Paying with their lives
The number of children dying before they reach their fifth birthday is rising in many of the poorest countries in the world. Nearly 11 million children die each year because they don't have access to medical care. We think that's disgusting.
Wednesday 5 December 2007
All children have the right to life and to grow up healthy. But health services are in a state of collapse in many of the poorest countries because national health budgets are just too small, investment has declined or they have been devastated by years of conflict. To help children achieve their right to healthcare, we're working to improve children's access to quality local health services.
Making the abolition of healthcare fees a reality
Put simply, children and their families cannot afford the cost of healthcare. In our report Paying with their Lives published in 2006, Save the Children estimates that the lives of 285,000 children in Africa could be saved every year if healthcare fees were abolished. Thousands more children would lead healthier lives without healthcare fees pushing their families into poverty.
African governments were encouraged by donors, such as the World Bank, to introduce fees to help pay for health services. However, fees fund less than 5% of what it costs countries in Africa to run public health services and managing them involves high administrative costs. Crucially, health service use drops dramatically when fees are introduced - often by 40 to 50%.
Liberia's health service has been badly weakened by almost 15 years of civil war. The government nominally suspended healthcare fees during the conflict but, after the war, it considered reintroducing them. We presented the Liberian government with the case against healthcare fees and worked with the UK government to provide practical support to the Liberian government. In 2006, the Liberian government committed to keeping health services free for patients, at least in the near future. But, despite its pledge, the government lacks the financial resources to fully implement this policy for the long term. We are working with the Liberian government and the UK Department for International Development to make sure that there is enough of the right kind of support from donor countries, and good planning in Liberia to make free healthcare a reality.
We have also been advocating for Sierra Leone's Ministry of Health to abolish healthcare fees. During negotiations, some groups proposed to increase user fees and scrap exemptions for children under five and pregnant women. This was an outrageous suggestion for a country with the highest child and maternal mortality in the world. We mobilised support from communities and local organisations, encouraged debate within the Ministry of Health and established a coalition of major international non-governmental organisations to speak with one, strong voice against the move. As a result, the plan has been halted and mothers and children under five will not have to pay for healthcare, which should save thousands of children's lives.
At a donor conference in Washington in 2006, we advocated for international donors to increase funding to healthcare in cash-strapped countries and to identify ways to abolish fees. We are also pressuring African governments to meet their pledge set out in the Abuja Declaration to spend 15 per cent of their budget on health.
Giving children access to basic healthcare in conflict-affected countries
As well as carrying out advocacy work, we're also helping children who live in countries where the governments and infrastructure have been devastated by years of civil war gain access to basic healthcare.
In the Democratic Republic of Congo, around 1,000 people still die every day from war-related causes, including disease, hunger and violence. We have provided 27 health centres with medical equipment and medicines and rehabilitated and equipped a further seven health centres, benefiting more than 286,000 people in North Kivu province in the east of the country. The centres have provided 14,036 children with immunisations and other basic healthcare and 4,670 babies were delivered by trained midwives.
Non-governmental organisations like Save the Children provide around three-quarters of all health services in Liberia. This year, we provided free healthcare and essential drugs five days a week to 22 clinics, allowing us to carry out consultations with 37,459 children under the age of five, and 244,252 people overall. We vaccinated 45,574 children against diseases such as polio, measles and yellow fever. Medical staff live nearby the clinics, located in five of the country's counties, in order to deal with emergencies.
Save the Children successfully rehabilitated and re-equipped five government health centres affected by the ongoing conflict in Cote d'lvoire with medical equipment, supplies and drugs. The health centres now provide basic health services to an estimated 65,000 people and drugs are supplied free of charge to pregnant women and children under five. We also vaccinated 8,378 children under the age of five.
We provided basic reproductive health equipment and supplies to 15 health centres in Kailahun district, eastern Sierra Leone, ensuring that 17,022 children under the age of five and 7,464 children between the ages of 5 -17 received essential healthcare. We also renovated ten badly damaged health centres. Women and children are increasingly using the centres. Last year, pregnant women made more than 8,000 antenatal visits in Kailahun district, compared to only 3,289 in 2005.
Save the Children has successfully handed over control of a basic healthcare service to a national non-governmental organisation in Afghanistan. The government contracted Save the Children in 2004 to provide basic healthcare to five rural districts of Jawjzan province as healthcare was non-existent in the region. We established two hospitals and nine health centres, reaching a population of 250,000 people, and provided training to improve the management of local authorities. Last year we installed toilets and clean water sources in primary schools in Mazare e Sharif. As a result, 4,647 students are less likely to be affected by diarrhoea and other illnesses caused by poor sanitation.
Reckitt Benckiser, a world leader in household cleaning, health and personal care products, is working in partnership with Save the Children to raise £1 million over the next three years to save the lives of 100,000 children under five in Tanzania and Angola by providing basic healthcare. Thirty years of war have left Angola's health service practically non-existent in certain areas. Thanks to Reckitt Benckiser's support, over the past year, we have supplied 39,000 anti-malaria drugs to Angolan health posts and centres, five key vaccinations to 5,725 children, more than 1,000 mosquito nets to children and mothers and trained 57 midwives on how to carry out safe deliveries. In Tanzania, the programme is focusing on improving the quality of healthcare in some of the poorest areas of the country and on ensuring that the poorest children have access to it.
What you can do
We're working flat out to get every child their rights and we're determined to make further, faster changes. We'd like you to get involved too.
