Child Survival and Development
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© UNICEF Swaziland 2007 |
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Pneumonia remains a major killer of children under five years old in swaziland. |
The HIV epidemic has had a major impact in Swaziland. In a population of 1 million, there are 200,000 persons living with HIV and AIDS and 70,000 orphaned children. Between 1997 and 2006, the life expectancy rate plummeted from 57 to 37 years, and the under-five mortality rate increased from 90 to 156 deaths per 1,000 live births.
The main killers of young children are HIV/AIDS (47%), followed by neonatal deaths (27%), pneumonia (12%), diarrhoea (10%), and others (4%). Malnutrition contributes to more than half of these deaths. Between 2007 and 2015, the average annual rate of reduction needed to meet the Millennium Development Goals (MDG) target of 36 deaths per thousand live births is more than 13 percent every year.
ACTION
Prevention of Mother to Child Transmission (PMTCT) of HIV & Paediatric HIV Care
With around 40,000 annual births and an HIV prevalence of 39.2 percent among pregnant women, 17,000 infants are exposed to HIV. In absence of PMTCT services, 6,800 newborns would be HIV positive. UNICEF is supporting:
• mainstreamed implementation and scale up of PMTCT and paediatric HIV care focusing on rural clinics, and
• creating synergies between PMTCT paediatric HIV care, and existing child health programmes to improve the outcomes of PMTCT programs for children. This is to ensure that by 2008 at least 80 percent of HIV-infected pregnant women receive ARV prophylaxis and at least 80 percent of HIV-exposed children receive cotrimoxazole prophylaxis. The cost of these interventions is estimated at USD $1 million annually.
Reducing Under-Five Deaths due to Pneumonia
Pneumonia remains a major killer of children under five years of age. It accounts for 12 percent of post neonatal childhood deaths in Swaziland. UNICEF supports actions related to prevention and improving access to treatment of pneumonia. Measles vaccination is ongoing and Hib as well as Pneumococcal vaccine are expected to be introduced soon. The cost of introducing new vaccines is around USD $500,000 annually.
Reducing Under-Five Deaths due to Diarrhoeal Disease
The Multiple Indicator Cluster Survey (MICS) in 2000 estimated the two week incidence of diarrhoea around 20% amongst under-five children surveyed. UNICEF supports prevention strategies like exclusive breastfeeding, hand washing and safe water supply and treatment using Lo osmolarity ORS and zinc. The cost for integrated management of Childhood illnesses including diarrhoea is USD $180,000 annually.
Neonatal Deaths – Safe Motherhood and New Born Care (NBC)
About 27 percent of under-five mortality in Swaziland occurs during the neo-natal period. UNICEF focuses on teaching families newborn care at home and improving immediate care of newborns within the PMTCT programme.
Reducing Under-Five Deaths due to Malnutrition and other causes
Malnutrition - amongst Swazi young children, 10 percent are underweight, 40 percent stunted and 1 percent wasted. UNICEF focuses on non food nutrition interventions like improving appropriate Infant and Young Child feeding, regular growth monitoring, nutrition surveys and micronutrient supplementation.
Other causes - UNICEF supports the national immunisation programme, distribution of insecticide treated bed nets in malaria endemic areas, and mass deworming campaigns.
