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| Surviving childhood in Africa | |
| (35 minutes later) | |
| A "staggering" number of children around the world are dying before the age of five, according to the United Nation's child agency. | A "staggering" number of children around the world are dying before the age of five, according to the United Nation's child agency. |
| Unicef' s latest figures estimate every day 17,000 under-fives die - 6.3 million a year - from largely preventable causes. | Unicef' s latest figures estimate every day 17,000 under-fives die - 6.3 million a year - from largely preventable causes. |
| This is despite the overall rate of infant mortality having been halved in the past two decades. | This is despite the overall rate of infant mortality having been halved in the past two decades. |
| Most of the deaths happen in the first hours or weeks following birth. | Most of the deaths happen in the first hours or weeks following birth. |
| Millennium Development Goal | Millennium Development Goal |
| Unicef says urgent action is needed to accelerate progress towards the Millennium Development Goal (MDG) of cutting infant mortality by two-thirds. | Unicef says urgent action is needed to accelerate progress towards the Millennium Development Goal (MDG) of cutting infant mortality by two-thirds. |
| The aim had been to reach the target by the end of 2015, but at current progress it won't be achieved until 2026. | The aim had been to reach the target by the end of 2015, but at current progress it won't be achieved until 2026. |
| Sub-Saharan Africa still has the highest infant mortality rate - 92 deaths per 1,000 live births, nearly 15 times the average for developed areas of the world. | Sub-Saharan Africa still has the highest infant mortality rate - 92 deaths per 1,000 live births, nearly 15 times the average for developed areas of the world. |
| Malawi has already achieved the MDG, with a decline of 72%. | Malawi has already achieved the MDG, with a decline of 72%. |
| Mahimbo Mdoe, the head of Unicef in Malawi, said this was a "fantastic achievement" and showed the target could be achieved in very low-income countries. | Mahimbo Mdoe, the head of Unicef in Malawi, said this was a "fantastic achievement" and showed the target could be achieved in very low-income countries. |
| He said one of the keys to Malawi's success had been the creation of a network of health workers with basic skills, who lived and worked in the community. | He said one of the keys to Malawi's success had been the creation of a network of health workers with basic skills, who lived and worked in the community. |
| Unicef has helped train thousands of these "Health Surveillance Assistants". | Unicef has helped train thousands of these "Health Surveillance Assistants". |
| Breastfeeding | Breastfeeding |
| They are responsible for a broad range of services, such as immunisation, giving health advice to mothers and treatment for diseases such as pneumonia, diarrhoea and malaria. | They are responsible for a broad range of services, such as immunisation, giving health advice to mothers and treatment for diseases such as pneumonia, diarrhoea and malaria. |
| "These are high impact, cost-effective measures," said Mr Mdoe. | "These are high impact, cost-effective measures," said Mr Mdoe. |
| "Like ensuring children sleep under a mosquito net to protect them from malaria, and encouraging mothers to breastfeed, which boosts a child's immunity and helps them to grow." | "Like ensuring children sleep under a mosquito net to protect them from malaria, and encouraging mothers to breastfeed, which boosts a child's immunity and helps them to grow." |
| But despite the advances in Malawi, it still faces many challenges, including malnutrition, HIV/Aids and poverty. | But despite the advances in Malawi, it still faces many challenges, including malnutrition, HIV/Aids and poverty. |
| "Cashgate" | "Cashgate" |
| The country is also dealing with the aftermath of a huge corruption scandal known as Cashgate, which became a key issue in elections this summer. | The country is also dealing with the aftermath of a huge corruption scandal known as Cashgate, which became a key issue in elections this summer. |
| An auditor's report earlier this year suggested the government had been defrauded of more than £30m by corrupt officials in one six-month period in 2013. | An auditor's report earlier this year suggested the government had been defrauded of more than £30m by corrupt officials in one six-month period in 2013. |
| The scandal led to international donors withholding aid in protest at poor governance. | The scandal led to international donors withholding aid in protest at poor governance. |
| In a report, Unicef has called for greater priority to be given to saving lives in the first four weeks of life. | In a report, Unicef has called for greater priority to be given to saving lives in the first four weeks of life. |
| Committing to Child Survival: A Promise Renewed lists a number of strategies to improve survival. | Committing to Child Survival: A Promise Renewed lists a number of strategies to improve survival. |
| It says starting to breastfeed within an hour of birth reduces the risk of death in this neonatal period by 44%. Fewer than half of newborns worldwide benefit from this approach. | It says starting to breastfeed within an hour of birth reduces the risk of death in this neonatal period by 44%. Fewer than half of newborns worldwide benefit from this approach. |
| The report says access to postnatal care is "abysmally low" in many countries in sub-Saharan Africa and South Asia. | The report says access to postnatal care is "abysmally low" in many countries in sub-Saharan Africa and South Asia. |
| Many of those problems are evident in Malawi, which has the world's highest rate of premature births, partly due to factors such as HIV infection, malaria and malnourishment. | Many of those problems are evident in Malawi, which has the world's highest rate of premature births, partly due to factors such as HIV infection, malaria and malnourishment. |
| Kangaroo care | Kangaroo care |
| Bwaila Maternity Hospital in the capital Lilongwe delivers 17,000 births a year. A new facility was opened four years ago with the support of the Rose Project, an Irish charity. | Bwaila Maternity Hospital in the capital Lilongwe delivers 17,000 births a year. A new facility was opened four years ago with the support of the Rose Project, an Irish charity. |
| Staff at the hospital told me there were often severe shortages of basic equipment, from gloves to medicines. | Staff at the hospital told me there were often severe shortages of basic equipment, from gloves to medicines. |
| Rachel Macleod-Spring, who has been a midwife there for seven years, said: "There have been huge improvements in care here in recent years, and there are much better surroundings for the mothers and babies, but it can still be very frustrating. | Rachel Macleod-Spring, who has been a midwife there for seven years, said: "There have been huge improvements in care here in recent years, and there are much better surroundings for the mothers and babies, but it can still be very frustrating. |
| "For several months we have been without a basic medicine, a steroid injection, which can help speed the development of the lungs of premature babies, and save lives." | "For several months we have been without a basic medicine, a steroid injection, which can help speed the development of the lungs of premature babies, and save lives." |
| The hospital, like others in Malawi, is promoting the use of "Kangaroo care", where mothers cradle their infants skin-to-skin. | The hospital, like others in Malawi, is promoting the use of "Kangaroo care", where mothers cradle their infants skin-to-skin. |
| This helps keep premature infants stay warm and promotes bonding between mother and child. | This helps keep premature infants stay warm and promotes bonding between mother and child. |
| Unicef said a 2014 study of Kangaroo care showed this simple intervention dramatically reduced the risk of hospital infections and hypothermia and encouraged breastfeeding. | Unicef said a 2014 study of Kangaroo care showed this simple intervention dramatically reduced the risk of hospital infections and hypothermia and encouraged breastfeeding. |
| Population growth | Population growth |
| One of the by-products of Malawi's falling child mortality is the rapid growth in its population. | One of the by-products of Malawi's falling child mortality is the rapid growth in its population. |
| It rose from four million people in the mid-60s to more than 16 million today. | It rose from four million people in the mid-60s to more than 16 million today. |
| More than half the population is under 18. | More than half the population is under 18. |
| Even if the fertility rate declines sharply, the population is expected to rise to 26 million by 2030, and this is placing a strain on public services and on the security of food supplies. | Even if the fertility rate declines sharply, the population is expected to rise to 26 million by 2030, and this is placing a strain on public services and on the security of food supplies. |
| New mothers are encouraged to use contraception to take control of their fertility. At present, women in Malawi have, on average, nearly six children each. | New mothers are encouraged to use contraception to take control of their fertility. At present, women in Malawi have, on average, nearly six children each. |
| Mahimbo Mdoe, of Unicef, said: "As women in Malawi see that their children are more likely to survive, then this should lead to them having fewer children. | Mahimbo Mdoe, of Unicef, said: "As women in Malawi see that their children are more likely to survive, then this should lead to them having fewer children. |
| "In smaller families, those children will be more likely to finish school and be productive economically, which will help them and Malawi to thrive." | "In smaller families, those children will be more likely to finish school and be productive economically, which will help them and Malawi to thrive." |