communities, and many other sectors of society, whose engagement is vital if marginalized and remote populations are to be reached.
Figures in The State of the World’s Children 2008 are drawn from a pool of data provided by national sources, which differ from country-to-country. Country estimates are then calculated in a uniform way for all countries. This is normally why the report’s figures often differ slightly from official government statistics.
Ms. Caroline den Dulk, UN Communications,
Mr. Trinh Anh Tuan, UN Communications,