Tag Archives: Child Deaths

Chad: Meningitis Vaccine Cuts Cases By 94 Per Cent

Thurs 12 September 2013 @ 16.30

A meningitis vaccine that has recently been rolled out in several African countries has reduced the incidence of the disease by 94 per cent in Chad after just a single dose per person, in what scientists say is a startling success for the new vaccine, called MenAfriVac.

And the presence of the bacteria responsible for the disease in people’s throats – carriage prevalence – dropped by 98 per cent, according to the study published in The Lancet today.

The research, based on an analysis of data from 1.8 million vaccinations in Chad, revealed that there were no cases of serogroup A meningococcal meningitis, the most dangerous strain of the disease, following vaccination.

“This is one of the most dramatic outcomes from a public health intervention that I have seen,” said lead author Brian Greenwood.

“There are now real prospects that the devastating effects of this infection in Africa can be prevented,” said Greenwood, a professor of clinical tropical medicine at the London School of Hygiene & Tropical Medicine, United Kingdom, which carried out the study together with the Centre de Support en Santé Internationale in Chad and other partners.

Deadly epidemics of meningitis A occur regularly in Sub-Saharan Africa’s meningitis belt, a band of 21 countries stretching from Senegal in the west to Ethiopia in the east, where around 450 million people are at risk.

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Timor-Leste: Maternal Mortality Crisis

DILI, 8 July 2013

Greater efforts are now needed to tackle the many challenges women     face in accessing health care in Timor-Leste, which has one of the highest maternal mortality ratios (MMR) in the world, experts say.

“Although there are 2.3 health workers for every 1,000 people, which meets the international minimum standard set by the World Health Organization (WHO), the quality and competency of these health professionals is questionable given the training available and shortage of trained doctors,” Jannatul Ferdous, a maternal and child health adviser at HADIAK, a locally implemented health project, working with the Ministry of Health, told IRIN.

“The main problems with providing emergency and child health services include the poor quality of health service providers, the shortage in trained health professionals and the logistics involved in accessing services,” Ferdous said.

According to a recent report entitled Trends in Maternal Mortality, only 30 percent of women give birth with a skilled birth attendant present.

Seventy percent of the country’s 1.1 million inhabitants live in remote areas.

“Health-seeking behaviour is one of the major issues, reflected by a low utilization of health services for antenatal and postnatal care. Some factors for low utilization of health services include concern about the availability of drugs; availability of healthcare providers, especially female health providers; distance to health facilities; and concern about getting permission to go for treatment from husbands and other family members,” Hongwei Gao, country representative for the UN Children’s Fund (UNICEF), explained.

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Children with Disabilities Report launched by UNICEF

Download  - Download the report30 May 2013

Entitled Children with Disabilities, the report examines the discrimination and deprivations that these children  Children with Disabilities and their families confront. It describes the progress that is being made, albeit unevenly, in ensuring that children with disabilities have the fair access to services and opportunities that is their right. And it urges governments, their international partners, civil society, and employers to take concrete steps to advance the cause of inclusion – as a matter of equity and for the benefit of all.

In order to achieve this goal, international agencies and donors and their national and local partners should include children with disabilities in the objectives, targets and monitoring indicators of all development programmes.

Exclusion is often the consequence of invisibility. Few countries have reliable information on how many of their citizens are children with disabilities, what disabilities they have or how these disabilities affect their lives. As a result, few are capable of knowing what types and amounts of support these children and their families need – much less how best to respond. One of the report’s chapters is therefore devoted to exploring challenges, progress and opportunities in the area of data collection and analysis.

The report also contains a series of personal essays by young people with disabilities and some of the people who work with children and adolescents with disabilities – among them, parents, caregivers and advocates.

It is our hope that this report will inform the dialogue and nurture the action that is necessary to create a world in which children with disabilities enjoy their rights on a par with other children, even in the most remote settings and the most deprived circumstances.

[Courtesy of UNICEF]

Seattle: Global Effort Targets the Leading Killers of Children

25 May 2013:

PATH, a Seattle-based global health development organisation, is aiming to save two million lives by 2015 by jointly tackling diarrhoea and pneumonia, the leading killers of children globally.

Steve Davis, president and CEO of PATH, delivered the message at the ninth annual PATH Breakfast for Global Health held in Seattle on Tuesday.

“Today we placed a bold stake in the ground, with partners around the world, to save two million lives by the end of 2015,” Davis said.

PATH will begin its efforts in India, Cambodia and Ethiopia, where intervention is most urgently needed and PATH has resources. While all three countries have seen their child mortality rates from diarrhoea drop, India’s pneumonia death rate remains stagnant, accounting for 24 percent of deaths of children under five, the same as in 2000, according to 2013 World Health Organisation statistics.

“No parent should have to bury a child because of something we can help prevent or treat,” Davis said.

Diarrhoea and pneumonia are two diseases that overwhelmingly affect children in African and Asian countries, Davis said, with diarrhoea claiming around 760,000 lives a year. And while the number of children dying in Africa before the age of five has decreased, it still vastly outnumbers all other parts of the world, according to the 2013 WHO statistics.

Melinda Gates, philanthropist and founder of the Bill and Melinda Gates Foundation, which helps fund health development and vaccines world wide, spoke at the breakfast of the importance of vaccinating children as well as “appropriate” science that meets the needs of communities in the developing countries.

“[The] developing world is littered with pilot programmes,” Gates said.

As he took to the stage, Davis pointed to a tool belt around his suit jacket. A visual aid, the belt allowed Davis to show and carry some of the tools that can prevent the deaths of so many children from diarrhoeal disease, tools that will be used to achieve PATH’s life-saving goal.

Clean water, soap, zinc tablets for oral rehydration therapy and the rotavirus vaccine, which stops some diarrhoeal diseases before they start, were all included.

But it’s not just science and vaccines that can improve the lives of communities ravaged by diarrhoea. Deeply held cultural traditions and ideas about the disease have to be altered as well.

Dr. Alfred Ochola, PATH’s Technical Advisor for Child Survival and Development in Kenya, spoke about educating Kenyans on how to reduce the risk of diarrhoea in their communities through hygiene practices like hand washing.

But Ochola, who lost a brother and sister to a diarrhoea outbreak in Kenya as a child, has found that at first, people are reluctant to embrace change.

“A big [challenge] is combating old beliefs that diarrhoea is a curse and not an infection, and that the death of a child is an inevitable part of life. ‘God will give you another one’ is a common saying in Kenya,” Ochola said.

Many people believe a child who has diarrhoea is cursed, Ochola said. Vomiting and diarrhoea are welcomed because it rids the body of the evil inside it, while it should be taken as a sign that something is seriously wrong.

Poverty is another challenge in combating the diseases. Although heart disease and diabetes are becoming the new illnesses of poverty, according to Davis, diarrhoea and pneumonia still adversely affect children of developing countries in Africa and Asia.

In Africa and Southeast Asia, the percentage of child deaths are higher than the global average and have not significantly decreased in 10 years.

Both regions have seen child mortality from diarrhoea fall from 13 percent to 11 percent of deaths from 2000 to 2010, but in Africa, the rate of death from pneumonia has actually increased, from 16 percent to 17 percent.

“Too many people lack the financial means to seek care when it’s most needed, like paying for transportation to get to a health facility far from home… We often reach women and their children too late,” Ochola said.

Ochola told the story of Jane Wamalwa, a Kenyan woman who came to understand the reasons behind making a change in long-held practices in treating and preventing diarrhoea. Wamalwa lost three children to the disease, and has now become a trusted source of information on good anti-diarrhoea practice in her community, Ochola said.

“It has become her calling,” he added.

[Courtesy AllAfrica News]

DRC: Malaria “Leading Killer of Children”

DRC 21 May 2013

Gaps in the healthcare system in the Democratic Republic of Congo (DRC) are hampering the fight against malaria, a leading killer of children, say experts.

Malaria accounts for about a third of outpatient consultations in DRC clinics, Leonard Kouadio, a UN Children’s Fund (UNICEF) health specialist, told IRIN. He added, “It is the leading cause of death among children under five years and is responsible for a significant proportion of deaths among older children and adults.”

Kouadio continued: “Recent retrospective mortality surveys have revealed that in all regions of the country, the fever is associated with 40 percent of [deaths of] children under five.”

Malaria is also a leading cause of school absenteeism in DRC, and it may have other adverse effects. “In cases of severe malaria, children who survive face serious health problems such as epilepsy, impaired vision or speech,” he said.

According to UN World Health Organization (WHO) estimates, out of about 660,000 malaria deaths globally in 2010, at least 40 percent occurred in DRC and Nigeria.

In DRC, malaria accounts for about half of all hospital consultations and admissions in children younger than five, according to the government’s National Programme for the Fight against Malaria (NMCP).

On average, Congolese children under five years old suffer six to 10 episodes of malaria per year, according to UNICEF’s Kouadio.

Other leading causes of death among under-five Congolese children include acute respiratory infections, diarrhoeal diseases and malnutrition, according to UNICEF’s 2013-2017 DRC Country Programme Document.

“It is apparent that major deficiencies in the health system have contributed to the severity of recurrent outbreaks [of malaria],” Jan Peter Stellema, Médecins Sans Frontières (MSF) operational manager, told IRIN via email.

“Mosquito nets are not being sent to vulnerable areas, and there are shortages of rapid diagnostic test [kits and] drugs and the equipment for carrying out blood transfusions vital for children suffering from anaemia caused by malaria.”

Other problems include costly care and management challenges.

For example, the treatment of an uncomplicated bout of malaria ranges from about US$22 to $35, and treatment for severe cases can cost $75 to $100, according to NMCP. Such costs are prohibitive for a large number of people, many of whom live on about one dollar a day.

“In DRC, the absence of other healthcare providers and overstretched health systems leave people vulnerable to contracting malaria.

Too many health centres lack the supplies necessary for coping with a new outbreak, and as a result children are dying because they did not receive care for malaria,” MSF’s Stellema said.

According to the DRC Country Programme Document, “Governance, management and coordination problems plague the [health] system at the national, provincial and local levels, thereby undermining political commitment, planning, budgetary expenditure, coordination and alignment of partnerships, the accountability and transparency of service providers, and the participation of the population in management of the services.”

It adds, “Combined with extreme poverty, these factors create financial barriers hampering families’ access to nutrition and services, and weaken the social standards that are essential for keeping families together and maintaining a protective environment for children.

“The absence of government investment and the fragmentation of public assistance have eroded the capacity of civil society and of functional public facilities to maintain quality services,” adds the DRC Country Programme Document.

“The re-mergence and expansion of certain epidemics (polio, measles and cholera) are proof of that.

In addition, little has been done to modernize infrastructure. Essential supply systems, such as the cold chain, have not been put in place,” it states.

There is an urgent need to address the struggling health system to fight malaria, experts say.

“The fight against this scourge must remain a top priority of the country, despite the lack of financial resources,” said UNICEF’s Kouadio.

“The government and its partners should increase the funding for the fight against malaria in the DRC, in particular, acquisition and universal distribution of mosquito nets to households, provision of essential drugs and rapid diagnostic test [kits], and dissemination of environmental sanitation measures.”

Malaria occurs almost year-round in DRC due its tropical climate and its river and lake system.

The country has some 30 large rivers totalling at least 20,000km of shoreline, and 15 lakes totalling about 180,000km, which offer environments conducive to the proliferation of diseases and disease vectors, including the Anopheles mosquito, which spreads malaria.

According to MSF’s Stellema, the DRC government and national and international health actors need to take rapid and sustainable measures to prevent and treat malaria in order to avoid unnecessary child deaths.

In 2012, MSF treated half a million Congolese for malaria, many of them children under five.

“MSF’s emergency response is saving lives in the short term. But in the longer term, the organization cannot address the [malaria] crisis alone,” said Stellema.

[Courtesy of IRIN]

Uganda: Paediatric Vaccine Crisis

KAMPALA, 20 May 2013  – Ugandan children are going unimmunized as the country grapples with persistent and widespread vaccine shortages, the result of insufficient funds and inefficient procurement and supply systems, officials say.

“We are getting reports and calls from all the districts about the stock-outs of all types of anti-immunization vaccines. They don’t have anti-TB [tuberculosis] vaccines, anti-tetanus, polio [vaccines]. The ministry is faced with inadequate funding for most of our programmes,” Asuman Lukwago, permanent secretary in the Ministry of Health, told IRIN.

“The current major problem on the vaccines is the distribution issue. We are working around the clock to have the problem solved and sorted out immediately.”

Most of the health centres across the country are facing critical shortages of vaccines to protect against tuberculosis, polio, tetanus, diphtheria, rotavirus and pneumonia, putting children at risk of largely preventable diseases.

Health officials now fear these frequent shortages could prevent mothers from bringing their children in for immunizations.

“You can’t [ask] mothers to move to health facilities three to four times and they don’t find vaccines. This practice discourages some of them to go back to the hospitals,” said Huda Oleru Abason, chairperson of the Parliamentary Forum on Immunization.

Procurement woes

In 2011, the government of Uganda shifted the procurement of vaccines and drugs from the Uganda National Expanded Programme on Immunization (UNEPI), under the Ministry of Health, to the National Medical Stores (NMS), an autonomous government corporation. The move was intended to inject efficiency into the country’s drug procurement system, but the drug shortages have continued.

Yet officials at NMS are blaming the shortages on late requisitions for vaccines by UNEPI. The procurement of drugs is the responsibility of NMS.

“Placing of orders is not the responsibility of NMS, it’s [the job of] UNEPI,” Dan Kimosho, a spokesperson at the NMS, told IRIN. “So if they don’t put request in time or under-quantified for the supplies, it’s not our problem. Our responsibility is to procure, store and deliver the requested vaccines. We can’t begin delivering vaccines to districts and health [facilities] if the orders have not been placed to us. We have the competency to deliver the requested drugs and vaccines.”

An estimated 48 percent of children under age five in Uganda are either unimmunized or under-immunized, meaning they do not complete their immunization schedules, according to the 2011 Uganda Demographic and Health Survey.

Uganda has recently experienced a decline in immunization levels, in part due to inadequate funding, health staff shortages and  [parents’]poor adherence to vaccination schedules.

In April 2013, the government launched a countrywide rotavirus and pneumococcal vaccination program targeting over 1.7 million children.

In an interview with IRIN, Director General of Health Services Ruth Achieng noted that, “Uganda is not doing very well in [its] immunization programme… We don’t want our children to die from preventable diseases. We need to act now. Otherwise, we shall get an outbreak of polio and tetanus.”

Uganda’s budget support for the Expanded Programme on Immunization, EPI, – which had been hailed for increased vaccination coverage between 2000-2007 – decreased by more than half in recent years, falling from 7.7 percent in the 2006-2007 financial year to 3.6 percent in 2009-2010.

Officials say the government has plans to revitalize the country’s immunization programs.
“We have worked out the revitalization plan, and if implemented well, we shall be able to change the low status of immunization in Uganda. The government has mobilized some funds and, with support from GAVI, everything is revisable. We are going to embark on [an] aggressive campaign to ensure there are no vaccine stock-outs in the country and ensure all the children are immunized,” the Ministry of Health’s Lukwago said.

There is also a legal push to improve immunization. An immunisation bill currently pending in parliament will make it illegal for parents and guardians to fail to have their children immunized. It also seeks to punish health officials who fail to offer immunization services to children.

[Courtesy of IRIN)

Uganda to Save Children’s Lives With Pneumonia Vaccine Drive

Pneumonia kills thousands of Ugandan children every year. A new vaccination programme aims to defeat the illness.

Uganda is rolling out the immunisation against pneumonia using a new vaccine called Pneumococcal Conjugate Vaccine (PCV 10). The vaccine has been introduced to mitigate the high infant and childhood death rate and illnesses due to lung infections.

Pneumococcal Conjugate Vaccine was first introduced in sub-Saharan Africa two years ago.

In Kenya and Ethiopia the vaccine was introduced in 2011.

Madagascar and Mozambique started using this vaccine in 2012.

Uganda and Zambia are introducing the vaccine in their routine immunisation programme this year.

Pneumonia is the second leading cause of infant mortality in Uganda after malaria with 18,000 children below the age of five dying of pneumonia every year.

Children under one year are most at risk of getting pneumonia. Factors that expose a child to the lung infection are lack of exclusive breastfeeding, indoor air pollution, poor nutrition and inadequate ventilation.

The health ministry’s director general of health services, Dr Jane Ruth Aceng, says the introduction of PCV 10 into the routine immunisation programme will prevent more than 94,071 new cases and save more than 10,796 lives per year.

“Children have been suffering from pneumonia without any measure of prevention, and we are happy that the government of Uganda in collaboration with GAVI [a coalition of children’s health NGOs] in introducing this new vaccine free of charge for all children under one year age” she says.

Children will get three doses. Infants will receive the first dose at six weeks, another at 10 weeks and the last dose at 14 weeks after birth.

Unicef’s Dr Irene Mwenyango says the drug is safe, free and effective against diseases caused by pneumococcus bacteria. It will offer immunity against infection of the brain covering (meningitis), infection of the lungs (pneumonia), bacteria in blood (bacteraemia), ear infections among others.

A total of 1,521,061 children are expected to be immunised this year across the country.

Administration of this vaccine was set to start on Saturday 27 April in the eastern district of Iganga and then rolled out throughout the country in all health centres

Uganda has low immunisation coverage with only 52 per cent of children fully immunised, so half the child population at a greater risk of being wiped out by preventable killer diseases.

This is attributed to inadequate community sensitisation and mobilisation.

And a sect calling itself 666 is reported to be campaigning against immunisation in rural areas, telling parents and guardians it is not safe. The government has vowed to deal with them since their message is confusing parents.

It is estimated that 17,216,000 euros will be spent on the new drug. Under the cost-sharing arrangement, the government of Uganda will contribute 919,000 euros while GAVI is contributing 16,296,000 euros.

According to the World Health Organisation (WHO) pneumonia is the world’s leading cause of child deaths, killing an estimated 1.2 million children under the age of five every year, more than Aids, malaria and tuberculosis combined.

[Courtesy of All Africa News]