The early years
An estimated 15 per cent of Sudan's population is aged below five years (Sudan Household Health Survey, 2006) - approximately 5.9 million children fall into this age group. They face significant threats from diarrhoeal disease, malaria, acute respiratory infections and vaccine-preventable diseases such as measles, meningitis and yellow fever - more than 1 child out of every 10 born in Sudan will not survive to her or his fifth birthday.
While 69 per cent of mothers receive ante-natal care, less than half of those receiving such care benefited from basic procedures such as checking blood pressure. Only 49 per cent of births take place with the help of a trained health worker, and only 19 per cent take place in a health facility. More than 10 per cent of all pregnancies result in stillbirths. Complications in pregnancy and childbirth, combined with a lack of adequate obstetric care services, leaves Sudan with one of the world's highest mortality ratios at 1,107 deaths per 100,000 live births.
Only one-third of infants are exclusively breastfed in Sudan for the first six months of their life - the rest are left exposed to considerable threats to their survival and early development. One-tenth of children under the age of five are severly underweight, more than 15 per cent are severely stunted, while just over 3 per cent are severely wasted. Consumption of iodised salt - vital in prevention against goitre and a valuable contributor to a child's mental and physical development - is just 11 per cent. More than 20 per cent of children under the age of five have never received vitamin A supplements, critical to strengthening immunity to disease.
Less than one-third of children receive all the recommended vaccinations before their first birthday, leaving them exposed to diphtheria, tuberculosis, measles and polio. While vaccination coverage appears to increase during the second year of a child's life, there remain considerable disparities between states - for example, diphtheria vaccination rates are above 85 per cent in two states, but lower than 20 per cent in seven others. The proportion of fully immunized children ranges amongst states from a high of 72 per cent to a low of just 5.5 per cent.
According to the Sudan Household Health Survey, more than 28 per cent of children under the age of five had experienced diarrhoeal disease just prior to the survey. More than 40 per cent of affected children received no treatment. More than 40 per cent of the population has no access to safe water supply, while 69 per cent of the population has no adequate sanitation, both factors contributing to diarrhoeal disease.
While more than a third of households have access to a mosquito net, only 18 per cent use an insecticide-treated net - the most effective protection against malaria. Less than 30 per cent of children under the age of five sleep under such a net. Very few young children - 2.6 per cent - receive anti-malarial treatment within 24 hours of showing symptoms of the disease.
Infants also face societal threats in parts of Sudan. Based on research undertaken in 2003, evidence indicated that an average of 110 new born babies were being abandoned in Khartoum every month, with half estimated to die before receiving any assistance. Economic pressure on families, and the stigma associated with children born out of wedlock are major factors leading to abandonment.