The impact of seasonal disasters, chronic deprivation and limited access to quality life-saving services is evident in DPRK child and maternal mortality rates. Maternal Mortality ratio stands at 66/100000 (SDHS 2014) and Under 5 mortality rate at 15/1000 (MICS 2017).
Ensuring the survival and health of children and women
More than half of under-five deaths occur during the first 28 days of life due to preterm birth complications, infections and hypothermia. Pneumonia (12 per cent for the post-neonatal period in 2015) and diarrhoea (6 per cent for the neonatal period in 2015) are also major contributors to under-five mortality. In the absence of a strong health system properly equipped and supplied , gains made in the last 10 years reducing the U5 and maternal mortality ratios may be lost.
MICS data showed high coverage in health care services and now it is necessary to jointly focus efforts to address disparities in service’s quality recognized on province level, between urban and rural areas, as well as in wellbeing of children living in household classified in different wealth index groups.
UNICEF will continue to support the Government focusing on the provision of life-saving humanitarian interventions for the most vulnerable communities.
In line with the UN Strategic Framework, the programme will contribute to the strengthening of health-care delivery to provide urgently required gender-sensitive, evidence-based preventive and curative services, which will help to reduce maternal, neonatal and under-five morbidity and mortality, and prevent and control childhood tuberculosis.
UNICEF will also support the Ministry of Public Health to better identify humanitarian needs and risks, and to promptly and effectively prepare for and respond to emergencies.
The Integrated Management of Newborn and Childhood Illnesses (IMNCI) programme focuses on the major causes of under-five mortality, including pneumonia, diarrhoea and undernutrition.
The integrated management of newborn and childhood illnesses protocol and guidelines have been tailored to the context of DPRK in coordination with WHO and UNFPA with addition of sections on sexual and reproductive health and childhood tuberculosis.
Along with the provision of essential medicine kits, the programme is implemented in 50 priority counties affected by the protracted humanitarian crises. In these counties, 5,000 household doctors (male and female) are trained and supplied with essential medicines and basic equipment to provide effective preventive, basic curative services and health promotion.
The delivery of immunization services is supported nationally and improved by training managers, upgrading the cold chain and enhancing monitoring systems to ensure quality services, with particular attention to hard-to-reach villages and those affected by the protracted humanitarian crisis. National vaccination coverage survey 2017 reflects homogenously high coverage rates of more than 95 per cent against all vaccines.
A costed package of evidence-based emergency obstetric and newborn care services is the implementation phase in nine convergent counties to demonstrate its contribution to reducing maternal and neonatal mortality, and to inform scale up by the Government.
Moreover, integrated pilot childhood disability early screening labs, early intervention units and reinforcing the technical capacities of the new-born care health services providers will support access to health-care and rehabilitation services for specific needs such as early identification of birth defects, developmental delays and disabilities; assessment and planning of early intervention therapy; provision of assistive aids and mobility devices and family support for children with disabilities.
The main implementing partner is the Ministry Public health that is responsible for all aspects of the health services delivery in the whole country. Other implementing partners include the Korean Federation for the Protection of the Disabled and the EUPS 7.