Child health
Fact sheet
Key facts
- From 1960 to 1990, child mortality in developing regions was halved to one child in 10 dying before the age of 5.
- Globally 6.91 million children under the age of 5 die every year, according to 2010 figures. That's nearly 900 every hour.
- More than half of these early child deaths are due to conditions that could be prevented or treated with access to simple, affordable interventions.
- Leading causes of death in under-5 children are pneumonia, pre-term birth complications, diarrhoea, birth asphyxia and malaria.
- Children in low-income countries are about 18 times more likely to die before the age of 5 than children in high-income countries.
- A child's risk of dying is highest in the neonatal period, the first 28 days of life. About 40% of child deaths under the age of 5 take place during this period.
- Pre-term birth, intrapartum-related complications (birth asphyxia or lack of breathing at birth), and infections cause most neonatal deaths.
- From the end of the neonatal period and through the first five years of life, the main causes of death are pneumonia, diarrhoea and malaria.
- Malnutrition is the underlying contributing factor in over one third of all child deaths, making children more vulnerable to severe disease.
- The Millennium Development Goal on child survival (MDG4) aims at reducing child mortality by two thirds by 2015, from the 1990 level.
- Reaching the MDG4 target will require universal coverage with key effective, affordable interventions: care for newborns and their mothers; infant and young child feeding; vaccines; prevention and case management of pneumonia, diarrhoea and sepsis; malaria control; and prevention and care of HIV/AIDS.
- In countries with high mortality, these interventions could reduce the number of deaths by more than half.
- To deliver these interventions, WHO promotes four main strategies:
- Appropriate home care and timely treatment of complications for newborns;
- Integrated management of childhood illness for all children under 5 years old;
- Expanded programme on immunization;
- Infant and young child feeding.
- These child health strategies are complemented by interventions for maternal health, in particular, skilled care during pregnancy and childbirth.
The situation
- In Viet Nam, the under-5 mortality rate, infant mortality rate and malnutrition rates are all decreasing, and Viet Nam is on track to achieve MDG4 (reducing child mortality by two thirds by 2015, from the 1990 level).
- Nationally, the under-5 mortality rate dropped from 53 per 1000 live births in 1990 to 16 per 1000 live births in 2011. In the same period, infant mortality decreased from 44 to 14 per 1000 live births.
- Immunization, which protects Vietnamese children every year against diseases such as measles, polio, diphtheria and tetanus, has contributed significantly to this success.
- Disease control programmes have also addressed important conditions such as diarrhoea, acute respiratory infection, malaria and malnutrition.
- Children under 6 are covered by health insurance.
Challenges
- Neonatal conditions, respiratory diseases, and diarrhoeal diseases remain major killers of children under 5 in Viet Nam.
- Injuries, including drowning and traffic accidents are an increasing cause of mortality and morbidity, in particular in children older than 1 year old.
- Neonatal mortality represents 60% of all under-5 deaths (WHO estimates 2011), thus requiring re-orientation of child health programmes. The Ministry of Health has identified newborn health as a priority in the Child Survival Plan 2008-2015.
- Stunting malnutrition and anaemia affect a third of children under 5, and overweight is increasing in large cities.
- Breastfeeding and young infant feeding practices are poor, with only 10% of mothers breastfeeding their children exclusively during the first six months.
- Despite progress, substantial disparities exist according to ethnicity and living standards. The mortality rate of children in mountainous and rural areas or in poor families and among ethnic minorities is two to three times higher than that of children in lowland areas or in better-off families.
- Although child mortality has declined in all income groups, the gap between the richest and the poorest families in society is increasing.
- Access to quality healthcare services is limited in remote and mountainous areas.
WHO's response
- Within the framework of the Millennium Development Goals, child health is an important concern for the Ministry of Health and the Government of Viet Nam.
- The National Plan of Action for Child Survival 2009-2015, developed with WHO support, has set the ambitious targets of reducing the neonatal mortality rate to less than 10 per 1000 live births and under-5 mortality to less than 18 per 1000 live births by 2015.
- Viet Nam made commitments to the UN Global Strategy for Women's and Children's Health, aimed at saving the lives of more than 16 million women and children over the next four years.
- Impressive results have been seen since Viet Nam adopted WHO’s Expanded Programme on Immunization (EPI) in the 1980s.
- More than 90% of children are now vaccinated against six common diseases. Polio was eradicated in 2000, neonatal tetanus was eliminated in 2005, measles cases have dropped by 90% and deaths from diphtheria are very low.
- WHO is currently working with Viet Nam on accelerated measles control, introduction of pentavalent vaccine, safe injection practices and vaccine quality control.
- WHO has helped to promote and implement the Integrated Management of Childhood Illnesses (IMCI). Since IMCI implementation began in 1999, WHO has supported the adaptation and updating of technical manuals and guidelines, and the development of a teaching curriculum for medical students.
- Thousands of district and provincial health workers had been trained on IMCI and all medical schools have an IMCI training programme. Efforts are now focusing on expanding IMCI pre-service training through the introduction of e-learning methodology.
- WHO supports activities in breast-feeding promotion such as reinforcing the Baby-Friendly Hospital Initiative, development of a communication campaign through different channels using the Communication for Behaviour Impact (COMBI) approach, capacity building of health staff and implementation of a national Code for Monitoring of Trading and Marketing Breast Milk Substitutes.
- WHO supports the Government of Viet Nam in strengthening neonatal care.