Keep Children and Mothers Alive


Keep Children and Mothers Alive

© UNICEF Uganda

Today, 386 children under the age of five will die in Uganda, and more than half will be under the age of one. With 141,000 children under five lost annually, Uganda is one of the 30 countries in the world with the highest number of deaths of children in that age group.

But on closer look, these numbers also reveal a promising trend: since 1990, the under-five mortality rate – the number of children dying under the age of five – has dropped 43 per cent. Since 2000, that number has dropped by 31 per cent.

This progress should inspire hope – and action. While the under-five mortality is dropping, children continue to face challenges to survival and health: the current high rates of malnutrition and stunting, and HIV transmitted from mother-to-child, illustrate some of these challenges.

The development gains Uganda has made are significant, but the momentum needs to be increased. By expanding the comprehensive approach of disease prevention, promotion of good health and nutrition, and village-level care with timely follow-up, we will ensure the under-five mortality rate goes down further and further, and more children are given a chance to survive and thrive.

To keep children and mothers alive, UNICEF Uganda is working with the Government and partners to support disease prevention; antenatal care; nutrition interventions; community health; water, sanitation and hygiene interventions; and HIV prevention.

Primary Health Care, Immunizations and Nutrition

• Village Health Teams and Integrated Community Case Management: UNICEF is strengthening the role of Uganda’s community health workers, the Village Health Teams (VHTs), by training and equipping them to directly reach children and mothers in homes, schools, youth centres, and places of worship.

Through Integrated Community Case Management (iCCM), which UNICEF spearheaded in 2010, we are expanding the community-level diagnosis and treatment of the top three killers of children under 5 in Uganda: malaria, pneumonia and diarrhoea. iCCM will also expand the diagnosis and referral of severe illness in children, including severe acute malnutrition.

• Maternal health and antenatal care: UNICEF is working to ensure more mothers make the recommended four antenatal care visits, and use a skilled attendant for childbirth.

UNICEF is also supporting the development of an innovative “Mother Reminder” system that uses SMS messaging to send notes that are relevant to the stage of their pregnancy, such as a reminder to get antenatal check-ups, or to be tested for HIV. If a woman is living with HIV, the system can provide information on exactly what she needs to do – and when – to prevent mother-to-child transmission of the virus. Messages continue after birth to alert mothers to necessary immunizations and local Child Health Days, as well as other events they can attend to improve their child’s health.

• Malaria prevention and control: Malaria is one of the top three killers of children under age 5 in Uganda.  Through UNICEF support, Village Health Teams are being trained to diagnose and treat the disease at the community level as part of Integrated Community Case Management.

UNICEF and partners are also providing logistical and technical oversight to the Global Fund distribution of over 7 million insecticidal mosquito nets to pregnant woman and children under 5.

• Immunizations and Vitamin A supplements: UNICEF works with the Government and partners to reach more children with vital immunizations and vitamin A supplements, whether through direct support, training to health workers, support to national campaigns (such as Child Health Days) or logistics and supply chain improvement.

Uganda recently achieved the elimination of Maternal and Neonatal Tetanus, a swift and painful disease that kills newborn babies and has a fatality rate that can be as high as 100 per cent without hospital care. With UNICEF support, between 2002 and 2009, 25 high-risk districts in Uganda were targeted for intervention, and close to two million women of child-bearing age received three doses of tetanus vaccines in those areas. It is the 20th nation to eliminate the disease since 2000.

UNICEF also led a polio immunization campaign in 2010 and 2011 that reached 3 million children under 5 with two doses of the polio vaccine. This campaign was launched in response to an outbreak of polio in Bugiri District in October 2010.

• Nutrition: Malnutrition rates in Uganda remain high due to multiple factors, such as traditional diets lacking in essential proteins, micro-nutrients and fats, and a relatively low rate of mothers who exclusively breastfeed their children. A result of malnutrition in children is stunting, which affects as much as 39 per cent of the young population here. Uganda has one of the highest numbers of stunted children in the world, yet it is generally rated a “food secure” nation (FAO/IPC 2010).

In response, UNICEF support has led to the national rollout of an Integrated Management of Acute Malnutrition plan (IMAM), and we work with partners in reaching mothers and expectant mothers in communities to increase knowledge about optimal feeding practices for babies as well as children older than 6 months.

UNICEF also directly supports the treatment of children suffering from severe acute malnutrition in Uganda, and in 2011 this effort reached over 12,600 children.

HIV Prevention
Uganda continues to struggle with the ravages of AIDS, with 18 per cent of all new HIV infections occurring through mother-to-child transmission. Mothers of HIV-exposed children sometimes abandon breastfeeding and therefore increase a baby’s risk of other infections, diarrhoea, and malnutrition. AIDS remains a leading cause of adult deaths, and married women account for the highest number of new cases of HIV.

Currently the prevention of mother-to-child transmission intervention (PMTCT) exists in about one-half of Uganda’s clinics. UNICEF is working to expand the availability of PMTCT to more clinics, as well as encourage pregnant women to be tested for HIV and access PMTCT if they’re HIV-positive.

UNICEF is also working with its partners to support antiretroviral therapy for children under 5 living with HIV.

Water, Sanitation and Hygiene (WASH)
Due to Uganda’s water and sanitation challenges, certain preventable illnesses persist for children under 5 such as diarrhoea, which can be deadly.

Less than half of Ugandans use improved sanitation facilities, and about a third live without access to safe drinking water. In schools, the pupil-to-latrine ratio is 54 pupils to 1 latrine stance, below the national standard of 40:1. Great disparities continue to exist in terms of safe water access: for instance, depending on where a Ugandan lives, the percentage of people with access to an improved water source ranges from 12 per cent to 85 per cent.

In response to these challenges, UNICEF Uganda’s WASH programme is working to increase access to safe water and sanitation, and to promote healthy behaviours like handwashing with soap. WASH also works to bolster national emergency coordination and response efforts. For example, when a landslide in 2010 in Bududa district in the east killed 300 people and displaced thousands from their homes, UNICEF responded with life-saving interventions within the first 72 hours to limit the incidence of illnesses.

UNICEF Uganda WASH sector works with key government ministries at the national and district levels, as well as strategic NGO partners, and continues to strengthen its partnership with communities, civil society, the private sector and other partners.

Additional areas of ALIVE support in Uganda:
• Advocacy for increased health funding for children
• Response to emergencies, such as disease outbreaks
• Support to improve the national health service delivery system



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