Child and maternal health
Ensuring quality and equitable health care for every child
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Despite a slow pace, Guinea-Bissau’s health indicators show a progressive reduction of child mortality rate, which dropped from 223 per 1000 live births in 2006 to 89 per 100 live births in 2014. However, the reduction of maternal mortality has not experienced such progress and is estimated at 900 per 100 000 live births (MICS 2014), one of the highest in the world. Neonatal mortality remains high as well, estimated at 35.8 per 1.000 live births, accounting for 44% of all under-five deaths. The neonatal mortality rate in Guinea-Bissau remains significantly higher than the average in west africa and sub-saharan africa.
In line with the sustainable development goals and the promise renewed pledge, UNICEF strategy in child and maternal health is not only reducing child mortality, but also promoting wellbeing and integrated early development for every child. Strategically, UNICEF will focus towards improving every newborns’ health for a triple return.
In terms of gender, breaching equity and gender gaps in quality coverage is also a UNICEF priority, together with improving the survival of mothers and newborns during pregnancy, delivery and neonatal period. Finally, UNICEF strategies include the effective leveraging of resources brought on by the ebola regional health crisis or other humanitarian crisis to strengthen the country’s health system with respect to WASH infrastructure but also including building capacities of health professionals in infection prevention as well as in epidemiologic surveillance.
The health and nutrition budget allocated by the government at 7 per cent of the total budget, half of the amount agreed by african heads of states in Abuja in 2001. Nevertheless, thanks to UNICEF advocacy, the government has disbursed more than USD 190 000 to pay for routine vaccines, complete GAVI Alliance funding and procure more than 200 000 vaccination cards. This was the first time in years that these costs were covered by public funds.
In 2018, UNICEF continued to support the ministry of health to improve availability and quality of maternal and neonatal care through the Guinean-Bissau ENAP. The focus was put on reduction of 1,000 deaths of new-born per year in the country. This support includes technical assistance, institutional capacity building through training, provision of medical equipment and materials, and regular formative supervision of health facilities. The project is now implemented in 35 maternities in the 11 health regions.
Scaling up community-based interventions to reduce infant and maternal mortality has been one of the greatest achievements resulting from UNICEF support to the ministry of health throughout the eleven health regions. As of end 2018, a network of around 4 000 community health workers (CHWs) is in place throughout the country.
As shown in the graphic above, regarding CHWs interventions to reduce simple diarrhoea cases in children under five, 96 per cent of total cases were treated with ORS and Zinc by CHWs. For cases of pneumonia, 91 per cent of children under five were treated with amoxicillin. With regards to malaria, overall case management at community level has been low, since CHWs were not timely provided with rapid tests and drugs. However, in the case of children under five, 80 per cent were provided malaria treatment at the community level.
Improving care for new-borns (0-28 days), 9 kangaroo mother care (KMC) units have been established are now functional and 40 hospital health staff have been trained in situ on KMC.
Regarding the global polio eradication initiative, the government, with UNICEF and WHO support, conducted a polio vaccination campaign for children of 0-59 months the result 308,173 (96.7 per cent) children were vaccinated. Also, as of end of december 2018, more than 53,474 out of 65,031 children under one year received Penta3 representing 82 per cent.