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Two Diseases Remain Biggest Killers of East Asia-Pacific and Viet Nam Children – UNICEF

A child undergoes a general examination at the Binh Thanh Trung Health Centre in Dong Thap, Viet Nam.
© UNICEF Viet Nam\2011\Dominic Blewett

Simple, cost-effective solutions to the diseases, aimed at poorest children, will significantly reduce child deaths.

Ha Noi, 12 June 2012 – A new report from UNICEF has highlighted the huge child survival gap between the richest and the poorest children by focusing on pneumonia and diarrhoea – the two primary killers of children under the age of five.

The new UNICEF report, Pneumonia and diarrhoea: Tackling the deadliest diseases for the world’s poorest children, identifies the tremendous opportunity to narrow the child survival gap within and between countries if proven and cost-effective interventions for pneumonia and diarrhoea are scaled up to reach the most disadvantaged children.
“We know what works against pneumonia and diarrhoea – the two illnesses that hit the poorest hardest,” said Anthony Lake, UNICEF Executive Director. “Scaling up simple interventions could overcome two of the biggest obstacles to increasing child survival, help give every child a fair chance to grow and thrive.” 

East Asia and Pacific countries have had tremendous success in reducing child mortality over the past 20 years. The total number of under-five deaths decreased in from 2.2 million in 1990 to close to 700,000 in 2010Pneumonia and diarrhoea accounted for nearly one-third of those deaths, most of which are among the poorest children. In Viet Nam, mortality rates among children under five decreased dramatically from 51 per 1,000 births in 1990 to 23 per 1,000 births in 2010.  Pneumonia and diarrhea remain the two main child killers, accounting for 12 percent and 10 percent of the under-5 deaths respectively in the country.

The prevention and treatments for both diseases often overlap, and include such basic steps as encouraging breastfeeding and hand-washing with soap; expanding access to decent sanitation; and disseminating oral rehydration salts to children with diarrhoea and antibiotics to children with bacterial pneumonia.

From 2006–2010, one third of children under 5 in the region with suspected pneumonia infections were not taken to an appropriate health care provider. Nearly half of children under-five with diarrhea did not received oral rehydration and continued feeding, signaling a failure to deliver one of the tried and true child survival interventions. In Viet Nam, overall, 7 per cent of children under five had diarrhoea in the past two weeks. More than a half of children (58 per cent) with diarrhoea received oral rehydration salts (ORS), and 70 per cent received ORS or homemade treatment. Regarding pneumonia, over 3 per cent of children age 0-59 months were reported to have had symptoms of pneumonia during the last two weeks. Of these children, 73 per cent were taken to an appropriate health care provider, and 68 per cent received antibiotics for suspected pneumonia.

Most of the countries in East Asia and the Pacific have sophisticated health care systems. But, across the region the poor are less likely than the wealthy to receive simple life-saving interventions for pneumonia and diarrhoea often because they live in rural or remote areas and do not have easy access to health care facilities.

“Where a child lives definitely impacts their access to health care, but there are still easy and affordable solutions for treating pneumonia and diarrhoea which could save lives, but require government commitment and action,” said Ms. Lotta Sylwander, UNICEF Viet Nam Representative. “Most countries in the region do not allow community health workers in remote areas to provide critical antibiotics to children with suspected pneumonia, and Viet Nam is one of them. In fact, only seven countries in East Asia and the Pacific have a national policy supporting community treatment of pneumonia with antibiotics despite the strong evidence it saves lives.”

Countries like Thailand, Mongolia and Malaysia, which support this approach, are examples where access to this simple intervention has reduced the risk of dying from pneumonia among children living in rural or hard to reach communities.

Another simple and effective way to safeguard babies from disease is exclusive breastfeeding. Yet less than one in five  infants younger than six months of age in Viet Nam are exclusively breastfed, depriving them of this critical protection.

Access to decent sanitation also continues to put millions of children at risk of contracting diarrhoeal diseases. In Viet Nam, an estimated 6.5 per cent of the population resort to open defecation and close to half of the population in rural areas do not use sanitation facilities hygienic enough to prevent excreta-related diseases such as diarrhoea. In addition, only 70 per cent of poorest households in Viet Nam have a handwashing place where water and soap is available in their homes, while close to 98 per cent of the richest households have a handwashing place available. According to recent evidence, the rate of mothers regularly washing hands with soap after defecation accounts for only 36 per cent, followed by washing hands with soap before eating (23 per cent), before and after preparing food for children (19 per cent), and after helping children go to stool and cleaning children’s bottom (15 per cent).

“Child deaths from pneumonia and diarrhoea can be significantly reduced by tackling these problems and focusing efforts on the poorest communities,” said Lotta Sylwander. “Through this, the tremendous progress in reducing the number of child deaths each year in Viet Nam can be accelerated, saving even more lives.”


UNICEF works in over 190 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 Viet Nam and its work visit:

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