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In South Asia, the Reaching Every District strategy continues to play a central role in improving young children’s survival rates through increased nationwide use of diphtheria-tetanus-pertussis vaccines. Through community outreach, supervision, training, and data collection and monitoring, massive immunization campaigns have reached vast numbers of children. UNICEF has helped Afghanistan, India, Nepal and Pakistan train female volunteers to administer polio vaccines and promote immunization against maternal and child tetanus.

The infant mortality rate in Afghanistan is alarmingly high at 165 deaths per 1,000 live births in 2005. In a comprehensive immuniza- tion campaign conducted with the local Ministry of Public Health, more than 1 million children under age five were vaccinated against measles, and more than 700,000 women of childbearing age received tetanus vaccines during 2006.

In 22 countries tetanus toxoid supplementary immunizations were administered during 2006. Approximately 11.5 million women of childbearing age received first doses, and an additional 29 million women received second or third doses.

During 2006, Bangladesh, with the support of UNICEF and the World Health Organization, conducted the world’s largest ever measles eradication campaign in just 20 days, vaccinating 33.5 million children between the ages of 9 months and 10 years.

Perhaps one of the more significant achievements of the integrated approach to child survival and development is the reduction in the number of polio-endemic countries. Egypt and Niger virtually eliminated poliovirus transmission in 2006.The remaining endemic countries, Afghanistan, India, Nigeria and Pakistan, have reduced the spread and geographical radius of polio through coordinated campaigns.

In Nigeria, for example, Immunization ‘Plus’ Days were held in high-risk states, offering the polio vaccine along with measles vaccinations, vitamin A supplements,

UNICEF ANNUAL REPORT 2006

deworming medicines and insecticide-treated mosquito nets. The sweeping campaign was funded by the Canadian International Development Agency, the German and Swedish Committees for UNICE , the Governments of Japan and Norway, Rotary International, the Centers for Disease Control and Prevention in the United States and UNICEF. As a result of the initiative, the percentage of Nigerian children not vaccinated against polio plummeted from 50 per cent in the first quarter of 2006 to 20 per cent in the third quarter.

Integration of services has resulted in previously unheard-of accomplishments. Malaria, the number one killer of children in sub-Saharan Africa, remains a formidable enemy. With financial support from the US President’s Malaria Initiative, the World Bank’s Global Strategy and Booster Program and the Global Fund to Fight AIDS, Tuberculosis and Malaria, insecticide-treated mosquito net coverage jumped in 2006. Togo is approaching the ‘Abuja Declaration on Roll Back Malaria in Africa’ target of 60 per cent coverage, and Eritrea, Malawi, Mali, Senegal, the United Republic ofTanzania and Zambia are making steady gains. In addition, 68 countries adopted use of artemisinin-based combination therapy for malaria, with 42 countries using these medicines as a first line of defence – a major treatment policy shift.

The use of community health workers has improved care for pregnant women, newborns and young children by promoting attended births, immediate and exclusive breastfeeding and other safe practices. During 2006, home-based post-natal care programmes were initiated in Indonesia, Nepal, Somalia, South Africa, Uganda, the United Republic of Tanzania and Yemen. Community support networks and media campaigns have contributed to rapid increases in exclusive breastfeeding in Bolivia, Colombia, Lesotho and Madagascar.

The commitment to integrated, community- based early childhood programmes was further reinforced by advocacy and legislation. In September 2006, the Government of

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