A community volunteer tells a story to children at an Early Childhood Care and Development Centre in Mawlamyinegyun township in Ayeyarwady Division.

INTERNATIONAL NGO Save the Children earlier this month launched a global initiative to reduce child mortality in 57 countries, including Myanmar, where 100,000 children under five die every year.

Save the Children’s country director, Mr Andrew Kirkwood, said the most common causes of death among children in Myanmar – diarrhoea, pneumonia and malaria – are preventable but continue to be problem because of the lack of funding for primary health care.

“Donors’ money for heath goes mostly to HIV/AIDS, TB and malaria but there is very little for supporting the improvement of primary healthcare. We would like to see more money available for maternal and child health,” Mr Kirkwood told The Myanmar Times on October 12. “Obviously we would like to see a reduction in child mortality. Most of those children die of preventable and treatable diseases like diarrhoea, pneumonia and malaria. We would like to work with the people of Myanmar to help reduce the number of children who die from those diseases every year.”

In Myanmar, Save the Children, in collaboration with the World Health Organisation and the UK Department for International Development, implements newborn and child survival programs in eight townships across the country, covering more than 40,000 children under the age of five. Four of these are in the Ayeyarwady delta, while the rest are spread across the country, including Magway Division, Yangon Division and Mon State.

“The main thing we do [in the project areas] is water and sanitation works, so we help the community to improve their access to water and good sanitation. We train health workers at the community level so they can identify and treat children with diarrhoea using an oral rehydration solution and zinc [tablets]. Zinc is very important because it reduces the severity of diarrhoea and also the chances it will reoccur,” Mr Kirkwood said.

Mr Kirkwood said that, in Myanmar, almost 90 percent of the under-five deaths occur in rural areas, where access to healthcare facilities is often limited. The cost of accessing treatment is also a significant barrier.

Accordingly, one of Save the Children’s priorities is to bring healthcare to people so they do not have to travel large distances for treatment for basic ailments.

“So we trained people at the community level who can identify and treat children with common illnesses and refer those people to health-care only when necessary.”

Complications related to childbirth are also a significant killer, he said. The majority of children under five years of age who die in the first year die in the first month. The majority of this group also die within 24 hours of birth.

“Reducing the number of children who die in the first year and first month – that’s related to the health of the mother. When a healthy mother gives birth, there is less likelihood of complications occurring. We also need to make sure that women are giving birth with the help of skilled birth attendants [because] that also reduces the number of children who die. And then, if there are complications, we need to make sure the women are referred to a proper hospital nearby. All those things are important in reducing the number of children who die in first day and first 28 days,” he said.

In addition to its child survival program, Save the Children has established more than 240 Early Child-hood Care and Development centres (ECCD) across 13 townships in Myanmar to provide care for children aged between three and five.

Save the Children’s newborn and child survival program is part of the local effort to achieve Millennium Development Goal No 4, which demands a two-thirds reduction of the number of children who die before their fifth birthday by 2015, compared to 1990 figures.

According to UNICEF figures, Myanmar’s child mortality rate had declined to 103 deaths per 1000 live births by 2007, down from 130 in 1990.

“Overall in Myanmar, child mortality has been reduced quite a lot already. If you compare now with 10 years ago, that child mortality figure is down which is good news but there’s still a lot of work that must be done quickly between now and 2015,” Mr Kirkwood said.