HEALTH AND NUTRITION

The Situation of Children

The earthquake struck areas that are predominantly poor, where health and nutrition conditions were below national averages even before the emergency. In many of the affected areas, services have been rehabilitated to pre-earthquake levels, albeit in temporary facilities and relying heavily on the referral of patients to township and county-level health centres. Access to healthcare is still difficult in remote areas because of the shortage of
transportation.

In August 2008, UNICEF conducted a baseline nutrition survey in Sichuan Province’s Lixian County and Beichuan County, both counties heavily affected by the earthquake. The survey, which sampled children aged 6 – 24 months, found that the prevalence of stunting was 13.9% and the prevalence of underweight was 9.1%. The survey also found that the prevalence of anaemia was 63%, nearly double the national average in rural areas. Improving nutritional status, especially micronutrient status, is urgently needed for children throughout the earthquake-affected area.

UNICEF’s assessments have found a need for maternal and child health training and equipment, health education, food and nutrition supplementation, and improved sanitation and hygiene.

In the aftermath of the earthquake, UNICEF has delivered and distributed health supplies to address the emergency and routine health needs of 1.4 million children and women in affected areas. Working with the Centre for Disease Control’s National Institute of Health Education, UNICEF has trained 450 health workers in Sichuan, Gansu, and Shaanxi on the correct application of the health supplies. Those health workers have since gone to conduct cascade training to further build capacity at the local level. Working with counterparts, UNICEF has also supported community health education in more than 100 temporary settlement camps.

UNICEF has been working with national and provincial counterparts to improve essential healthcare services for vulnerable children and women in 14 earthquake-affected counties. UNICEF is adapting national guidelines, building capacity among local health workers in township and county-level hospitals, and conducting community education. UNICEF is also exploring the possible use of conditional cash transfer modalities to vulnerable families.

The UNICEF-supported Expanded Programme on Immunization is currently coordinating with national and local authorities and the World Health Organization to procure and distribute equipment to upgrade the cold chain to transport and store vaccines in earthquake-affected areas. The team is also working on a system to track and monitor vaccination campaigns in the earthquake-affected areas.

To improve nutrition status in earthquake-affected areas, UNICEF is collaborating with the Ministry of Health’s Bureau of Disease Control and the China Centre for Disease Control’s Institute of Nutrition and Food Safety to conduct nutrition assessments and provide micronutrient supplements. In September, young children aged 6 – 24 months in Sichuan’s Lixian and Beichuan Counties started receiving a soy-based micronutrient supplement.
UNICEF is contributing to this intervention by supporting staff training, as well as monitoring and evaluation.

Based on relevant international experience and the results of the baseline survey that UNICEF conducted in August, UNICEF is working with counterparts to develop a national nutrition security plan for the emergency areas. The plan includes nutrition assessments, interventions, and ongoing monitoring and evaluation. UNICEF is currently designing a nutritional monitoring project in three counties, one in each of the earthquake-affected
provinces of Sichuan, Gansu, and Shaanxi.

In late 2008, UNICEF will conduct a comprehensive assessment of children and women’s health and nutrition status in 14 earthquake-affected counties.

In the coming months and throughout 2009, UNICEF will continue to work with hospitals to ensure the provision of basic and comprehensive emergency obstetric and newborn services. UNICEF will continue to work to restore and improve access to maternal and child health care by supporting local equipment procurement, health staff and management training, and the development of the health information system. Additionally, UNICEF will be conducting campaigns to improve health literacy, paying particular attention to the displaced people still living in settlement camps. Collectively, these activities will reach an estimated 2.5 million beneficiaries.

UNICEF will continue to work with counterparts to upgrade the cold chain to support the provision of vaccines in earthquake-affected areas. Procurement will be done locally to assure reduced cost and ease of maintenance. Additionally, UNICEF will be working with the United Nations Foundation and the American Red Cross to launch a measles campaign in Sichuan in March 2009.

In the coming months, UNICEF will train healthcare providers on the dietary needs and recommended nutritional intake of children and pregnant women. UNICEF will also work with counterparts to conduct a final evaluation of the pilot soy-based micronutrient supplement intervention that is currently underway. Following that evaluation, UNICEF will work with counterparts to expand the intervention to 14 earthquake-affected counties in Sichuan, Gansu, and Shaanxi. UNICEF will help to develop the training plan and identify
potential suppliers of the soy-based supplement. Experiences from these 14 counties will provide lessons for other poor counties with high levels of malnutrition and iron deficiency that are currently not receiving any nutritional supplements.