Health and nutrition
For every child in Iraq, the right to survival, growth and development.
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Challenges
Maternal, Neonatal and Child Health Care - MNCH:
Many women and newborns do not receive quality maternal and child care, even when they are able to access health facilities before, during, and after pregnancy and childbirth.
Management system issues, lack of medication, and lack of expertise in parts of the country all impede the delivery of Primary Healthcare Centre (PHC) services. Gender inequity, can also further hinder women’s timely access to health care.
Immunization Services:
Immunization programs has been especially affected since they are linked with the quality of primary health care services. National coverage for almost all antigens has declined and there are disparities at the at the districts and sub-districts level.
Even though Iraq has achieved 80% and 82% coverage for DTP3 containing antigen in 2016 and 2017 respectively, Iraq is among the top ten countries globally in term of DTP3 unvaccinated children (about half million children) which highlight the urgent need to reach for those missed communities and unvaccinated children.
Nutrition Services:
One in every five children is stunted in Iraq. Chronic malnutrition is a major challenge with long term effects. Malnourishment reduces children’s chances of survival, hindering health and growth, and is likely to have long-lasting harmful consequences for a child’s cognitive ability and his or her school performance. Infant and young child feeding (IYCF) practices in Iraq are weak.
Post-natal breastfeeding practices are extremely low and stand at 19.6 per cent, with most infants receiving additional milk and other liquids shortly after birth. Continuation of breastfeeding is poor with only 22.7 per cent of mothers reporting offering breast milk until the child reaches 24 months. In Iraq’s current state of insecurity and population displacement, good child feeding practices are in even more jeopardy.
Health and Nutrition Emergency Response:
Many health facilities have been damaged, looted or have lost their staff due to displacement. In Ninewa, Salaheddin and Anbar, twenty two PHCs were destroyed, and over a 101 partially damaged, affecting a third of the people in those governorates.
Hospitals and health clinics are running short of medical supplies and doctors/medical staff are finding it difficult to cope with needs of the displaced population, with health services unavailable to at least 40% of all internally displaced populations.
Solutions
Maternal, Neonatal and Child Health Care - MNCH:
Immunization Services:
1)Reforming Expanded programme on immunization (EPI)
This includes mainly:
a) Timely provision of all EPI antigens (vaccines) to all children in Iraq maintaining vaccine efficacy through the approaches of district model to utilize the sophisticated technology to track children’s vaccination status starting from the birth registration office until they are fully vaccinated and trace those who unvaccinated children
b) Strengthening the Iraq immunization supply chain through conducting a comprehensive effective vaccine management assessment and developing a continuous improvement plan 2019-2021 accordingly.
2) Achieve at least 85% vaccination rates for all EPI antigens (vaccines) nationally and 80% in the highest risk governorates/districts
Through: review/update guidelines and training programs; develop district specific micro plan with updating of population movement/access and mapping in low performing districts; enhance the capacity of 3,000 different levels medical and paramedical staff; communications and social mobilization interventions to increase community demand for vaccination.
3. Maintain Polio Free status
Through strengthening routine immunization and supporting supplementary immunization activities. In addition, supporting focused C4D interventions on polio eradication including awareness creation for the PHCs staff on “active surveillance”
Nutrition Services:
UNICEF is working with the Iraqi Ministry of Health to scale up of high-impact nutrition interventions in order to address sub-optimal infant and young child feeding practices and their impact of children’s development – including child stunting – and is promoting exclusive breastfeeding, and the delivery of micronutrient supplementation initiatives.
UNICEF supports engaging with local communities as an essential part of its strategy to improve the capacity to manage acute malnutrition. UNICE is also and initiate linkages between Iraq and global initiatives against malnutrition such as the Scaling Up Nutrition movement; and twining of Iraqi Nutrition Research Institute - NRI with one of the regional NRIs.
Health and Nutrition Emergency Response:
1. Saving New-born lives:UNICEF is prioritizing the lives and wellbeing of newborns through home visits in IDP and host communities by raising awareness about post-natal care for mothers and breastfeeding counselling. In addition, a MNCH communication interventions for social and behavior change to improve maternal and new-born health outcomes.
2. Protection against vaccine preventable diseases(EPI): with particular attention to polio and measles through supplementary vaccination campaigns, with particular focus on start EPI services in all PHCs in the liberated area. In addition, UNICEF is ensuring vaccines reach people in low immunization coverage area, and in particular areas with high number of returnees and IDPs.
3. Working Towards Better Nutrition Services: by ensuring that children under five in IDP – especially the most vulnerable in camps and other areas are screened and managed for Acute Malnutrition, improve their feeding practices and supplementation for micronutrient deficiencies to ensure the right to nutrition for every child.
Vision
By 2024 newborns, children, adolescents and women, especially the most vulnerable, access and equitably use affordable, high - impact, quality health and nutrition services. The programme will address three main deprivations: limited access to immunization and newborn care services; and poor nutrition practices by mothers, especially in the first 1,000 days of life.
The programme will focus on system-strengthening and improvement of the delivery and quality of decentralized services for the most vulnerable children, adolescents and mothers. The programme will generate evidence and data to inform adjustments in legislation, policies and the national budget and build the capacity of various duty-bearers, including the Government, health-care providers and community leaders.
The programme will support the design of packages to improve quality of care at health-facility level in the most vulnerable governorates and in humanitarian situations, starting from newborn care through promotion of the Kangaroo Mother Care initiative.
Other priorities include strengthening immunization cold chain management system, effective vaccine storage and development of continuous improvement plans to deliver high quality, sustainable and equitable immunization services to the most vulnerable communities. Capacity will be developed to trace, count and reduce the number of unvaccinated children, and to strengthen emergency preparedness and response to disease outbreaks.