Over the past 25 years, Egypt has recorded important achievements in improving child and maternal survival and health. Between 1988 and 2014, the under-5 mortality rate declined from 108 to 27 child deaths per 1,000 live births; slightly more than half of these deaths occurred in the first month of the child life . Progress in coverage of prenatal care in Egypt has also been noteworthy in the last decade. In 2014, around 90 percent of mothers underwent antenatal care checks during pregnancy, 83 percent of them having had antenatal care on a regular basis. Among all births, 92 percent were attended by a skilled birth attendant and 87 per cent took place in a health facility . As for the immunization rate, 92 per cent of children aged 18-29 months were fully immunized in 2014; the children had received complete vaccination against tuberculosis, measles, diphtheria, pertussis, tetanus and polio .
Despite these significant improvements, regional disparities remain substantial in child survival in the most disadvantaged areas of the country (especially in rural areas). In 2014, the under-5 mortality rate ranged between 42 deaths per 1,000 live births in rural Upper Egypt and 20 deaths per 1,000 live births in urban areas. Neonatal mortality was at its highest level in rural Upper Egypt, at 21 child deaths per 1,000 live births, compared with 10 child deaths per 1,000 live births in Urban Lower Egypt . Substantial inequalities persist also between socio-economic groups. Maternal mortality followed a similar declining trend, from 174 maternal deaths per 100,000 live births in 1992 to 52 maternal deaths per 100,000 live births in 2013 . Most maternal deaths occur during and post-delivery periods. In addition to that, data for the postnatal care visit shows less encouraging trends, with only 14 percent of the newborns receiving the recommended postnatal health checks within 2 days from birth .
Regarding Syrian refugees, the Ministry of Health and Population has allowed Syrians to use public healthcare services. With the increased demand for healthcare services, a strategic shift has been made to reduce parallel health systems to further increase access to quality and equitable healthcare in an efficient and sustainable manner. However, healthcare services are already significantly overstretched in Egypt. Further progress in reducing childhood mortality depends on the capacity of the country to adequately address geographical inequalities, improve the quality of health services – including the quality of staff training and equipment, and improve health-seeking behaviours and healthy practices.