Death and malnutrition among children

Rising poverty, driven by population growth and other issues, leads to increasing hunger and subsequently rising diseases (and death) caused by malnutrition, unsanitary living conditions and limited access to drugs and medical care. The ones that suffer the most from poor diet and nutrition are children, especially street children.

Goal four of the United Nations Millennium Development Goals is to reduce child mortality; the achievable target is a two-thirds reduction in the under-five child mortality rate. According the World Health Organization on the Philippines: “While the probability of reducing the…mortality rate…has been adjudged highly probable, it may not be realized unless deaths during the first 28 days (neonatal period) are dealt with, as they account for 40% of deaths among the under-five (17 per 1000 live births).” The next statement about the country is: “Progress to curtail neonatal deaths is dismal, with death rates among this age group showing only the barest decline over the past 20 years.”

These deaths could be prevented by having qualified, skilled healthcare workers on hand for the births. Pneumonia, bacterial sepsis and birth complications are the leading causes of death. 60% of completed (not necessarily successful) pregnancies occur at home, two-thirds with unskilled attendants. Being in a healthcare facility does not necessarily mean that the conditions will be better either. Many pregnant women do not have access to qualified healthcare centers, prenatal nutrition and care, and even neonatal (post-birth) care and nutrition. Poor nutrition has long-lasting negative effects on impoverished children — for those of course that survive.

The United Nations Education for All 2010 Report had this to say about malnutrition related problems like low birth weight: “These children face a heightened risk of early mortality: low birth weight is an underlying factor in 60% to 80% of deaths in the first month. They also face longer-term risks of disadvantage in health and education. Low birth weight is strongly associated with loss of years in school and poorer cognitive skills which undermine the potential benefits of improved secondary education.” According to UNICEF, from 2003-2008 20% of births in the Philippines are under-weight. Using the World Health Organization (WHO) guidelines, 28% of children from 2003-2008 were under-weight. In the same period, the WHO estimates that 34% of children under five had stunted growth.

Micronutrient deficiency, especially in iodine and Vitamin A, is a problem. Iodine deficiency, even in a moderate case, can cause a loss of ten to fifteen points on IQ tests. Vitamin A deficiency is linked to poor concentration, poor eyesight and poor health. According to the WHO, 1.5 million Filipino children age 6-12 have moderate iodine deficiency. Vitamin A deficiency increased from 1993 to 2003 from 35% to 40%. Anemia increased, with children from 6-12 months old at 66% and 6-11 years at 37.4%. The combination of poor education and poor nutrition means children from poor backgrounds face almost insurmountable obstacles from birth.

Reports indicate that the Philippines has about 13 hospital beds for every 10,000 people (public and private hospitals). This is one of the lowest ratios in the world. Population is growing, but few new public facilities are being built. This number does not include public clinics, but it does give an indication of the weakness of our healthcare system. Healthcare spending as a percentage of GDP is 2.9%, again one of the lowest in the world.

Our poor child nutrition and mortality rates are caused by poverty and limited access to quality healthcare facilities and staff. Poverty is an economic and social issue, but access to good healthcare can be addressed with proper long-term planning and targeted investments. Further cooperation between national and local government and private institutions is necessary as well. Our public health care facilities are in dire need of replacement or renovation, especially primary care centers. Reports detail long waiting times, perceived inferior medications, a lack of supplies, staff shortages and are thus avoided. Primary care centers mostly service the poor and their children. –Alejandro R. Roces (The Philippine Star)