Tanzania is setting example in Africa as far as cutting down the number of deaths among children aged five years and below.
Demographic surveys indicate that under-five mortality in Tanzania has dropped from 147 in 1999 down to 43 per 1000 live births in 2022.
This comes to light in Arusha during the Regional Consultative Meeting, on reviewing and strengthening the implementation of the Integrated Management of Childhood Illness (IMCI) in Africa.
“The World Health Organization, the US Agency for International Development (USAID) and UNICEF have championed both facility and community components of the Integrated Management of Childhood Illness (IMCI) as key strategies for alleviating the high levels of Child mortality and morbidity in low resources countries.”
Dr Zabuloni Yoti – WHO Representative in Tanzania.
However, just as Tanzania cuts down children’s deaths due to preventable diseases, the Sub-Saharan African region still has the highest rates of child mortality.
In 2022, according to health experts meeting in Arusha, 2.7 million children lost their lives in the Sub-Saharan Region.
That is more than 50 percent of the global child mortality number of five million recorded in 2022.
Apparently, the greatest proportions of post-neonatal deaths were recorded in West and Central Africa.
The common causes of child deaths are largely preventable.
“Common infectious diseases, pneumonia, malaria, and diarrhea continue to be the leading causes of under-five deaths, alongside neonatal conditions,” adds Dr Felix Bundala the Acting director of Reproductive and Child Health in the Ministry of Health.
It was also observed that many African countries have achieved significant reductions in child mortality in the last 25 years but the annual average rate of reduction of 3 percent is still much lower than the 10 percent required to achieve the Sustainable Development Goals’ target.
Tanzania started implementation of IMCI in 1996 in two pilot districts. The national rollout started in 1998, through 11-days classroom IMCI case management training.
In 2000, a Multi-Country Evaluations (MCE) was conducted in Brazil, Peru, Bangladesh, Uganda and Tanzania; indicating that, IMCI reduced child mortality by 13 percent in Tanzania, improved quality of care and rational use of medicines across a range of countries.
The country has embraced IMCI and consistently supported implementation and achieved 80 percent coverage for many of the districts.
The rapid coverage has been mainly attributed to the adoption of the distance learning mode. Significant investment also went into ensuring IMCI training during graduate, Allied health, and nursing training.
Several reviews by UNICEF, WHO and partners, including a 2016 global IMCI stocktaking indicate that the coverage remains very low, failing to attain the envisaged target of having 60 percent of sick children seen by IMCI-trained Health workers.
The Child Health Specialist at UNICEF Headquarters in New York, Anne Detjen, says multiple health system factors have been associated with the slow scale-up and limited sustainability and include cost, inadequate human resources, lack of essential supplies, and poor referral systems.
Too many children still face multiple risks to their health and well-being and are often missed by programs and services.
Children dying from these preventable causes often are amongst the poorest, facing multiple deprivations and risks, including lack of access to quality health care including immunization, malnutrition, lack of safe water, and pollution.
According to WHO, however the global under-five mortality rate fell by 59 per cent, from 93 deaths per 1,000 live births in 1990 to 38 in 2021.
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