Child health and nutrition
Every child, including adolescents, survives and thrives, with access to nutritious diets, quality health care, nurturing practices and essential supplies
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Progress and challenges
In the past two decades, Algeria has exponentially improved and expanded its health infrastructure and access to healthcare [1], especially in community and primary healthcare, making it freely available for all, including migrants. This has resulted in a sharp decline in both communicable diseases as well as maternal and child deaths.
The World Health Organization (WHO) certified that Algeria has eliminated three major communicable diseases: polio in 2016, neonatal tetanus in 2018 and malaria in 2019. Maternal mortality fell from 117.4 to 48.5 per 100,000 live births between 1999 and 2019 and neonatal mortality decreased from 16 to 12 per 1,000 live births between 2013 and 2019. Maternal healthcare coverage is nearly universal with 99 per cent of births assisted.
Yet Algeria’s health system is faced with challenges in the quality of services and some disparities in service delivery. For example, infant and neonatal mortality rates were higher in the north-east region (24 and 18 per 1,000 live births, respectively), the south (23 and 16 per 1,000 live births, respectively) and among the poorest quintile (23 and 17 per 1,000 live births, respectively).
Overall neonatal mortality and exclusive breastfeeding rates have stagnated and the uptake of immunization has regressed. Neonatal mortality accounts for 70 per cent of child deaths. The full immunization rate fell from 83.1 per cent in 2013 to 61 per cent in 2019 mainly due to parental hesitancy over vaccination, and challenges faced for supply chain and management of the Expanded Programme on Immunization (EPI) at central and local levels. The lowest rates of full immunization were in the central highland regions (31 per cent) and among the poorest quintile (47.4 per cent). Exclusive breastfeeding at 28.7 per cent is low although it has increased slightly from 25.5 per cent in 2013.
New challenges have emerged as a result of an aging population and a shift from acute infections and deficiency diseases to chronic illnesses, typical of industrialized countries, and possible pandemics while still putting in place measures to manage COVID-19. Being overweight is now a major public health concern and is a growing threat to women’s and children’s well-being in Algeria, largely driven by unhealthy and highly processed foods combined with a lack of physical activity and sedentary behaviour. The country has an obesity rate of 22 per cent and is among the top 20 countries in the world that have high rates of obesity.1 About 12.8 per cent of children under the age of 5 are overweight. The prevalence is even higher in the north-central region and north-west region where 15.4 per cent and 15 per cent respectively are overweight. Being overweight undermines children’s physical and emotional well-being and increases the risk of being overweight later in life, making them susceptible to non-communicable diseases and putting individuals, families, and societies at a disadvantage economically. In Algeria, it is estimated that if there is no intervention to tackle obesity, by 2030, 46 per cent of the population will be obese. [2]
[1] All the data in this paragraph are taken from MICS 2019 unless otherwise indicated.
[2] Statement by the Ministry of Health
After the COVID-19 pandemic, which had a detrimental impact on healthcare, we supported the Government to build a more resilient health system, particularly improving maternal and child healthcare to reduce neonatal mortality and increase immunization at community level. For example, we donated cold chain equipment that has been used to improve the expanded immunization programme, and the oxygen donated for COVID-19 treatment is now being used to improve maternal and neonatal care, including treating newborns with low oxygen levels in their blood that if left untreated can lead to death. UNICEF has also supported training to improve both cold chain management for vaccinations and the use of oxygen for neonatal survival, two key priority interventions for child survival.
UNICEF support
UNICEF support aims to ensure that newborns, young children, adolescents, pregnant and lactating women and families benefit from quality healthcare services and adopt good health behaviours.
To achieve this, UNICEF contributes to the priority areas of the Government Action Plan 2021–2024 and the joint UN strategic outcome on human development which in turn contribute to achieving Sustainable Development Goals (SDGs) 2 and 3 on health and nutrition, and UNSDCF 2023–2027 strategic outcome 3.
UNICEF supports the Government’s Child Survival and Development programme to strengthen access to quality health services, accelerate the reduction of maternal and neonatal mortality, and reinforce the prevention and control of communicable diseases, including vaccine-controllable diseases, and enhance communication for the promotion of good parenting practices on health and nutrition.
Primary health care services for mothers and their children need to be resilient and inclusive. UNICEF supports access to essential packages of high-quality maternal and newborn services, such as promotive and preventive lifesaving interventions delivered by well-trained health professionals to assist births and provide pre- and post-natal care. The focus is on expert care for small and sick newborn babies, including kangaroo care for premature babies that use skin-to-skin contact between parents and babies to increase their chances of survival. UNICEF also supports increased vaccination uptake particularly supporting the monitoring of the implementation of a new vaccine schedule as well as addressing vaccine hesitancy among some population groups. A strong health information system is needed and is being built on the experience and lessons learnt from the COVID-19 pandemic.
In nutrition, the focus is on the promotion of infant and young child feeding, and healthy eating practices for older children to prevent childhood overweight and obesity. Evidence-based behaviour change campaigns are being adapted, exclusive breastfeeding is being encouraged in regions with low rates, and healthy eating is promoted in schools and the community at large.
Cross- and intersectoral collaboration need strengthening. This means integrating early childhood development in cross-sectional national programmes based on an evaluation and subsequent recommendations of Early Childhood Development (ECD) programmes. The first 1,000 days of a child’s life from conception to 2 years of age and the prevention and early detection of physical and mental health disabilities are prioritised. It also includes reinforcing cross-sectional collaboration with the education sector. The school health programme involves enhancing the mental and physical health of school children and adolescents, including the early detection of autism, and promoting healthy eating habits and exercise to avoid overweight and obesity.
What we do to achieve better health and nutrition outcomes for children:
1. The health system is strengthened in the areas of planning, implementation and monitoring-evaluation to ensure quality care services for the target populations. UNICEF supports the strengthening of the national health system by providing technical training for planning, developing an evidence-based national reform plan and updating national maternal and child health programme. Innovative methods are supported to improve quality implementation and governance of maternal and child health programmes, including at a decentralized level. Priority is given to reducing maternal and neonatal morbidity and mortality, and improving the quality of services, particularly in the most vulnerable regions (shadow areas), in line with national priorities which are included in the Government's Action Plan (2020). This is critical for the implementation of the President's Programme which is focused on reducing regional disparities.
2. The capacities of health structures are strengthened to ensure better prevention of vaccine-preventable diseases. UNICEF supports the evaluation of the expanded programme on immunization (EPI), the in-depth analysis of vaccine data from MICS 6, the extension of the implementation of the electronic vaccination record and the conducting of socio-anthropological surveys to identify the socio-cultural barriers that hinder vaccination. In addition, UNICEF assists with cold chain equipment in the ‘grey’ areas and capacity building for their professionals. Emphasis is also placed on strengthening communication strategies for the promotion of vaccination.
3. Families and health personnel have enhanced knowledge that promotes healthy eating practices, particularly for infants and young children. UNICEF supports evidence-based social and behaviour change programmes that improve parental knowledge and practices in infant and young child feeding, particularly the promotion of exclusive breastfeeding by targeting regions with low rates. In addition, UNICEF supports initiatives to prevent overweight and obesity in children and young people. UNICEF assists with the sharing of information through traditional channels, such as radio, television, face-to-face and religious gatherings and also social media and the private sector (mobile telephone operators).
Main partners
The programme is led by the Ministry of Health. Other partners include the Ministry of National Education and Ministry of Interior, the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Population Fund (UNFPA).
