According to the UN Inter-agency Group for Child Mortality Estimation, the under-five mortality rate in the 14 Pacific island countries covered by UNICEF declined from 38 deaths per 1,000 live births in 1990 to 26 per 1,000 live births in 2012. While impressive this 30% reduction is however lower than compared to other regions such as sub-Saharan Africa where child mortality is also high.
Wide disparities in child survival exist between and within countries. For example under-five mortality is 11 deaths per 1,000 live births in Cook Islands compared to 60 per 1,000 live births in Kiribati. Demographic health surveys from different Pacific island countries confirm that children living in low-income households experience a higher risk of dying before age 5, with neonatal complications, pneumonia and diarrhoea among the leading causes of death. In the Pacific, low-income households tend to be local in urban informal settlements and on remote islands.
Across the 14 Pacific island countries immunisation coverage and progress varies. All countries have managed to maintain polio-free status and there were no measles outbreaks in 2013. Over the past few years, routine vaccine coverage has steadily increased in all countries except for in Federated States of Micronesia, Vanuatu, Samoa, Solomon Islands. Monitoring however shows that despite high national immunisation coverage, a significant number of children are missed and do not receive the recommended number of vaccine doses. Maintenance of the vaccine cold chain is another major concern and Health ministries need additional donor support to introduce and deliver new vaccines against rotavirus, human papilloma, pneumonia and polio.
Health systems across all 14 Pacific island countries are significantly constrained and additionally challenged by obesity, diabetes and other non-communicable diseases, and a high prevalence of under nutrition and infectious diseases among children. Rates of exclusive breast-feeding during the first six months are lagging and compromising infants’ nutritional status and immunity -raising their susceptibility to diarrhoea. Demographic health surveys indicate that under-five stunting is prevalent, ranging from 10% in Tuvalu to 33% in Solomon Islands.
From 2013 to 2017, the Health programme will build on past successes to achieve the following results for children: