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UNICEF says rural poor lagging behind in health in Middle East and North Africa

© UNICEF/NYHQ2010-2102/Lopez
A health worker measures a boy’s mid-upper arm circumference to assess his nutrition status at a clinic in Ibb Governorate, Yemen. Yemen is one of the poorest countries in the world, with some of the highest rates of child malnutrition.

AMMAN, 10 May 2011 – UNICEF said today that although a number of countries in the Middle East and North Africa (MENA) region have made considerable progress towards improving the health of mothers and children, disparities within these countries persist, making this progress inequitable.

“The health and well-being of mothers and children is often determined not by what country they live in, but by their income and where they live within a country,” said Shahida Azfar, UNICEF Regional Director for the Middle East and North Africa at the launch of a study on inequities in maternal and child health in the region. “If these countries are to meet the Millennium Development Goals by 2015, they need to ensure that access to health is equal to all.”

The study looks at access to maternal and child health among two groups - the poorest and richest 20 per cent of the population, and urban and rural dwellers - in 10 countries and territories: Algeria, Djibouti, Iraq, Egypt, Jordan, the occupied Palestinian territory, Sudan, Syria, Tunisia and Yemen.

Data for five indicators are analysed: under-five mortality, measles vaccination among one-year olds, the proportion of births attended by a skilled health professional, antenatal care coverage, and contraceptive use.

The study finds that health inequalities in relation to the wealth index are more pronounced than those between urban and rural populations. Children born to the richest 20 per cent of the population are more likely to survive and be vaccinated than children from poorer households. Likewise, women are more likely to use contraception, see a doctor during their pregnancy, and receive professional medical assistance during delivery, if they are from the richest quintile of the population.

Sudan and Yemen have the highest inequalities, whether by income or place of residence. In Yemen, a child born among the poorest 20 per cent of the population is three times more likely to die before the age of five than a child from the richest 20 per cent. In Sudan, a child from a rich household is twice as likely to be vaccinated against measles than a child from a poor household.

The study puts forward a series of recommendations to reach the most deprived women and children with basic services:

- Allocating more resources to health programmes at the community and village level to strengthen the outreach of health services;

- Training and deploying more community health workers with skills to work with simplified modern techniques and help deliver cost-effective and affordable quality services;

- Providing incentives by eliminating user fees and covering or reimbursing transportation costs for the poor and marginalized segments of the population;

- Strengthening data collection methods and tracking systems.

The study is part of UNICEF’s global efforts to sharpen focus on equity, so that all children, particularly those who suffer the highest level of deprivation in a society, can have access to education, health care, safe water, adequate sanitation and other services necessary for the their survival and growth.


UNICEF is on the ground in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS.  UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit: www.unicef.org.

For more information, please contact:
Charbel Raji, UNICEF Regional Office for the Middle East and North Africa

Najwa Mekki, UNICEF Regional Office for the Middle East and North Africa




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