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Supporting health and nutrition actions

12 November 2013 – Today, in observance of the World Pneumonia Day and several countries around the world are organizing activities that inform the public on prevention measures. In Mongolia, UNICEF is handing over to the Khuvsgul aimag health department some basic health and nutrition supplies such as essential medicines, growth monitoring equipment, micronutrient supplements as well as nutrition counseling and maternal waiting facilities that include rooms for newborn care.

The child health and nutrition supplies handed over are worth a total of 367,075,568 MNT. These include 300,204,133 MNT for health and 66,868,435 MNT for nutrition items. The value of these items will be enhanced by ongoing Integrated Management of Newborn and Childhood Illnesses training for health workers and a communication strategy to be implemented in 2014.

This day is particularly relevant; given that in Mongolia, same as in Khuvsgul children are still dying due to Pneumonia and Diarrhoea-also known as ‘the forgotten killers’.            
Mr. Mohamed Fall, UNICEF Representative in Mongolia highlighted that one in five children dying before their fifth birthday in Mongolia still succumb to pneumonia and diarrhoea – conditions that can be prevented and managed easily with timely care. Both diseases also have significant and avoidable long term consequences. Repeated episodes of diarrhoea in children under five increase the risk of stunting which itself is associated with decreased cognitive functions. Prevalence of these is also behind the fact that 1 out of every 5 children in Mongolia suffers from chronic malnutrition. The most common sequela of pneumonia is lung volume reduction with the risk highest in children under the age of two. Proper nutrition helps give every child the best start in life. Malnutrition traps people into a lifelong cycle of poor nutrition, illness, poverty and inequity. ‘The damage to the physical and cognitive development, especially during the first two years of a child’s life, is largely irreversible. A child’s poorer school performance results in future income reduction of up to 22% on average’ Mr. Fall further emphasized.

Mongolia is making considerable progress in reducing under-five mortality. There remain, however, huge disparities between aimags and unfinished businesses to tackle these diseases. The combined mortality due to pneumonia and diarrhoea dropped from 31% in 2000 to 20% of total U5 mortality in 2012. Pneumonia has registered 5% reduction since 2000 and, diarrhoea,  6% respectively. The 2010 MICS report revealed that diarrhoea prevalence peaked during the introduction of complementary feeding periods, mostly affecting children aged 0-23 months.

Newborn complications are the biggest killer in Mongolia. These account for 60% of all U5 mortality and these levels have remained stagnant during the last decade. In Khuvsgul aimag we have conducted in 2012 a needs assessment of emergency obstetric and newborn care, which revealed shortages of essential care that do not require heavy investment of high technology and medical equipment.

To reduce childhood pneumonia and diarrhoea, we need to focus on interventions that directly lower their transmission and severity. We need to promote access to life-saving treatment once a child becomes unwell. In addition, we need to strengthen existing programmes or implement new ones targeting interventions for children younger than 2 years. Timely infant vaccination, breastfeeding, high-quality early childhood nutrition, improving rates of care-seeking and appropriate case management will accelerate the reduction in mortality and morbidity.
Global Action Plan on Pneumonia and Diarrhoea provides a framework Protect, Prevent and Treat which advocates for implementing an integrated approach:
•    Protecting children by establishing and promoting  good health practices at home /handwashing, breastfeeding, care seeking, good quality nutrition at home/
•    Preventing children from becoming ill from pneumonia and diarrhoea by ensuring universal coverage of immunization, HIV prevention and healthy environments;
•    Treating children with pneumonia and diarrhoea with appropriate treatment.
By implementing above integrated actions on child survival in Khuvsgul we demonstrate UNICEF’s commitment to reduce disparity and improve the effectiveness of community level interventions. The results of these interventions will provide evidence for their scaling up and improving coverage of low cost, high-impact health and nutrition interventions to enhance maternal and child health and nutrition of Mongolia. Enhancing and integrating interventions will maximize their effectiveness. For instance, infant and young child feeding and micronutrient supplementation and other accelerated child survival interventions can be effectively combined as a holistic package that will maximize impact.

“We expect great results in the reduction of mortality linked to pneumonia and diarrhea. I am confident that with the combination of your hard work and all above interventions we will achieve MDG4 soon” said Mr. Fall.

Mr. Tserenjav, Khuvsgul aimag Governor, Mr. Damdinsuren, Director of Khuvsgul Health Department, Mrs. Bolormaa, Officer, Ministry of Health and Mr. Mohamed Fall, Representative of UNICEF, Mongolia participated in handing over of supplies ceremony that took place in Khuvsgul on 12 November 2013.



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