Child and Maternal Health
Over the past 20 years, Egypt has made significant progress on maternal and under-five-year child mortality. The under 5 child mortality was reduced by 70% (between 1990 to 2008) and the maternal mortality was reduced by 73% (between 1992 to 2008) . Despite this reduction, large disparities in child survival still persist at national level in particular for the neonatal period which was reduced at a slower pace. Currently 9 out of 10 deaths of children under the age of 5 take place before the child's first birthday, and about one half of these deaths occur during the first month of life .
Disparities are associated with socio-economic and geographical factors which remain important challenges affecting the poorest layers of the population. Rural Upper Egypt has higher neonatal mortality rates than Urban Lower Egypt (20 versus 11.2 per 1000 live births respectively). In the meantime, the neonatal mortality rate in urban governorates shows steady increase from 17 (in 2005) to 21 (in 2008), most likely due to the increasing urbanization and growth of slums.
Recent studies have identified that the main barriers affecting progress towards reducing neonatal mortality are:
To successfully reduce neonatal mortality, the identified barriers need to be addressed and specific interventions put in place and supported to reach the most deprived population, where mortality rates remain high.
UNICEF’s InterventionsUNICEF’s decades long partnership with the Ministry of Health and Population resulted in a track record of flagship programmes including, Expanded Programme on Immunization, Baby Friendly Hospital Initiative, Polio Eradication, Maternal Neonatal Tetanus Elimination, Integrated Management of Neonatal and Childhood Illness. The current programme, includes two main strategic interventions to reduce perinatal and neonatal mortality;
1. Newborn, Child and Maternal Health Services
The programme supports MoHP to expand the Perinatal Care Programme Initiative to tackle neonatal mortality in selected deprived areas. This initiative offers a model integrating maternal, neonatal and child health as well as nutrition interventions at community level and in health facilities. The programme also focuses on improving service quality (such as training of health care workers), and strengthening information systems on data related to mother and child health and enhancing supportive supervision and monitoring systems. Through these interventions more than 200,000 children and their mothers have been reached since 2008. According to the health information system of the MoHP, the programme has contributed to an average 38% reduction in the Neonatal Mortality Rate in the targeted fourteen communities in Upper Egypt.
2. Family and Community Health Care and Health Seeking Behaviour
Promotion of key health, nutrition and hygiene practices at household and community levels is the second main component of the programme. It aims to encourage the adoption of healthier life styles among disadvantaged communities and increase demand for quality health services. The interventions are implemented in the most deprived governorates of Qena, Sohag and Assiut, reaching more than 100,000 people annually. UNICEF also supports national efforts to maintain Egypt’s polio free status (12 million children under the age of 5 were vaccinated during 2012 immunization campaign), as well as prevent measles and rubella among 36 million children. Currently the programme is also working on preventing child and maternal deaths, diseases and injuries, through developing the Egyptian version of the “Facts for Life” package and promoting it among health workers, families and children.
Programme Expected Results
- MoHP has strengthened institutional capacity to scale-up community based health and nutrition interventions as well as perinatal care programmes.
- Pregnant and lactating women in targeted disadvantaged villages, in three governorates of Upper Egypt, adopt neonatal and child care best practices.
- The perinatal and neonatal mortality surveillance system is consolidated and expanded in two additional governorates in Upper Egypt.
- Equity-focused young child survival and development data are generated and analysed for policy advocacy and system strengthening.
- Emerging child health needs in urban/slum areas are identified and urban health programmes are designed to ensure access of urban poor children to basic health services.