Kyrgyz initiatives help reduce preventable child mortality
More than half of the deaths among children under 5 years old are due to diseases that are preventable and treatable through simple, affordable and evidence-based interventions. Measures such as providing antenatal care consultations, informing pregnant women about the dangers of smoking and alcohol and vaccinating mothers against tetanus are all protective actions with a measurable effect. However, there is not equal access to health-care facilities and information. Preventable and treatable infectious diseases, such as pneumonia and diarrhoea, remain the leading causes of child deaths.
Kyrgyzstan has done much to improve the quality of antenatal and postpartum care, with good results. Child mortality in the country has declined substantially, from 50 per 1000 live births in 2000 to 22 per 1000 live births in 2012. A number of initiatives have contributed to this progress. National programmes on preventing micronutrient deficiency, as well as anaemia, in pregnant women and children and improvements in the management of common childhood illnesses, including pneumonia and diarrhoea, have been set up in implementation of the WHO integrated management of childhood illness strategy. Kyrgyzstan is also one of the first countries in the eastern part of the WHO European Region to ratify a law to protect, promote and support breastfeeding and to provide parenting skills programmes.
Challenge of reaching vulnerable groups
However, as in many countries, these interventions do not reach all those who need them most – people on low-income and families without social protection in remote areas.
The story of a 22-year-old mother from a deprived family is a tragic example of the many challenges that individuals and health systems face. In her 32nd week of pregnancy, the woman was hospitalized in a severe state of eclampsia. The early signs of toxicity and anaemia had not been detected during antenatal care visits. The health-care professionals performed a caesarian section to save the lives of the mother and child. When the mother returned home to her village, she stopped breastfeeding early and started giving her baby cow’s milk with water 6–7 times a day.
The infant, who was already weak, became even weaker and underweight and contracted a lung infection. The baby was not taken to a clinic for treatment due to a lack of money and family support. In the end, he was admitted to hospital but it was too late for hospital staff to save his life. He died from an acute respiratory infection (pneumonia) at the age of 3 months. Pneumonia is normally treatable but multiple factors, such as severe malnutrition, prematurity and retarded growth, had all compromised his health.
This sad case is one of thousands of deaths among young children for social and financial reasons and lack of family support, as well as inadequate medical care and counselling.
Protecting young children’s health: the European child and adolescent health strategy
Strong family and community support, social protection, a sufficient level of health knowledge among parents and a good partnership between parents and skilled health staff are all protective factors.
The European child and adolescent health strategy focuses on measures that strengthen people-centred health systems to ensure universal access to high-quality maternal and child health services, particularly for vulnerable groups.
Actions to tackle preventable deaths among such children include:
- providing antenatal care consultations;
- early breastfeeding, with support for and the promotion of exclusive breastfeeding during the first 6 months of life; and
- introducing new vaccines to reinforce and scale up existing interventions of proven efficacy to prevent pneumonia and diarrhoea.