Say Yes, February 2002: Early Childcare
A happy family group, Diyarbakır.
Photograph by Sumru Kutlu © UNICEF Turkey 2001
Turkey has yet to reach targets for immunisation, infant mortality, maternal mortality and malnutrition. However, an uneven distribution of healthcare professionals between urban and rural areas and between the provinces, lack of motivation in personnel affected by the economic crisis, insufficient government health insurance and social security coverage are just some of the problems affecting progress. Add to this the problem of wide-spread illiteracy among women and the well-being of mothers and their children is seriously threatened. So what is being done?
Objectives of the Mother and Child Health Project
- To halve the IMR to 20‰
- To reduce the U5MR by 50%;
- Inform all pregnant women about the benefits and management of breastfeeding;
- To reduce the MMR by 50% in project provinces;
- To reduce micro-nutrient deficiencies by 50%;
- To reduce the rate of low birth weight by 50% in project provinces;
- To eliminate IDD before 2005;
- To monitor and support the social and cognitive development and growth of 50% of under-8s by supporting their families.
With two World Bank-sponsored surveys under way already, UNICEF is supporting a range of programmes under the Mother and Child Health Project, in order to improve routine coverage rates of vaccines, reduce infant and maternal mortality rates and to generally promote growth and development. The project also aims to eliminate micro-nutrient deficiencies, especially Iodine Deficiency Disorders (IDD) and to strengthen access and demand for primary healthcare services and to reduce rates of malnutrition.
It is of vital importance that all newborns are properly registered in order to ensure timely access to the necessary health services.
Integrated Management of Childhood Illnesses (IMCI)
In Turkey, 60% of infant deaths occur during the neonatal period, mostly on the first day. The high MMR means that the birth process itself requires close attention. UNICEF supported the Newborn Resuscitation Programme (NRP) in forty-six provinces and so far a total of 1,300 healthcare personnel have been trained.
IMCI channels a variety of programmes and resources, including an operational referral system, into a cost-effective strategy which includes interventions in homes as well as healthcare facilities. IMCI aims to reduce child mortality, illness and disability and to enhance growth and development. Technical assistance and support was given to the MOH in 2001 to help with the formation of an IMCI team. A central training team was established and training materials were adapted to train teams in the pilot provinces of İzmir and Şanlıurfa.
A survey planned for 2002 will identify the causes and frequency of perinatal and neonatal deaths and the IMCI strategy will be refined accordingly.
Expanded Programme on Immunisation (EPI)
The Turkey Demographic and Health Survey (TDHS) for 1998 showed that 87% of infants received BCG and 86% had their first dose of DPT. Most had been vaccinated in the first twelve months.
However, only 46% of infants received all of the required vaccinations in the first twelve months. In the eastern provinces, coverage was very low at 23% and in western and central provinces at 50% and 52% respectively. The extent of coverage was found to be related to the levels of education of the mothers.
The EPI seeks to achieve the most extensively sustainable routine coverage rates of vaccinations for Diptheria, Pertussis, Tetanus, Hepatitis B, Measles, Poliomyelitis and Tuberculosis.
With the exception of Hepatitis B and Pertussis, school children are also receiving vaccinations and expectant mothers are being vaccinated against Tetanus.
Until the EPI gains the political and financial support necessary to implement the National Action Plan, the targets for coverage and quality of routine immunisation services are likely to remain unmet. In order to bring the programme closer to achieving it's goals, UNICEF has supplied cold chain equipment, almost 400,000 EPI brochures and guideline manuals for healthcare personnel.
Read Got Your Shots Kids? -- our simple guide to immunising your child against the major childhood diseases. [PDF 1.9MB]
Read more about immunisation in our Programmes section.
The Autumn 2002 issue of Say Yes features more about Turkey’s successful Polio Eradication Programme.
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SAY YES, FEBRUARY 2002
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MONE has been asking teachers and students in all schools to collect pledges for Say Yes for Children. The Ministry of Health (MOH) is collecting signatures from all of it’s family planning and healthcare centres across the country.