Programme

Programme

Health

The Child Survival and Development programme aims at contributing to the reduction of maternal and child mortality and morbidity, especially in the most deprived areas of Egypt.

IPHN programme in Um El Qosoor family health unit, Manfalut, Assiut
UNICEF Egypt/2017/Ahmed Hayman

Challenges

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 [1]. 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 [1]. 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 [1].

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 [2]. 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 [2]. 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 [1].

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.

 

[1] Egypt Demographic and Health Survey 2014

[2] MoHP (2014) Maternal Mortality Bulletin

Solutions

UNICEF’s partnership with the Ministry of Health and Population resulted in flagship programmes including the Expanded Programme on Immunization, the Baby Friendly Hospital Initiative, polio eradication, maternal and neonatal tetanus elimination, and the integrated management of neonatal and childhood illness. The current UNICEF programme aims to reduce the neonatal mortality and child malnutrition by improving the quality and accessibility of an integrated package of essential maternal, neonatal and child health services in disadvantaged areas and by promoting health, nutrition and hygiene awareness.

The Integrated Perinatal Health Care and Nutrition programme is co-supported by the Ministry of Health and Population and UNICEF. It aims at reducing the neonatal mortality by 20 percent and child malnutrition by 30 percent in the targeted disadvantaged areas.

The programme is implemented in 269 family health units and relevant health districts in 4 governorates of Upper Egypt and 2 governorates of Lower Egypt, covering a population of around 3 million people.

It addresses equity and specifically targets the most vulnerable women, newborns and under five children through a continuum-of-care approach. UNICEF also provides support to build the capacity of health care providers, strengthens the healthcare system, promotes communication for behavioural changes, and creates an enabling environment for maternal and infant health.

In 2014, in collaboration with the Ministry of Health and Population and the Cairo governorate, UNICEF launched the Integrated Child Survival Partnership initiative in the selected Informal areas in Cairo governorate. It reinforces the governmental development efforts in slum communities to improve the health status of mothers and under-5 children, through a replicable model of partnership that widens improved access to health, nutrition and water connection, sanitation and hygiene services in slum communities. Two communities have been selected by the Cairo governorate as models: Ezbet Khirallah - around 261,000 inhabitants, and Ezbet Abu Hashish - with around 70,000 inhabitants.

Health Quality Improvement Programme is a World Bank-funded project, which assists primary health care facilities in meeting national health care quality standards in Egypt’s poorest 1,000 villages in the target governorates of Qena, Sohag, Assiut, Minia and Beni Suif. The Ministry of Health and Population has requested UNICEF to support the project by providing technical expertise for the independent verification process, which assess the performance of primary health care units against a range of indicators.

Regarding interventions related to Syrian refugees, UNICEF has provided support for the Ministry of Health and Population to enhance the capability of its primary health care units to meet the increased demand since 2013. Basic equipment and training were provided for 102 primary healthcare units in areas with a high concentration of Syrian refugees. Furthermore, 235 Syrian women community health workers were also recruited and trained to raise the awareness of Syrian families on health and to encourage them to make use of public primary health care units.