UNICEF believes that the first five years of a child’s life are the most important for healthy development. These early years are some of the most vulnerable in a child’s life and positive influences to their health help ensure a good start in life.
Integrated services for child survival and birth registration
The rate of under-five mortality in The Gambia is 73 for every thousand children (UN Inter-agency Group for Child Mortality Estimation, 2013). Despite this figure, under five mortality has seen improvement in the past five years - Gambian children are benefiting from UNICEF’s integrated services approach to reduce child mortality and manage illnesses in a timely manner.
The method is to create a “one stop shop” of services, emphasizing on prevention and timely initiation of treatment through routine reproductive and child health services immunizations, and sensitization on the importance of adequate nutrition, prevention of illnesses as well as voluntary counseling and testing (VCT), prevention of mother to child transmissions (PMTCT) and early infant diagnosis (EID) of HIV/AIDS. About 90 per cent of children receive routine immunizations through the expanded programme for immunization (EPI) that is available at every health facility in the country. Because of the integrated services, coverage of Vitamin A supplements for children and lactating mothers is on the increase. These same health facilities sensitize mothers on the importance of insecticide treated bed-nets (ITNs) to prevent malaria. The Gambia has shown progress in scaling up ITN use. The number of children under age five sleeping under an ITN has surged from 15 per cent in 2000 to 33.3per cent in 2010 (MICS 2010).
The integrated service has also helped in improving access to birth registration of children under five years. Mother’s take their baby to health clinics for birth registration after the traditional naming ceremony – a week after the baby is born. Over the past few years, however, the prevalence of birth registration has been undulant, increasing to 55 per cent in 2005 from 32 per cent in 2002, and declining to 52.5 per cent in 2010 (MICS 2002, 2005, 2010).
The integrated services are widely available for all children under five years and mothers. Recognizing the challenges of reaching all children through base services, mobile out-reach health posts and services are available to target hard-to-reach children. Nation-wide campaigns and door to door immunizations also take place to supplement the routine programme.
Early child development
Studies have shown that children who are encouraged to learn at an early age are more likely to enroll in school and complete primary school. UNICEF promotes early learning and stimulation in the development of children under five years, through an early childhood development programme (ECD).
The programme, which makes available preschool activities to poor and hard to reach children, also helps ensure school “readiness” for children and makes sure that the technical capacity is in place for children to fully benefit. UNICEF promotes ECD facilitators, parental education and the provision of teaching and learning materials.