Early years
The majority of children in the Pacific are either born in a health centre or in hospitals. However, some are still delivered at home, especially in remote island communities. Most children born in urban areas are registered at birth whereas those born in rural areas may be registered later or not registered at all. Many countries in the region have an inadequate birth registration system. This is mainly because of the lack of awareness on the importance of birth registration. Many registrations are not timely, levels of registrations vary from country to country and none of the countries have a complete or nearly complete coverage. The importance of birth registration as a means of fulfilling the rights of having an identity and a nationality is still not fully appreciated, Also, incomplete birth registration has affected the health and education sectors planning processes, as under-reporting results in incorrect estimation of the needs of the children. Since the 1960s, the health status of children in the Pacific region has made significant progress. This is due mainly to the improvement of health programmes and more focus on maternal and child health. Under-five mortality rates (U5MR) in all Pacific Island countries are currently below the average for developing countries (below 90 per 1,000 live births in 2002). Most Pacific Island children are born healthy as shown by the overall low infant mortality rates (IMR) and U5MR rates which vary from 12 per 1,000 live births in Niue to 20 per live births in Samoa. However, in Kiribati, Vanuatu and Solomon Islands the IMR and U5MR are still high. Currently leading causes of death in children under-five years of age include acute-respiratory infections, diarrhoea, malaria (in Solomon Islands and Vanuatu only) and perinatal complications and injuries. Child injuries in the domestic environment such as drowning and road accidents are increasingly recognized as a major problem affecting young children in many Pacific Island countries. Malnutrition has been a persistent problem for young children in many countries . While there is a stunting and low birth weight in some countries, obesity has become a growing concern in others. Infectious diseases (i.e. diarrhoea, intestinal parasite) are common due to the contaminated water and poor hygiene practices. Malnutrition rates as measured in underweight children vary from almost nil in most Polynesian countries to between 6-27% in RMI, Fiji, FSM, Vanuatu and the Solomon Islands. Kiribati, FSM and RMI have high rates of Vitamin A deficiency. There is still inadequate awareness of the importance of the need for early stimulation for better development of children as well as the need for support to parents and caregivers of children 0 - 3 years of age. Emphasis is now on parenting education and home or community-based early childhood development services. Various services may be available but these services are not reaching the young children and families in most need.
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