達不到減低兒童死亡率的目標,約3,500萬名5歲以下兒童將有性命威脅

 

達不到減低兒童死亡率的目標,約3,500萬名5歲以下兒童將有性命威脅

國際消息 00:26

紐約/香港,2013年9月13日—— 聯合國兒童基金會(UNICEF)一份最新報告顯示,若不積極改變現狀,全球將無法實現「千禧發展目標4」 —— 在2015年前將5歲以下兒童死亡率降低2/3。更嚴重的是,按照目前的發展趨勢,這個目標在2028年前仍將無法實現。

不採取積極行動,付出的代價勢將更為沉重:如果國際社會不立即採取行動,加快進度,在2015至2028年間,預料會有多達3,500萬名兒童死於可預防疾病。
這是一個壞消息,幸而這份報告也帶來不少喜訊。報告顯示,大幅降低兒童死亡率是切實可行的。據估計,全球每年5歲以下兒童死亡人數從1990年的1,260萬降至2012年的約660萬。在過去22年,全球約有9,000萬瀕死邊緣的兒童得以倖存。
「是的,我們應慶祝已取得的成果。」UNICEF執行主任安東尼.雷克說,「但為了實現目標,我們還有更多工作要做,怎能慶祝呢?我們有能力加快工作進度—— 我們知道應該怎麼做,但我們需要在更大的危機感驅使下,加快推進行動。」
就在1年多前,埃塞俄比亞、印度和美國政府與UNICEF共同發起「致力於兒童生存:重申承諾」的倡議運動,號召全球攜手努力,避免兒童死於可預防的疾病。
APR
截至目前,已有176個政府簽署了這一承諾,並宣誓允諾會加快提高兒童生存率的工作進度。數百個民間團體、宗教組織和獨立人士也承諾支援這個讓每一名兒童獲得良好人生開端的共同目標。
(Centre) Irma Irene Yat Chú, an indigenous Mayan woman, holds her 1-year-old daughter, Lisbeth Gabriela, at home in the community of Chivencorral in Cobán Municipality, in Alta Verapaz Department. Volunteer health workers from a community health centre, (left-right) Laura de Jesús Icoó Pop and Mario Cucul, prepare a measles vaccine for Lisbeth. The centre, run by the Ministry of Health with support from UNICEF, serves a population of 3,476 and is open twice a week. Through home visits, volunteer health workers provide routine health care and immunizations for pregnant women and children under age 5 who are unable to travel to the health centre. [#6 IN SEQUENCE OF EIGHT] In November 2012 in Guatemala, the Government and other partners are continuing to assure sustained routine immunization of children – now reaching 92 per cent of all infants – against a range of vaccine-preventable diseases. The country’s last endemic case of measles was in 1997. In the entire Americas Region (covering North, Central and South America), the last endemic measles case was in 2002 and the last endemic case of rubella was in 2009 – part of global efforts to eradicate these diseases. Worldwide, measles remains a leading cause of death among young children: In 2010, an estimated 139,300 people – mainly children under the age of 5 – died from the disease. Nevertheless, these deaths decreased by 71 per cent from 2001 to 2011, thanks in part to the Measles & Rubella Initiative, a global partnership led by the American Red Cross, the United Nations Foundation, the United States Centers for Disease Control and Prevention (CDC), WHO and UNICEF. In Guatemala, despite this success, significant other challenges for children remain, much of it related to poverty levels that affect more than half of all children and adolescents. Poverty also contributes to chronic malnutrition affecting half of all under-5 children (with higher rates among indigenous populations); an average national education level of under six years of primary school (under three years for the rural poor); and high, though decreasing, rates of violence. Guatemala is also one of the world’s most vulnerable countries to climate change, suffering a major climate-related emergency every year since 2008. On the positive side, birth registration is improving, with more than 95 per cent of newborns now being registered. UNICEF is working with the Government and other partners to sustain achievements in health, address the high levels of malnutrition, strengthen responses to crimes against children and increase protection services for children throughout public services. 《致力於兒童生存:重申承諾——2013年度進展報告》研究自1990年以來的兒童死亡率趨勢,分析了5歲以下兒童死亡的主要原因,並點出各國和國際社會拯救兒童生命的努力。迄今所取得的進展,可歸功於各國政府、民間團體和私營部門的共同努力,以及增加可負擔、有實證可循的干預措施,例如:採用殺蟲劑處理過的蚊帳、藥品、疫苗、正確的母乳餵哺方式、營養補充品和醫療食品、口服防脫水鹽以治療腹瀉、已改善的安全飲用水和衞生設施等等。
報告顯示,在世界各地、各收入階層,包括在低收入國家,可預防的兒童死亡都大幅下降。事實上,一些世界上最貧困的國家,自1990年以來,在兒童生存方面所取得的進展最為明顯。一些兒童死亡率高的低收入國家,如孟加拉、埃塞俄比亞、利比里亞、馬拉維、尼泊爾和坦桑尼亞,當地的5歲以下兒童死亡率亦已較1990年的降低了2/3,甚至更多。這些國家在2015年最後期限來臨前,成功實現了降低兒童死亡率的「千禧發展目標4」。
自上世紀90年代以來,全球已經加快降低兒童死亡率的步伐,年下降率增加超過4倍。撒哈拉以南非洲地區也加快了降低兒童死亡率的步伐,自20世紀90年代初以來,其年下降率增加超過5倍。過去7年裡,東南部非洲地區更躋身全球取得最佳進展的地區之列,在2005至2012年間,5歲以下兒童死亡的年下降率為5.3%。
相反,與全球其它地區相比,非洲中西部地區在兒童生存方面取得的進展卻處於最低水平。同時,該地區的兒童死亡率亦為最高,每8名兒童中幾乎就有1人在5歲前死亡。自1990年以來,中西部非洲地區每年死亡的兒童人數幾乎沒有減少。
肺炎、腹瀉、瘧疾仍是全球兒童的主要死因,每天奪去約6,000名5歲以下兒童的生命。在所有的兒童死亡中,近半數與營養不良相關。
對於幼童而言,出生後的第1個月最為脆弱。在2012年,近300萬名嬰兒在出生後第1個月內死亡,大部分均死於能夠簡單預防的疾病。
UNICEF Representative in the Central African Republic Souleymane Diabaté plays with a baby at the ADECOM (Association for Community Development) health post in the Bogbaya neighbourhood in Bangui, the capital, during the measles vaccination campaign. A woman and another child are seated nearby. Children are also receiving vitamin A and deworming tablets during the campaign. Mr. Diabaté’s shirt bears the UNICEF logo. From 22 to 26 May 2013 in the Central African Republic, an emergency measles vaccination campaign is being held after eight children in Bangui, the capital, tested positive for the disease in April. The campaign is being implemented by the Ministry of Health, the World Health Organization (WHO), UNICEF and other partners and aims to immunize an estimated 125,000 children under age 5. Measles remains a leading cause of death among young children worldwide. In the Central African Republic, one of the world’s poorest countries, the measles vaccination rate stands at a low 62 per cent. Recent conflict has also contributed to a further breakdown in health and other services and put hundreds of thousands of children at risk of the disease. An estimated 246,500 vaccines have been despatched to Bangui in response to the outbreak, and to improve routine measles vaccination in the country’s high-risk regions. In response to the current crisis, UNICEF is supporting emergency health activities in Bangui’s four main hospitals and at health centres throughout the country (including health supplies for up to 141,000 people for three months), as well as interventions in the areas of nutrition, water, sanitation and hygiene (WASH), education and child protection.
要扭轉這種災難性趨勢,必需立即在各個領域採取行動,正如「千禧發展目標」所述——減少貧困、降低孕產婦死亡率、改善教育和性別平等、促進環境的可持續發展。
「我們能夠,並必需取得進展。」雷克先生說,「有協調一致的行動、有效的策略、充足的資源和堅定的政治意願,就能夠落實支持兒童和孕產婦生存,將大幅降低兒童死亡率變成可行的事;從道義上,也有必要這樣做。」
編者說明:
國家進展示例
• 在孟加拉,5歲以下兒童死亡率自1990至2012年下降了72%,主要歸功於兒童防疫注射得到推廣、採用口服防脫水鹽治療腹瀉、以及提供維生素A補充劑。擴大的社區衞生工作者網路也提高了醫療服務質素,並促進了衞生設施的使用。女性地位和文化水準的提高、女性健康得到改善、扶貧政策的實施,也在降低兒童死亡率方面發揮了作用。
• 在巴西,運用綜合策略下,5歲以下兒童死亡率自1990至2012年下降了77%。這些策略包括為社區提供醫療服務、改善衞生條件、提高女性文化知識水準、推廣母乳餵哺和接種疫苗。
• 埃塞俄比亞是「行動號召」的共同發起國之一,在降低5歲以下兒童死亡率已取得巨大進展,自1990年以來兒童死亡率下降了67%。在埃塞俄比亞實施的衞生推廣項目,充分體現了社區衞生工作者為偏遠地區兒童和母親提供優質醫療服務的重要性。該項目於2004年實施,目前組織有38,000名由政府支薪的女性衞生推廣工作者。UNICEF的支持,則包括提供疫苗存放裝置、分娩床、藥品等醫療用品,以至針對衞生工作者的培訓。該項目還提供治療嚴重急性營養不良、腹瀉、瘧疾和肺炎的兒童。
29 May 2011: A child is administered a dosage of vitamin A from a red capsule at Bharashakati Government Primary School, Ujirpur, during the UNICEF supported National Vitamin A Plus Campaign, NVAC in Barisal. The National Vitamin A Plus Campaign (NVAC) has been running for almost a decade and is one of the biggest in Bangladesh. In 2010, more than 95 per cent of children aged 12 to 59 months received Vitamin A supplementation and more than 93 per cent infants aged 9 to 11 months received Vitamin A supplementation. In 2011, as part of a new trial, infants aged six to eight months are eligible to receive the vaccination in seven districts. 900,000 infants between six and eight months were targeted during the one-day campaign. In the years prior, infants aged nine to 11 months received the vaccine as part of a wider immunization campaign against measles but following recommendations by the World Health Organisation, it was decided those aged between six and 59 months were to receive the vaccination as part of the specific Vitamin A campaign. Bangladesh has a poor dietary intake of Vitamin A and less than 40 per cent of pregnant and lactating women receive enough Vitamin A as part of their diets. The supplement protects against night blindness, helps cells function, aids the production of protective red blood cells and boosts the body’s immune system. Because the campaign also aims to increase awareness around Vitamin A, more than 400,000 volunteers and 60,000 health service providers across Bangladesh assisted in getting people to distribution points, administering the droplets and disseminating information about the importance of Vitamin A and healthy living. Messages had been broadcast on television and radio as well as through megaphones attached to the back of moving vehicles. Posters were hung around villages and mosques delivered information to worshippers. Since 1997, the prevalence of night blindness in children has been maintained below the 1% threshold that signals a public health problem but on-going support is needed. The NVAC campaign targeting infants from six months is expected to run bi-annually for the next three years. It is being implemented by the Institute of Public Health Nutrition (IPHN), under the Ministry of Health and Family Welfare, in collaboration with the Expanded Programme on Immunization (EPI) and Primary Health Care. It is supported by UNICEF, the Micronutrient Initiative and WHO. As her mother watches, a man health worker marks a girl's fingernail to indicate that she has received a dose of oral polio vaccine, during the door-to-door polio NIDs in the village of Beles in Tigray Region. [#5 IN SEQUENCE OF SIXTEEN] From 1 to 5 April 2005 in Ethiopia, the first of two rounds of National Immunization Days (NIDs) against polio this year targeted 14.7 million children under five. Although Ethiopia had been polio-free for four years, the current NIDs are in response to two cases of polio detected in children in the Tigray Region in December 2004 and early January 2005. Some 100,000 volunteers and health workers are participating in the campaign which will go door-to-door in an effort to reach all children. UNICEF is providing 21 million doses of vaccine for the campaign. The Ethiopian outbreak is part of a larger outbreak in many previously polio-free African countries, following the suspension of polio immunization campaigns for several months in northern Nigeria in late 2003 and part of 2004 that caused a surge of new cases. Mass vaccinations resumed in Nigeria early this year and NIDs against the disease are now underway in 22 African countries, aimed at reaching 100 million children.
關於「致力於兒童生存:重申承諾」
「重申承諾」是一項全球運動,旨在配合「每個婦女、每個兒童」的倡議——這倡議由聯合國秘書長潘基文發起,旨在動員和加強全球行動,改善婦女和兒童健康——通過行動和宣傳加速減少可預防的孕產婦、新生兒和兒童死亡。
埃塞俄比亞、印度和美國政府與UNICEF一同於2012年6月召開的高峰會議「兒童生存行動號召」上發起了這項運動。該會議旨在探討促進兒童生存方面進展的途徑。來自政府、民間團體和私營部門的合作伙伴也參與的「行動號召」會議,並致力改善兒童的生存情況。