PROGRESS is being made in scaling up effective child and maternal health and nutrition programs in Myanmar, the United Nations Children’s Fund (UNICEF) said last week.
Maternal and neonatal tetanus, which can be caught when delivery takes place in unhygienic circumstances, has now almost been eliminated from the country, according to UNICEF. The disease is one of the leading killers of newborn babies – in 2004, about 128,000 died globally from the disease – but by the end of 2008 it had been eliminated from all but 46 countries after a concerted campaign dating back to the 1980s.
Other programs have increased immunisation coverage and vitamin and mineral supplementation, the organisation said.
These programs have helped to reduce child and maternal mortality but the reduction is hard to quantify, as reliable statistics are still difficult to obtain.
Dr Osamu Kunii, the head of the health and nutrition section at UNICEF Myanmar, said data trends showed the child mortality rate was improving.
“The survey that the Department of Health and UNICEF conducted in 2003 showed that the under-5 mortality rate (U5MR) is 66.1 per 1000 live births. Compared to previous data, this indicates there is a trend to reducing child mortality,” Dr Kunii said. Data from 1995 put the U5MR at 82.4 per 1000 live births.
The major causes of under-five deaths are acute respiratory infection, diarrhoea, premature birth and malaria. About half of these deaths are influenced by nutritional problems, Dr Kunii said.
Changes in the maternal mortality rate are similarly difficult to gauge. Statistics show the maternal mortality rate in Myanmar was about 360 deaths per 100,000 live births in 2000, according to the Global Study conducted by the World Health Organisation, UNICEF and the United Nations Population Fund (UNFPA). By 2005, this had dropped to 316 deaths, according to the Cause-Specific Maternal Mortality Study, which was conducted by the DOH and UNICEF.
“The major causes of maternal deaths are haemorrhage, hypertension, abortion related, prolonged/obstructed labour, and puerperal sepsis,” Dr Kunii said, adding that most child and maternal deaths are preventable and treatable.
One of the key indicators in reduced maternal mortality is skilled birth attendants. The percentage of births that took place with a skilled birth attendant present rose from 40.1 percent in 2001 to 64.2pc in 2007.
Dr Thein Thein Htay, director general of the Department of Health (DOH) under the Ministry of Heath, said the department had prioritised improving the knowledge and skills of health workers.
The reduction of the child and maternal mortality rate, which is one of the Millennium Development Goals, depends on developing the skills of health workers and the ministry would provide more regular courses for midwives, Dr Thein Thein Htay told The Myanmar Times.
“To have more qualified midwives, we will focus first on hospitals and then improve efforts to distribute teaching aids to all the townships in the country,” he said.
Dr Kunii said there was a significant geographic difference in the under-5 mortality rate in Myanmar. The rate is two times higher in rural areas than in urban areas, and particularly high in mountainous areas and the central plains region.
“A similar trend can be found in the maternal mortality rate,” he said.
Myanmar’s child and maternal mortality rates are amongst the highest in Southeast Asia. As a signatory to the Millennium Development Goals, the country has committed to reducing the child mortality rate by two-thirds by 2015, compared to 1990 levels. At the same time, it has also committed to reducing the maternal mortality rate by three-quarters.
Myanmar had recorded a 21pc decline in child mortality to 2007 and a 45.5pc decline in maternal mortality to 2005, according to UN statistics.
Laos had achieved a 57pc reduction in child mortality to 2007, while Cambodia had achieved a 24pc reduction over the same period, according to UNICEF figures.
